Deep learning enables reduced gadolinium dose for contrast-enhanced brain MRI.

PubMed

Gong, Enhao; Pauly, John M; Wintermark, Max; Zaharchuk, Greg

2018-02-13

There are concerns over gadolinium deposition from gadolinium-based contrast agents (GBCA) administration. To reduce gadolinium dose in contrast-enhanced brain MRI using a deep learning method. Retrospective, crossover. Sixty patients receiving clinically indicated contrast-enhanced brain MRI. 3D T 1 -weighted inversion-recovery prepped fast-spoiled-gradient-echo (IR-FSPGR) imaging was acquired at both 1.5T and 3T. In 60 brain MRI exams, the IR-FSPGR sequence was obtained under three conditions: precontrast, postcontrast images with 10% low-dose (0.01mmol/kg) and 100% full-dose (0.1 mmol/kg) of gadobenate dimeglumine. We trained a deep learning model using the first 10 cases (with mixed indications) to approximate full-dose images from the precontrast and low-dose images. Synthesized full-dose images were created using the trained model in two test sets: 20 patients with mixed indications and 30 patients with glioma. For both test sets, low-dose, true full-dose, and the synthesized full-dose postcontrast image sets were compared quantitatively using peak-signal-to-noise-ratios (PSNR) and structural-similarity-index (SSIM). For the test set comprised of 20 patients with mixed indications, two neuroradiologists scored blindly and independently for the three postcontrast image sets, evaluating image quality, motion-artifact suppression, and contrast enhancement compared with precontrast images. Results were assessed using paired t-tests and noninferiority tests. The proposed deep learning method yielded significant (n = 50, P < 0.001) improvements over the low-dose images (>5 dB PSNR gains and >11.0% SSIM). Ratings on image quality (n = 20, P = 0.003) and contrast enhancement (n = 20, P < 0.001) were significantly increased. Compared to true full-dose images, the synthesized full-dose images have a slight but not significant reduction in image quality (n = 20, P = 0.083) and contrast enhancement (n = 20, P = 0.068). Slightly

Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) of cadaveric shoulders: comparison of contrast dynamics in hyaline and fibrous cartilage after intraarticular gadolinium injection.

PubMed

Wiener, E; Hodler, J; Pfirrmann, C W A

2009-01-01

Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is a novel method to investigate cartilaginous and fibrocartilaginous structures. To investigate the contrast dynamics in hyaline and fibrous cartilage of the glenohumeral joint after intraarticular injection of gadopentetate dimeglumine. Transverse T(1) maps were acquired on a 1.5T scanner before and after intraarticular injection of 2.0 mmol/l gadopentetate dimeglumine in five cadaveric shoulders using a dual flip angle three-dimensional gradient echo (3D-GRE) sequence. The acquisition time for the T(1) maps was 5 min 5 s for the whole shoulder. Measurements were repeated every 15 min over 2.5 hours. Regions of interest (ROIs) covering the glenoid cartilage and the labrum were drawn to assess the temporal evolution of the relaxation parameters. T(1) of unenhanced hyaline cartilage of the glenoid was 568+/-34 ms. T(1) of unenhanced fibrous cartilage of the labrum was 552+/-38 ms. Significant differences (P=0.002 and 0.03) in the relaxation parameters were already measurable after 15 min. After 2 to 2.5 hours, hyaline and fibrous cartilage still demonstrated decreasing relaxation parameters, with a larger range of the T(1)(Gd) values in fibrous cartilage. T(1) and triangle Delta R(1) values of hyaline and fibrous cartilage after 2.5 hours were 351+/-16 ms and 1.1+/-0.09 s(-1), and 332+/-31 ms and 1.2+/-0.1 s(-1), respectively. A significant decrease in T(1)(Gd) was found 15 min after intraarticular contrast injection. Contrast accumulation was faster in hyaline than in fibrous cartilage. After 2.5 hours, contrast accumulation showed a higher rate of decrease in hyaline cartilage, but neither hyaline nor fibrous cartilage had reached equilibrium.

Comparison of arterial input functions measured from ultra-fast dynamic contrast enhanced MRI and dynamic contrast enhanced computed tomography in prostate cancer patients

NASA Astrophysics Data System (ADS)

Wang, Shiyang; Lu, Zhengfeng; Fan, Xiaobing; Medved, Milica; Jiang, Xia; Sammet, Steffen; Yousuf, Ambereen; Pineda, Federico; Oto, Aytekin; Karczmar, Gregory S.

2018-02-01

The purpose of this study was to evaluate the accuracy of arterial input functions (AIFs) measured from dynamic contrast enhanced (DCE) MRI following a low dose of contrast media injection. The AIFs measured from DCE computed tomography (CT) were used as ‘gold standard’. A total of twenty patients received CT and MRI scans on the same day. Patients received 120 ml Iohexol in DCE-CT and a low dose of (0.015 mM kg-1) of gadobenate dimeglumine in DCE-MRI. The AIFs were measured in the iliac artery and normalized to the CT and MRI contrast agent doses. To correct for different temporal resolution and sampling periods of CT and MRI, an empirical mathematical model (EMM) was used to fit the AIFs first. Then numerical AIFs (AIFCT and AIFMRI) were calculated based on fitting parameters. The AIFMRI was convolved with a ‘contrast agent injection’ function (AIFMRICON ) to correct for the difference between MRI and CT contrast agent injection times (~1.5 s versus 30 s). The results show that the EMMs accurately fitted AIFs measured from CT and MRI. There was no significant difference (p  >  0.05) between the maximum peak amplitude of AIFs from CT (22.1  ±  4.1 mM/dose) and MRI after convolution (22.3  ±  5.2 mM/dose). The shapes of the AIFCT and AIFMRICON were very similar. Our results demonstrated that AIFs can be accurately measured by MRI following low dose contrast agent injection.

Every three-hour versus every six-hour oral feeding in preterm infants: a randomised clinical trial.

PubMed

Gray, Megan M; Medoff-Cooper, Barbara; Enlow, Elizabeth M; Mukhopadhyay, Sagori; DeMauro, Sara B

2017-02-01

This trial compares two oral feeding schedules, every three-hour and every six-hour oral feeding attempts, to determine which schedule allows for more rapid attainment of full oral feeding in preterm infants. Infants born at ≤33-week gestation were randomly assigned to receive oral feeding every three hours or every six hours if feeding cues were present. The primary outcome was time to full oral feeding; secondary outcomes include respiratory and apnoea rates, growth and length of stay. A total of 55 infants were recruited. There was no difference between the groups in the primary or secondary outcomes. For preterm infants fed when oral feeding cues are present, an every six-hour schedule did not alter the time to full oral feeding and had no effect on rates of tachypnoea, apnoea or length of hospital stay compared to every three-hour feeding schedule. An every six-hour oral feeding schedule led to only small reductions in number of oral feeding attempts per day. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Optimisation of dynamic nuclear polarisation of [1-13C] pyruvate by addition of gadolinium-based contrast agents

NASA Astrophysics Data System (ADS)

Friesen-Waldner, Lanette; Chen, Albert; Mander, Will; Scholl, Timothy J.; McKenzie, Charles A.

2012-10-01

Dynamic nuclear polarisation (DNP) of carbon-13 (13C) enriched endogenous compounds provides a novel means for magnetic resonance imaging and spectroscopy of biological processes. Adding small amounts of gadolinium-based contrast agents (GBCAs) to the 13C-enriched substrate matrix increases the amount of hyperpolarisation that can be achieved, but also may decrease the longitudinal relaxation time (T1) of the 13C nucleus in solution. This study examined the effects of five different GBCA at concentrations of 0.5, 1, 2, and 3 mM on [1-13C]-enriched pyruvic acid. It was found that contrast agents with an open chain structure (Gadobenate dimeglumine, Gadopentetate dimeglumine, Gadodiamide) caused the largest enhancement (up to 82%) in solid state polarisation relative to solutions without GBCA. In the liquid state, T1 of pyruvate decreased by as much as 62% and polarisation was much lower (70%) relative to solutions without GBCA added. Conversely, for GBCA with macrocyclic structures (Gadoterate meglumine, Gadoteridol), the solid state polarisation enhancement was only slightly less than the open chain GBCA, but enhanced polarisation was retained much better in the liquid state with minimal decrease in T1 (25% at the highest GBCA concentrations). Near maximum polarisation in the solid state was obtained at a GBCA concentration of 2 mM, with a higher concentration of 3 mM producing minimal improvement. These results indicate that the macrocyclic contrast agents provide the best combination of high solid state and liquid state polarisations with minimal loss of T1 in experiments with hyperpolarised 13C-enriched pyruvate. This suggests that macrocyclic contrast agents should be the GBCA of choice for maximising signal in experiments with hyperpolarised 13C-enriched pyruvate, particularly for in vivo measurements where shortened substrate T1 is especially problematic.

Gadolinium-enhanced MR images of the growing piglet skeleton: ionic versus nonionic contrast agent.

PubMed

Menezes, Nina M; Olear, Elizabeth A; Li, Xiaoming; Connolly, Susan A; Zurakowski, David; Foley, Mary; Shapiro, Frederic; Jaramillo, Diego

2006-05-01

To determine whether there are differences in the distribution of ionic and nonionic gadolinium-based contrast agents by evaluating contrast enhancement of the physis, epiphyseal cartilage, secondary ossification center, and metaphysis in the knees of normal piglets. Following approval from the Subcommittee on Research Animal Care, knees of 12 3-week-old piglets were imaged at 3-T magnetic resonance (MR) imaging after intravenous injection of gadoteridol (nonionic contrast agent; n = 6) or gadopentetate dimeglumine (ionic contrast agent; n = 6). Early enhancement evaluation with gradient-echo MR imaging was quantified and compared (Student t test) by means of enhancement ratios. Distribution of contrast material was assessed and compared (Student t test) by means of T1 measurements obtained before and at three 15-minute intervals after contrast agent administration. The relative visibility of the physis, epiphyseal cartilage, secondary ossification center, and metaphysis was qualitatively assessed by two observers and compared (Wilcoxon signed rank test). Differences in matrix content and cellularity that might explain the imaging findings were studied at histologic evaluation. Enhancement ratios were significantly higher for gadoteridol than for gadopentetate dimeglumine in the physis, epiphyseal cartilage, and secondary ossification center (P < .05). After contrast agent administration, T1 values decreased sharply for both agents-but more so for gadoteridol. Additionally, there was less variability in T1 values across structures with this contrast agent. Gadoteridol resulted in greater visibility of the physis, while gadopentetate dimeglumine resulted in greater contrast between the physis and metaphysis (P < .05). The results suggest different roles for the two gadolinium-based contrast agents: The nonionic contrast medium is better suited for evaluating perfusion and anatomic definition in the immature skeleton, while the ionic contrast medium is better for

Advancing pharmacovigilance through academic-legal collaboration: the case of gadolinium-based contrast agents and nephrogenic systemic fibrosis-a Research on Adverse Drug Events and Reports (RADAR) report.

PubMed

Edwards, B J; Laumann, A E; Nardone, B; Miller, F H; Restaino, J; Raisch, D W; McKoy, J M; Hammel, J A; Bhatt, K; Bauer, K; Samaras, A T; Fisher, M J; Bull, C; Saddleton, E; Belknap, S M; Thomsen, H S; Kanal, E; Cowper, S E; Abu Alfa, A K; West, D P

2014-10-01

To compare and contrast three databases, that is, The International Centre for Nephrogenic Systemic Fibrosis Registry (ICNSFR), the Food and Drug Administration Adverse Event Reporting System (FAERS) and a legal data set, through pharmacovigilance and to evaluate international nephrogenic systemic fibrosis (NSF) safety efforts. The Research on Adverse Drug events And Reports methodology was used for assessment-the FAERS (through June 2009), ICNSFR and the legal data set (January 2002 to December 2010). Safety information was obtained from the European Medicines Agency, the Danish Medicine Agency and the Food and Drug Administration. The FAERS encompassed the largest number (n = 1395) of NSF reports. The ICNSFR contained the most complete (n = 335, 100%) histopathological data. A total of 382 individual biopsy-proven, product-specific NSF cases were analysed from the legal data set. 76.2% (291/382) identified exposure to gadodiamide, of which 67.7% (197/291) were unconfounded. Additionally, 40.1% (153/382) of cases involved gadopentetate dimeglumine, of which 48.4% (74/153) were unconfounded, while gadoversetamide was identified in 7.3% (28/382) of which 28.6% (8/28) were unconfounded. Some cases involved gadobenate dimeglumine or gadoteridol, 5.8% (22/382), all of which were confounded. The mean number of exposures to gadolinium-based contrast agents (GBCAs) was gadodiamide (3), gadopentetate dimeglumine (5) and gadoversetamide (2). Of the 279 unconfounded cases, all involved a linear-structured GBCA. 205 (73.5%) were a non-ionic GBCA while 74 (26.5%) were an ionic GBCA. Clinical and legal databases exhibit unique characteristics that prove complementary in safety evaluations. Use of the legal data set allowed the identification of the most commonly implicated GBCA. This article is the first to demonstrate explicitly the utility of a legal data set to pharmacovigilance research.

Gadobutrol Versus Gadopentetate Dimeglumine or Gadobenate Dimeglumine Before DCE-MRI in Diagnosing Patients With Multiple Sclerosis, Grade II-IV Glioma, or Brain Metastases

ClinicalTrials.gov

2017-03-22

Adult Anaplastic (Malignant) Meningioma; Adult Anaplastic Astrocytoma; Adult Anaplastic Ependymoma; Adult Anaplastic Oligodendroglioma; Adult Brain Stem Glioma; Adult Choroid Plexus Neoplasm; Adult Diffuse Astrocytoma; Adult Ependymoblastoma; Adult Ependymoma; Adult Giant Cell Glioblastoma; Adult Glioblastoma; Adult Gliosarcoma; Adult Grade II Meningioma; Adult Medulloblastoma; Adult Mixed Glioma; Adult Oligodendroglioma; Adult Papillary Meningioma; Adult Pineal Gland Astrocytoma; Adult Pineoblastoma; Adult Primary Melanocytic Lesion of Meninges; Adult Supratentorial Primitive Neuroectodermal Tumor; Malignant Adult Intracranial Hemangiopericytoma; Metastatic Malignant Neoplasm in the Brain; Multiple Sclerosis; Recurrent Adult Brain Neoplasm

Case Studies of Three African-American Families Use of Literacy during Nonschool Hours

ERIC Educational Resources Information Center

Walker, Patricia A.

2011-01-01

The use of literacy during non-school hours of three African-American families was examined. This study used a qualitative research design to probe the meanings and value of literacy in the homes of three African-American families during nonschool hours, including before school, after school, weekends, holidays, and summer breaks. The structure…

Gadolinium deposition disease: Initial description of a disease that has been around for a while.

PubMed

Semelka, Richard C; Ramalho, Joana; Vakharia, Ami; AlObaidy, Mamdoh; Burke, Lauren M; Jay, Michael; Ramalho, Miguel

2016-12-01

To describe the clinical manifestations of presumed gadolinium toxicity in patients with normal renal function. Participants were recruited from two online gadolinium toxicity support groups. The survey was anonymous and individuals were instructed to respond to the survey only if they had evidence of normal renal function, evidence of gadolinium in their system beyond 30days of this MRI, and no pre-existent clinical symptoms and/or signs of this type. 42 subjects responded to the survey (age: 28-69, mean 49.1±22.4years). The most common findings were: central pain (n=15), peripheral pain (n=26), headache (n=28), and bone pain (n=26). Only subjects with distal leg and arm distribution described skin thickening (n=22). Clouded mentation and headache were the symptoms described as persistent beyond 3months in 29 subjects. Residual disease was present in all patients. Twenty-eight patients described symptoms following administration of one brand of Gadolinium-Based Contrast Agent (GBCA), 21 after a single GBCA administration and 7 after multiple GBCA administrations, including: gadopentetate dimeglumine, n=9; gadodiamide, n=4; gadoversetamide, n=4; gadobenate dimeglumine, n=4; gadobutrol, n=1; gadoteridol, n=2; and unknown, n=4. Gadolinium toxicity appears to arise following GBCA administration, which appears to contain clinical features seen in Nephrogenic Systemic Fibrosis, but also features not observed in that condition. Copyright © 2016 Elsevier Inc. All rights reserved.

Drug-carrying microbubbles as a theranostic tool in convection-enhanced delivery for brain tumor therapy.

PubMed

Chen, Pin-Yuan; Yeh, Chih-Kuang; Hsu, Po-Hung; Lin, Chung-Yin; Huang, Chiung-Yin; Wei, Kuo-Chen; Liu, Hao-Li

2017-06-27

Convection-enhanced delivery (CED) is a promising technique for infusing a therapeutic agent through a catheter with a pressure gradient to create bulk flow for improving drug spread into the brain. So far, gadopentetate dimeglumine (Gd-DTPA) is the most commonly applied surrogate agent for predicting drug distribution through magnetic resonance imaging (MRI). However, Gd-DTPA provides only a short observation duration, and concurrent infusion provides an indirect measure of the exact drug distribution. In this study, we propose using microbubbles as a contrast agent for MRI monitoring, and evaluate their use as a drug-carrying vehicle to directly monitor the infused drug. Results show that microbubbles can provide excellent detectability through MRI relaxometry and accurately represent drug distribution during CED infusion. Compared with the short half-life of Gd-DTPA (1-2 hours), microbubbles allow an extended observation period of up to 12 hours. Moreover, microbubbles provide a sufficiently high drug payload, and glioma mice that underwent a CED infusion of microbubbles carrying doxorubicin presented considerable tumor growth suppression and a significantly improved survival rate. This study recommends microbubbles as a new theranostic tool for CED procedures.

Survey of Internal Medicine Physicians Trained in Three Different Eras: Reflections on Duty-Hour Reform

PubMed Central

Larsen, Carolyn M.; Issa, Meltiady; Croghan, Ivana T.; Buechler, Tamara E.; Burton, M. Caroline

2014-01-01

Objectives To survey internal medicine physicians and residents who have completed residency in three different eras of medical training regarding their experiences during their intern year and their perceptions of duty-hour reform. Methods An online survey was administered to 268 residents, fellows, and staff physicians who had completed or were completing residency during one of three eras of training: before the 80-hour work week, after the 80-hour work week (instituted in 2003), and after the 16-hour limit on continuous shifts for interns (instituted in 2011). The survey assessed experiences during their intern year of residency and perceptions regarding resident duty-hour reform. Results The majority of respondents (n = 32; 54%) indicated that duty-hour restrictions would result in residents being less prepared for their future careers. In addition, 36% (n = 21) of respondents anticipated a decrease in the quality of patient care under the restricted duty hours. A total of 41% (n = 24) were undecided regarding the impact of duty-hour reform on patient care. Respondents reported time spent on independent study, research, and conference attendance did not increase following the institution of duty-hour restrictions. Conclusions Survey responses indicated that after 18 months of experience with the Accreditation Council for Graduate Medical Education duty-hour restrictions, physician opinions were mixed and a substantial number remain undecided regarding the impact of duty-hour restrictions on resident career preparedness and the quality of patient care. PMID:24945179

Survey of internal medicine physicians trained in three different eras: reflections on duty-hour reform.

PubMed

Larsen, Carolyn M; Issa, Meltiady; Croghan, Ivana T; Buechler, Tamara E; Burton, M Caroline

2014-06-01

To survey internal medicine physicians and residents who have completed residency in three different eras of medical training regarding their experiences during their intern year and their perceptions of duty-hour reform. An online survey was administered to 268 residents, fellows, and staff physicians who had completed or were completing residency during one of three eras of training: before the 80-hour work week, after the 80-hour work week (instituted in 2003), and after the 16-hour limit on continuous shifts for interns (instituted in 2011). The survey assessed experiences during their intern year of residency and perceptions regarding resident duty-hour reform. The majority of respondents (n = 32; 54%) indicated that duty-hour restrictions would result in residents being less prepared for their future careers. In addition, 36% (n = 21) of respondents anticipated a decrease in the quality of patient care under the restricted duty hours. A total of 41% (n = 24) were undecided regarding the impact of duty-hour reform on patient care. Respondents reported time spent on independent study, research, and conference attendance did not increase following the institution of duty-hour restrictions. Survey responses indicated that after 18 months of experience with the Accreditation Council for Graduate Medical Education duty-hour restrictions, physician opinions were mixed and a substantial number remain undecided regarding the impact of duty-hour restrictions on resident career preparedness and the quality of patient care.

Comparison of Inner Ear Contrast Enhancement among Patients with Unilateral Inner Ear Symptoms in MR Images Obtained 10 Minutes and 4 Hours after Gadolinium Injection.

PubMed

Kim, T Y; Park, D W; Lee, Y J; Lee, J Y; Lee, S H; Chung, J H; Lee, S

2015-12-01

Recently 4-hour delayed-enhanced 3D-FLAIR MR imaging has been used in pathophysiologic analysis of the inner ear in many auditory diseases, including sudden sensorineural hearing loss, but comparison among different time points is not clear in patients with unilateral inner ear symptoms. We compared the signal-intensity ratios of the inner ears in patients with unilateral inner ear symptoms on 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images after IV gadolinium injection. The 10-minute delayed-enhanced and 4-hour delayed-enhanced 3D-FLAIR MR images were retrospectively analyzed. Signal-intensity ratios between the cerebellum and inner ear structures, such as the cochleae, vestibules, and vestibulocochlear nerve were assessed. Multiple comparisons were performed. Signal-intensity ratios of the affected cochleae, vestibules, and vestibulocochlear nerve were higher than those of unaffected sides in both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. At the affected side, signal-intensity ratios of the vestibulocochlear nerve were higher in patients with nonsudden sensorineural hearing loss than in those with sudden sensorineural hearing loss on both 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The signal-intensity ratios of some affected inner ear structures were higher than those of the unaffected sides in a group of 30 patients with sudden sensorineural hearing loss and 20 patients with nonsudden sensorineural hearing loss on 10-minute delayed-enhanced and 4-hour delayed-enhanced images. Signal-intensity ratios of the inner ear show statistically significant increases in many diseases, especially neuritis, in 10-minute delayed-enhanced and 4-hour delayed-enhanced images. The 4-hour delayed-enhanced images may be superior in neural inflammatory-dominant conditions, while 10-minute delayed-enhanced images may be superior in neural noninflammatory-dominant conditions. © 2015 by American Journal of

Resident Duty Hours: Enhancing Sleep, Supervision, and Safety

ERIC Educational Resources Information Center

Ulmer, Cheryl, Ed.; Wolman, Dianne Miller, Ed.; Johns, Michael M. E., Ed.

2009-01-01

Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect…

Critical Questions Regarding Gadolinium Deposition in the Brain and Body After Injections of the Gadolinium-Based Contrast Agents, Safety, and Clinical Recommendations in Consideration of the EMA's Pharmacovigilance and Risk Assessment Committee Recommendation for Suspension of the Marketing Authorizations for 4 Linear Agents.

PubMed

Runge, Val M

2017-06-01

For magnetic resonance, the established class of intravenous contrast media is the gadolinium-based contrast agents. In the 3 decades since initial approval, these have proven in general to be very safe for human administration. However, in 2006, a devastating late adverse reaction to administration of the less stable gadolinium-based contrast agents was identified, nephrogenic systemic fibrosis. The result of actions taken by the European Medicines Agency and the US Food and Drug Administration, stratifying the agents by risk and contraindicating specific agents in severe renal dysfunction, has led to no new cases being identified in North America or Europe. Subsequently, in 2014, long-term deposition in the brain of gadolinium was first shown, after administration of 2 nonionic linear chelates, gadodiamide, and gadopentetate dimeglumine. This has led to an intense focus on the question of in vivo distribution, possible dechelation, and subsequent deposition of gadolinium, together with substantial clarification of the phenomenon as well as stratification of the agents on this basis. This review focuses on 8 critical questions regarding gadolinium deposition in the brain and body, with the answers and discussion therein important for future regulatory decisions and clinical practice. It is now clear that dechelation of gadolinium occurs in vivo with the linear agents and is responsible for this phenomenon, with key experts in the field recommending, except where there is no suitable alternative, a shift in clinical practice from the linear to macrocyclic agents. In addition, on March 10, 2017, the Pharmacovigilance and Risk Assessment Committee of the European Medicines Agency recommended suspension of the marketing authorization for 4 linear gadolinium contrast agents-specifically Omniscan, Optimark, Magnevist, and MultiHance (gadodiamide, gadoversetamide, gadopentetate dimeglumine, and gadobenate dimeglumine)-for intravenous injection. Cited in the report was

High- and ultrahigh-field magnetic resonance imaging of naïve, injured and scarred vocal fold mucosae in rats.

PubMed

Kishimoto, Ayami Ohno; Kishimoto, Yo; Young, David L; Zhang, Jinjin; Rowland, Ian J; Welham, Nathan V

2016-11-01

Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4.7 T) and ultrahigh-field (9.4 T) magnetic resonance imaging to resolve key vocal fold subepithelial tissue structures in the rat, an important and widely used preclinical model in vocal fold biology. We conducted serial in vivo and ex vivo imaging, evaluated an array of acquisition sequences and contrast agents, and successfully resolved key anatomic features of naïve, acutely injured, and chronically scarred vocal fold mucosae on the ex vivo scans. Naïve lamina propria was hyperintense on T1-weighted imaging with gadobenate dimeglumine contrast enhancement, whereas chronic scar was characterized by reduced lamina propria T1 signal intensity and mucosal volume. Acutely injured mucosa was hypointense on T2-weighted imaging; lesion volume steadily increased, peaked at 5 days post-injury, and then decreased - consistent with the physiology of acute, followed by subacute, hemorrhage and associated changes in the magnetic state of hemoglobin and its degradation products. Intravenous administration of superparamagnetic iron oxide conferred no T2 contrast enhancement during the acute injury period. These findings confirm that magnetic resonance imaging can resolve anatomic substructures within naïve vocal fold mucosa, qualitative and quantitative features of acute injury, and the presence of chronic scar. © 2016. Published by The Company of Biologists Ltd.

High- and ultrahigh-field magnetic resonance imaging of naïve, injured and scarred vocal fold mucosae in rats

PubMed Central

Kishimoto, Ayami Ohno; Kishimoto, Yo; Young, David L.; Zhang, Jinjin

2016-01-01

ABSTRACT Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4.7 T) and ultrahigh-field (9.4 T) magnetic resonance imaging to resolve key vocal fold subepithelial tissue structures in the rat, an important and widely used preclinical model in vocal fold biology. We conducted serial in vivo and ex vivo imaging, evaluated an array of acquisition sequences and contrast agents, and successfully resolved key anatomic features of naïve, acutely injured, and chronically scarred vocal fold mucosae on the ex vivo scans. Naïve lamina propria was hyperintense on T1-weighted imaging with gadobenate dimeglumine contrast enhancement, whereas chronic scar was characterized by reduced lamina propria T1 signal intensity and mucosal volume. Acutely injured mucosa was hypointense on T2-weighted imaging; lesion volume steadily increased, peaked at 5 days post-injury, and then decreased – consistent with the physiology of acute, followed by subacute, hemorrhage and associated changes in the magnetic state of hemoglobin and its degradation products. Intravenous administration of superparamagnetic iron oxide conferred no T2 contrast enhancement during the acute injury period. These findings confirm that magnetic resonance imaging can resolve anatomic substructures within naïve vocal fold mucosa, qualitative and quantitative features of acute injury, and the presence of chronic scar. PMID:27638667

Low-Molecular-Weight Iron Chelates May Be an Alternative to Gadolinium-based Contrast Agents for T1-weighted Contrast-enhanced MR Imaging.

PubMed

Boehm-Sturm, Philipp; Haeckel, Akvile; Hauptmann, Ralf; Mueller, Susanne; Kuhl, Christiane K; Schellenberger, Eyk A

2018-02-01

Purpose To synthesize two low-molecular-weight iron chelates and compare their T1 contrast effects with those of a commercial gadolinium-based contrast agent for their applicability in dynamic contrast material-enhanced (DCE) magnetic resonance (MR) imaging. Materials and Methods The animal experiments were approved by the local ethics committee. Two previously described iron (Fe) chelates of pentetic acid (Fe-DTPA) and of trans-cyclohexane diamine tetraacetic acid (Fe-tCDTA) were synthesized with stability constants several orders of magnitude higher than those of gadolinium-based contrast agents. The T1 contrast effects of the two chelates were compared with those of gadopentetate dimeglumine in blood serum phantoms at 1.5 T, 3 T, and 7 T. For in vivo studies, a human breast cancer cell line (MDA-231) was implanted in five mice per group. The dynamic contrast effects of the chelates were compared by performing DCE MR imaging with intravenous application of Fe-DTPA or Fe-tCDTA on day 1 and DCE MR imaging in the same tumors with gadopentetate dimeglumine on day 2. Quantitative DCE maps were generated with software and were compared by means of a one-tailed Pearson correlation test. Results Relaxivities in serum (0.94 T at room temperature) of Fe-tCDTA (r1 = 2.2 mmol -1 · sec -1 , r2 = 2.5 mmol -1 · sec -1 ) and Fe-DTPA (r1 = 0.9 mmol -1 · sec -1 , r2 = 0.9 mmol -1 · sec -1 ) were approximately twofold and fivefold lower, respectively, compared with those of gadopentetate dimeglumine (r1 = 4.1 mmol -1 · sec -1 , r2 = 4.8 mmol -1 · sec -1 ). Used at moderately higher concentrations, however, iron chelates generated similar contrast effects at T1-weighted MR imaging in vitro in serum, in vivo in blood, and for DCE MR imaging of breast cancer xenografts. The volume transfer constant values for Fe-DTPA and Fe-tCDTA in the same tumors correlated well with those observed for gadopentetate dimeglumine (Fe-tCDTA Pearson R, 0.99; P = .0003; Fe-DTPA Pearson R, 0.97; P

Three Object-Oriented enhancement for EPICS

NASA Astrophysics Data System (ADS)

Osberg, E. A.; Dohan, D. A.; Richter, R.; Biggs, R.; Chillara, K.; Wade, D.; Bossom, J.

1994-12-01

In line with our group's intention of producing software using, where possible, Object-Oriented methodologies and techniques in the development of RF control systems, we have undertaken three projects to enhance the EPICS software environment. Two of the projects involve interfaces to EPICs Channel Access from Object-Oriented languages. The third is an enhancement to the EPICS State Notation Language to better support the Shlaer-Mellor Object-Oriented Analysis and Design Methodology. This paper discusses the motivation, approaches, results and future directions of these three projects.

3.0 Tesla high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) of the pulmonary circulation: initial experience with a 32-channel phased array coil using a high relaxivity contrast agent.

PubMed

Nael, Kambiz; Fenchel, Michael; Krishnam, Mayil; Finn, J Paul; Laub, Gerhard; Ruehm, Stefan G

2007-06-01

To evaluate the technical feasibility of high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with highly accelerated parallel acquisition at 3.0 T using a 32-channel phased array coil, and a high relaxivity contrast agent. Ten adult healthy volunteers (5 men, 5 women, aged 21-66 years) underwent high spatial resolution CE-MRA of the pulmonary circulation. Imaging was performed at 3 T using a 32-channel phase array coil. After intravenous injection of 1 mL of gadobenate dimeglumine (Gd-BOPTA) at 1.5 mL/s, a timing bolus was used to measure the transit time from the arm vein to the main pulmonary artery. Subsequently following intravenous injection of 0.1 mmol/kg of Gd-BOPTA at the same rate, isotropic high spatial resolution data sets (1 x 1 x 1 mm3) CE-MRA of the entire pulmonary circulation were acquired using a fast gradient-recalled echo sequence (TR/TE 3/1.2 milliseconds, FA 18 degrees) and highly accelerated parallel acquisition (GRAPPA x 6) during a 20-second breath hold. The presence of artifact, noise, and image quality of the pulmonary arterial segments were evaluated independently by 2 radiologists. Phantom measurements were performed to assess the signal-to-noise ratio (SNR). Statistical analysis of data was performed by using Wilcoxon rank sum test and 2-sample Student t test. The interobserver variability was tested by kappa coefficient. All studies were of diagnostic quality as determined by both observers. The pulmonary arteries were routinely identified up to fifth-order branches, with definition in the diagnostic range and excellent interobserver agreement (kappa = 0.84, 95% confidence interval 0.77-0.90). Phantom measurements showed significantly lower SNR (P < 0.01) using GRAPPA (17.3 +/- 18.8) compared with measurements without parallel acquisition (58 +/- 49.4). The described 3 T CE-MRA protocol in addition to high T1 relaxivity of Gd-BOPTA provides sufficient SNR to support highly accelerated parallel acquisition

MR imaging biomarkers for evaluating therapeutic effects shortly after near infrared photoimmunotherapy

PubMed Central

Nakamura, Yuko; Bernardo, Marcelino; Nagaya, Tadanobu; Sato, Kazuhide; Harada, Toshiko; Choyke, Peter L.; Kobayashi, Hisataka

2016-01-01

Near infrared photoimmunotherapy (NIR-PIT) is a new cancer treatment that combines the specificity of antibodies for targeting tumors with the toxicity induced by photon absorbers after irradiation with NIR light. The purpose of this study was to determine if MR imaging can detect changes in the MR properties of tumor within several hours of NIR-PIT. A431 cells were injected subcutaneously in the right and left dorsi of 12 mice. Six days later, the mice were injected with a photon absorber, IR700, conjugated to panitumumab, an antibody targeting epidermal growth factor receptor. One day later, only right sided tumor was exposed to NIR light (treated tumor). MRI was performed 1 day before and 1-2 hours after NIR-PIT using gadofosveset for six mice and gadopentetate dimeglumine for another six mice. T2 relaxation times, the apparent diffusion coefficient (ADC) for the following combinations of b-values: 0-1000, 200-1000 and 500-1000 s/mm2 and enhancement indices were compared before and after NIR-PIT using a two-sided paired t-test. For treated tumors, T2 relaxation time increased after NIR-PIT (p < 0.01) and all three ADC values decreased after NIR-PIT (p < 0.01). Moreover, the enhancement area under the curve (AUC) using gadofosveset increased after NIR-PIT (p = 0.02). In conclusion, prolongation of T2, reductions in ADC and increased enhancement using gadofosveset are seen within 2 hours of NIR-PIT treatment of tumors. Thus, MRI can be a useful imaging biomarker for detecting early therapeutic changes after NIR-PIT. PMID:26885619

Three-Stage Production Cost Modeling Approach for Evaluating the Benefits of Intra-Hour Scheduling between Balancing Authorities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samaan, Nader A.; Milligan, Michael; Hunsaker, Matthew

This paper introduces a Production Cost Modeling (PCM) approach to evaluate the benefits of intra-hour scheduling between Balancing Authorities (BAs). The system operation is modeled in a three-stage sequential manner: day ahead (DA)-hour ahead (HA)-real time (RT). In addition to contingency reserve, each BA will need to carry out “up” and “down” load following and regulation reserve capacity requirements in the DA and HA time frames. In the real-time simulation, only contingency and regulation reserves are carried out as load following is deployed. To model current real-time operation with hourly schedules, a new constraint was introduced to force each BAmore » net exchange schedule deviation from HA schedules to be within NERC ACE limits. Case studies that investigate the benefits of moving from hourly exchange schedules between WECC BAs into 10-min exchange schedules under two different levels of wind and solar penetration (11% and 33%) are presented.« less

Three-Stage Production Cost Modeling Approach for Evaluating the Benefits of Intra-Hour Scheduling Between Balancing Authorities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Samaan, Nader; Milligan, Michael; Hunsaker, Matt

This paper introduces a production cost modeling approach for evaluating the benefits of intra-hour scheduling among Balancing Authorities (BAs). System operation is modeled in a three-stage sequential manner: day ahead (DA)-hour ahead (HA) real time (RT). In addition to contingency reserve, each BA will need to carry out 'up' and 'down' load following and regulation reserve capacity requirements in the DA and HA time frames. In the RT simulation, only contingency and regulation reserves are carried out as load following is deployed. To model current RT operation with hourly schedules, a new constraint was introduced to force each BA netmore » exchange schedule deviation from HA schedules to be within North American Electric Reliability Corporation (NERC) area control error (ACE) limits. Case studies that investigate the benefits of moving from hourly exchange schedules between Western Electricity Coordinating Council (WECC) BAs into 10-minute exchange schedules under two different levels of wind and solar penetration (11% and 33%) are presented.« less

Time-delayed contrast-enhanced MRI improves detection of brain metastases and apparent treatment volumes.

PubMed

Kushnirsky, Marina; Nguyen, Vinh; Katz, Joel S; Steinklein, Jared; Rosen, Lisa; Warshall, Craig; Schulder, Michael; Knisely, Jonathan P S

2016-02-01

Contrast-enhanced MRI is the preeminent diagnostic test for brain metastasis (BM). Detection of BMs for stereotactic radiosurgery (SRS) planning may improve with a time delay following administration of a high-relaxivity agent for 1.5-T and 3-T imaging systems. Metastasis detection with time-delayed MRI was evaluated in this study. Fifty-three volumetric MRI studies from 38 patients undergoing SRS for BMs were evaluated. All studies used 0.1-mmol/kg gadobenate dimeglumine (MultiHance; Bracco Diagnostics) immediately after injection, followed by 2 more axial T1-weighted sequences after 5-minute intervals (final image acquisition commenced 15 minutes after contrast injection). Two studies were motion limited and excluded. Two hundred eighty-seven BMs were identified. The studies were randomized and examined separately by 3 radiologists, who were blinded to the temporal sequence. Each radiologist recorded the number of BMs detected per scan. A Wilcoxon signed-rank test compared BM numbers between scans. One radiologist determined the scan on which BMs were best defined. All confirmed, visible tumors were contoured using iPlan RT treatment planning software on each of the 3 MRI data sets. A linear mixed model was used to analyze volume changes. The interclass correlations for Scans 1, 2, and 3 were 0.7392, 0.7951, and 0.7290, respectively, demonstrating excellent interrater reliability. At least 1 new lesion was detected in the second scan as compared with the first in 35.3% of subjects (95% CI 22.4%-49.9%). The increase in BM numbers between Scans 1 and 2 ranged from 1 to 10. At least 1 new lesion was detected in the third scan as compared with the second in 21.6% of subjects (95% CI 11.3%-35.3%). The increase in BM numbers between Scans 2 and 3 ranged from 1 to 9. Between Scans 1 and 3, additional tumors were seen on 43.1% of scans (increase ranged from 1 to 14). The median increase in tumor number for all comparisons was 1. There was a significant increase in number

A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

PubMed

Shea, Judy A; Dinges, David F; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Volpp, Kevin G

2014-03-01

Protected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that are personnel neutral. Randomized trial at Philadelphia Veterans Affairs Medical Center (PVAMC) Medical Service and Hospital of the University of Pennsylvania (HUP) Oncology Unit. During 2010-2011, four-week blocks were randomly assigned to a standard intern schedule (extended duty overnight shifts of up to 30 hours), or sequential protected sleep periods (phone sign-out midnight to 3:00 AM [early shift] intern 1; 3:00 to 6:00 AM [late shift] intern 2). Participants wore wrist Actiwatches, completed sleep diaries, and performed daily assessments of behavioral alertness. Between-group comparisons of means and proportions controlled for within-person correlations. HUP interns had significantly longer sleep durations during both early (2.40 hours) and late (2.44 hours) protected periods compared with controls (1.55 hours, P < .0001). At PVAMC sleep duration was longer only for the late shift group (2.40 versus 1.90 hours, P < .036). Interns assigned to either protected period were significantly less likely to have call nights with no sleep and had fewer attentional lapses on the Psychomotor Vigilance Test. Differences in patient outcomes between standard schedule months versus intervention months were not observed. Protected sleep periods of three hours resulted in more sleep during call and reductions in periods of prolonged wakefulness, providing a plausible alternative to 16-hour shifts.

Morton neuroma: evaluation with MR imaging performed with contrast enhancement and fat suppression.

PubMed

Terk, M R; Kwong, P K; Suthar, M; Horvath, B C; Colletti, P M

1993-10-01

To evaluate clinically suspected Morton neuroma with contrast material-enhanced magnetic resonance (MR) images. Fifteen patients with clinically suspected Morton neuroma underwent examination with conventional T1- and T2-weighted MR imaging and a combination of fat suppression and administration of gadopentetate dimeglumine. A T1-weighted spectral presaturation with inversion recovery sequence was used for fat suppression. In six patients, a tumor that conformed to the clinical findings was seen in the interdigital space; surgical findings in these patients correlated closely with the imaging findings in all patients. Patients without positive findings on MR images tended to have less typical clinical findings and received nonsurgical treatment. In all patients, the lesions were best depicted with the combination of contrast-enhanced imaging and fat suppression; conventional MR images either entirely failed to demonstrate the lesions or demonstrated the lesions less clearly. In patients who need imaging confirmation of a clinically suspected Morton neuroma, the combination of fat suppression and contrast enhancement provides reliable high-contrast images.

A newly developed solution enhances thirty-hour preservation in a canine lung transplantation model.

PubMed

Liu, C J; Ueda, M; Kosaka, S; Hirata, T; Yokomise, H; Inui, K; Hitomi, S; Wada, H

1996-09-01

Ischemia and reperfusion cause the production of oxygen free radicals. These damage grafts or disrupt normal vascular homeostatic mechanisms, with a parallel reduction in endothelial nitric oxide and adenosine 3',5'-cyclic monophosphate levels. We hypothesized that lung preservation failure may be related to these events. To improve lung preservation, we prepared a new ET-Kyoto solution, which contains N-acetylcysteine (a radical scavenger), nitroglycerin (to elevate the nitric oxide level), and dibutyryl adenosine 3',5'-cyclic monophosphate (to elevate the adenosine 3',5'-cyclic monophosphate level) and examined its efficacy in a canine single-lung transplantation model. Lungs were flushed with new ET-Kyoto solution (group I, n = 9), basal ET-Kyoto solution (group II, n = 6), basal ET-Kyoto solution plus ethanol and propylene glycol (solvents of nitroglycerin; group III, n = 6), or low-potassium dextran glucose solution (group IV, n = 6), and stored at 4 degrees C for 30 hours. After left single-lung transplantation, the right main bronchus and right pulmonary artery were ligated and the functions of the transplanted lung were assessed for 6 hours. Arterial oxygen tension was significantly higher in group I than in groups II, III, and IV (p < 0.05). Peak inspiratory pressure and wet-to-dry lung weight ratio were significantly lower in group I than in groups II and IV (p < 0.01). Histologic and ultrastructural studies showed better preservation in group I than in groups II, III, and IV. We conclude that the new ET-Kyoto solution provides enhanced 30-hour lung preservation.

Three Fresh Exposures, Enhanced Color

NASA Technical Reports Server (NTRS)

2004-01-01

This enhanced-color panoramic camera image from the Mars Exploration Rover Opportunity features three holes created by the rock abrasion tool between sols 143 and 148 (June 18 and June 23, 2004) inside 'Endurance Crater.' The enhanced image makes the red colors a little redder and blue colors a little bluer, allowing viewers to see differences too subtle to be seen without the exaggeration. When compared with an approximately true color image, the tailings from the rock abrasion tool and the interior of the abraded holes are more prominent in this view. Being able to discriminate color variations helps scientists determine rocks' compositional differences and texture variations. This image was created using the 753-, 535- and 432-nanometer filters.

Outcome in patients admitted outside regular hospital working hours: does time until regular working hours matter?

PubMed

Nakajima, Makoto; Inatomi, Yuichiro; Yonehara, Toshiro; Watanabe, Masaki; Ando, Yukio

2015-01-01

The aim of this study was to investigate whether stratifying patients according to the time period from admission to the start of regular working hours would help detect a weekend effect in acute stroke patients. Ischemic stroke patients admitted between October 2002 and March 2012 were analyzed. Working hours were defined as 9:00-17:00 on weekdays. Patients were divided into those admitted during working hours (no-wait group) and three other groups according to the time from admission to working hours: ≤24 h (short-wait group), 24-48 h (medium-wait group), and >48 h (long-wait group). The modified Rankin Scale score and mortality at three-months were compared among the groups. Of 5625 patients, 3323 (59%) were admitted outside working hours. The proportion of patients with an mRS score 0-1 at three-months showed a decreasing trend with the time period before working hours: 47% (no-wait group), 42% (short-wait group), 42% (medium-wait group), and 38% (long-wait group), respectively (P < 0·001). When the no-wait group was used as a reference, the odds ratio for modified Rankin Scale score 0-1 was 0·88 (95% confidence interval, 0·75-1·04) in the short-wait group, 0·86 (0·69-1·07) in the medium-wait group, and 0·67 (0·53-0·85) in the long-wait group after adjusting for sex, age, premorbid mRS score, previous morbidity, stroke severity, and vascular risk factors. Mortality at three-months was not different between the no-wait group and the other groups. A weekend effect might be evident if patients were stratified according to the time period from admission until working hours. © 2014 World Stroke Organization.

75 FR 285 - Hours of Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... period long enough to provide restorative sleep regardless of the number of hours worked prior to the... No. FMCSA-2004-19608] RIN 2126-AB26 Hours of Service AGENCY: Federal Motor Carrier Safety... hold three public listening sessions to solicit comments and information on potential hours-of- service...

Equilibrium-phase MR angiography: Comparison of unspecific extracellular and protein-binding gadolinium-based contrast media with respect to image quality.

PubMed

Erb-Eigner, Katharina; Taupitz, Matthias; Asbach, Patrick

2016-01-01

The purpose of this study was to compare contrast and image quality of whole-body equilibrium-phase high-spatial-resolution MR angiography using a non-protein-binding unspecific extracellular gadolinium-based contrast medium with that of two contrast media with different protein-binding properties. 45 patients were examined using either 15 mL of gadobutrol (non-protein-binding, n = 15), 32 mL of gadobenate dimeglumine (weakly protein binding, n = 15) or 11 mL gadofosveset trisodium (protein binding, n = 15) followed by equilibrium-phase high-spatial-resolution MR-angiography of four consecutive anatomic regions. The time elapsed between the contrast injection and the beginning of the equilibrium-phase image acquisition in the respective region was measured and was up to 21 min. Signal intensity was measured in two vessels per region and in muscle tissue. Relative contrast (RC) values were calculated. Vessel contrast, artifacts and image quality were rated by two radiologists in consensus on a five-point scale. Compared with gadobutrol, gadofosveset trisodium revealed significantly higher RC values only when acquired later than 15 min after bolus injection. Otherwise, no significant differences between the three contrast media were found regarding vascular contrast and image quality. Equilibrium-phase high-spatial-resolution MR-angiography using a weakly protein-binding or even non-protein-binding contrast medium is equivalent to using a stronger protein-binding contrast medium when image acquisition is within the first 15 min after contrast injection, and allows depiction of the vasculature with high contrast and image quality. The protein-binding contrast medium was superior for imaging only later than 15 min after contrast medium injection. Copyright © 2015 John Wiley & Sons, Ltd.

Impact of gadolinium-based contrast agent in the assessment of Crohn's disease activity: Is contrast agent injection necessary?

PubMed

Quaia, Emilio; Sozzi, Michele; Gennari, Antonio Giulio; Pontello, Michele; Angileri, Roberta; Cova, Maria Assunta

2016-03-01

To determine whether magnetic resonance enterography (MRE) performed without intravenous contrast injection is diagnostically noninferior to conventional contrast-enhanced MRE (CE-MRE) in patients with Crohn's disease (CD). This was an Institutional Review Board (IRB)-approved retrospective study. Ninety-six patients (52 male and 44 female; 47.18 years ± 13.6) with a diagnosis of CD underwent MRE at 1.5T including T2 -weighted single-shot turbo-spin-echo, T2 -weighted spectral fat presaturation with inversion recovery (SPAIR), T1 -weighted balanced fast-field-echo MR sequences, and CE-MRE consisting in T1 -weighted breath-hold THRIVE 3D MRI sequences after administration of gadobenate dimeglumine (0.2 mL/kg of body weight). Unenhanced MRE, CE-MRE, and unenhanced MRE plus CE-MRE were reviewed in separate sessions with blinding by two readers in consensus, and subsequently by two other readers independently considering a subgroup of 20 patients. Crohn's Disease Endoscopic Index of Severity (CDEIS) and/or histologic analysis of the surgical specimen were considered as reference standards for the assessment of inflammatory activity. Patients revealed prevalently active (n = 55 patients) or quiescent CD (n = 41 patients). The agreement between unenhanced MRE vs. CE-MRE in interpreting active bowel inflammation was 96% (123/128 bowel segments; one-sided 95% confidence interval [CI], >94.4%). Unenhanced MRE vs. CE-MRE vs. unenhanced MRE plus CE-MRE revealed a diagnostic accuracy of 93% [90/96] vs. 92% [88/96] vs. 97% [93/96] (P > 0.05) in the diagnosis of active CD. Interreader agreement was very good for all variables (κ value = 0.8-0.9) except for the measurement of the length of disease (κ value = 0.45). Unenhanced MRE was noninferior to CE-MRE in diagnosing active inflammation in patients with CD. © 2015 Wiley Periodicals, Inc.

Flexible work in call centres: Working hours, work-life conflict & health.

PubMed

Bohle, Philip; Willaby, Harold; Quinlan, Michael; McNamara, Maria

2011-01-01

Call-centre workers encounter major psychosocial pressures, including high work intensity and undesirable working hours. Little is known, however, about whether these pressures vary with employment status and how they affect work-life conflict and health. Questionnaire data were collected from 179 telephone operators in Sydney, Australia, of whom 124 (69.3%) were female and 54 (30.2%) were male. Ninety-three (52%) were permanent full-time workers, 37 (20.7%) were permanent part-time, and 49 (27.4%) were casual employees. Hypothesised structural relationships between employment status, working hours and work organisation, work-life conflict and health were tested using partial least squares modelling in PLS (Chin, 1998). The final model demonstrated satisfactory fit. It supported important elements of the hypothesised structure, although four of the proposed paths failed to reach significance and the fit was enhanced by adding a path. The final model indicated that casual workers reported more variable working hours which were relatively weakly associated with greater dissatisfaction with hours. The interaction of schedule control and variability of hours also predicted dissatisfaction with hours. Conversely, permanent workers reported greater work intensity, which was associated with both lower work schedule control and greater work-life conflict. Greater work-life conflict was associated with more fatigue and psychological symptoms. Labour market factors and the undesirability of longer hours in a stressful, high-intensity work environment appear to have contributed to the results. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Balancing Authority Cooperation Concepts - Intra-Hour Scheduling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hunsaker, Matthew; Samaan, Nader; Milligan, Michael

2013-03-29

The overall objective of this study was to understand, on an Interconnection-wide basis, the effects intra-hour scheduling compared to hourly scheduling. Moreover, the study sought to understand how the benefits of intra-hour scheduling would change by altering the input assumptions in different scenarios. This report describes results of three separate scenarios with differing key assumptions and comparing the production costs between hourly scheduling and 10-minute scheduling performance. The different scenarios were chosen to provide insight into how the estimated benefits might change by altering input assumptions. Several key assumptions were different in the three scenarios, however most assumptions were similarmore » and/or unchanged among the scenarios.« less

The Three-Continent, 24-Hour Help Desk: An Academic First?

ERIC Educational Resources Information Center

Sykes, Jean

2002-01-01

Describes Follow the Sun, a computer help-desk service that takes advantage of time differences around the world to permit four universities (University of Colorado Boulder, Australia's Macquarie and Newcastle universities, and the London School of Economics) to share services and provide 24-hour support to users. (EV)

Enhanced startle responsivity 24 hours after acute stress exposure.

PubMed

Herten, Nadja; Otto, Tobias; Adolph, Dirk; Pause, Bettina M; Kumsta, Robert; Wolf, Oliver T

2016-10-01

Cortisol release in a stressful situation can be beneficial for memory encoding and memory consolidation. Stimuli, such as odors, related to the stressful episode may successfully cue memory contents of the stress experience. The current investigation aimed at testing the potency of stress to influence startle responsivity 24 hr later and to implicitly reactivate emotional memory traces triggered by an odor involved. Participants were assigned to either a stress (Trier Social Stress Test [TSST]) or control (friendly TSST [f-TSST]) condition featuring an ambient odor. On the next day, participants underwent an auditory startle paradigm while their eyeblink reflex was recorded by an electrooculogram. Three different olfactory stimuli were delivered, one being the target odor presented the day before. Additionally, negative, positive, and pictures of the committee members were included for comparing general startle responsivity and fear-potentiated startle. Participants of the stress group demonstrated an enhanced startle response across all stimuli compared to participants of the control group. There were no specific effects with regard to the target odor. The typical fear-potentiated startle response occurred. Stressed participants tended to rate the target odor more aversive than control participants. Odor recognition memory did not differ between the groups, suggesting an implicit effect on odor valence. Our results show that acute stress exposure enhances startle responsivity 24 hr later. This effect might be caused by a shift of amygdala function causing heightened sensitivity, but lower levels of specificity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Reducing bed rest time from five to three hours does not increase complications after cardiac catheterization: the THREE CATH Trial 1

PubMed Central

Matte, Roselene; Hilário, Thamires de Souza; Reich, Rejane; Aliti, Graziella Badin; Rabelo-Silva, Eneida Rejane

2016-01-01

Abstract Objective: to compare the incidence of vascular complications in patients undergoing transfemoral cardiac catheterization with a 6F introducer sheath followed by 3-hour versus 5-hour rest. Methods: randomized clinical trial. Subjects in the intervention group (IG) ambulated 3 hours after sheath removal, versus 5 hours in the control group (CG). All patients remained in the catheterization laboratory for 5 hours and were assessed hourly, and were contacted 24, 48, and 72 h after hospital discharge. Results: the sample comprised 367 patients in the IG and 363 in the GC. During cath lab stay, hematoma was the most common complication in both groups, occurring in 12 (3%) IG and 13 (4%) CG subjects (P=0.87). Bleeding occurred in 4 (1%) IG and 6 (2%) CG subjects (P=0.51), and vasovagal reaction in 5 (1.4%) IG and 4 (1.1%) CG subjects (P=0.75). At 24-h, 48-h, and 72-h bruising was the most commonly reported complication in both groups. None of the comparisons revealed any significant between-group differences. Conclusion: the results of this trial show that reducing bed rest time to 3 hours after elective cardiac catheterization is safe and does not increase complications as compared with a 5-hour rest. ClinicalTrials.gov Identifier: NCT-01740856 PMID:27463113

Work hours and absenteeism among police officers.

PubMed

Fekedulegn, Desta; Burchfiel, Cecil M; Hartley, Tara A; Baughman, Penelope; Charles, Luenda E; Andrew, Michael E; Violanti, John M

2013-01-01

In this study, the cross-sectional association of paid work hours with episodes of work absence was examined in a cohort of police officers. Study subjects were participants from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009. Among 395 study participants with complete data, day-by-day work history records during the one-year period prior to date of examination were used to determine episodes of one-day and three day work absence. The Negative binomial regression analysis was used to examine rate ratios (RR) of work absence. Analyses were also stratified by gender. A one-hour increase in total work hours was associated with 5% reduction in rate of one-day work absence (RR = 0.95, 95% CI: 0.92 - 0.98) and with 8% reduction in rate of three-day work absence (RR = 0.92, 95% CI: 0.89 - 0.95). The association of total work hours with episodes of one-day work absence was significant only in men while the association with episodes of three-day work absence was evident in men and women. In conclusion, in this cohort of police officers, work hours were negatively associated with both durations of work absence (one-day, > or = 3 consecutive days).

Work Hours and Absenteeism Among Police Officers

PubMed Central

Fekedulegn, Desta; Burchfiel, Cecil M.; Hartley, Tara A.; Baughman, Penelope; Charles, Luenda E.; Andrew, Michael E.; Violanti, John M.

2015-01-01

In this study, the cross-sectional association of paid work hours with episodes of work absence was examined in a cohort of police officers. Study subjects were participants from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009. Among 395 study participants with complete data, day-by-day work history records during the one-year period prior to date of examination were used to determine episodes of one-day and three day work absence. The Negative binomial regression analysis was used to examine rate ratios (RR) of work absence. Analyses were also by gender. A one-hour increase in total work hours was associated with 5% reduction in rate of stratified one-day work absence (RR = 0.95, 95% CI: 0.92 – 0.98) and with 8% reduction in rate of three-day work absence (RR = 0.92, 95% CI: 0.89 – 0.95). The association of total work hours with episodes of one-day work absence was significant only in men while the association with episodes of three-day work absence was evident in men and women. In conclusion, in this cohort of police officers, work hours were negatively associated with both durations of work absence (one-day, ≥ 3 consecutive days). PMID:24707589

Prognostic value of contrast-enhanced MR mammography in patients with breast cancer.

PubMed

Fischer, U; Kopka, L; Brinck, U; Korabiowska, M; Schauer, A; Grabbe, E

1997-01-01

The objective of this study was to evaluate the prognostic value of contrast-enhanced MR mammography in patients with breast cancer. A total of 190 patients with breast cancer (37 noninvasive carcinomas, 153 invasive carcinomas) underwent dynamic contrast-enhanced MR mammography preoperatively. Using 1.5-T unit, T1-weighted sequences (2D FLASH) were obtained repeatedly one time before and five times after IV administration of 0.1 mmol gadopentetate-dimeglumine per kilogram body weight. The findings on MR imaging were correlated with histopathologically defined prognostic factors (histological type, tumor size, tumor grading, metastasis in lymph nodes). In addition, immunohistochemically defined prognostic factors (c-erbB-1, c-erbB-2, p53, Ki-67) were correlated with the signal increase on MR mammogram in 40 patients. There was no significant correlation between the findings on MR mammography and the histopathological type of carcinoma, the grading, and the lymphonodular status. Noninvasive carcinomas showed a higher rate of moderate (38 %) or low (27 %) enhancement on MR imaging than invasive carcinomas (6 and 3 %). The results on MR mammography and the results of immunohistochemical stainings did not correlate significantly. Noninvasive carcinomas showed significantly lower enhancement than invasive carcinomas. However, the signal behavior of contrast-enhanced MR mammography is not related to established histopathological prognostic parameters as subtyping, grading, nodal status, and the expression of certain oncogenes/tumor suppressor genes.

Registrar working hours in Cape Town.

PubMed

Vadia, S; Kahn, D

2005-08-01

The number of hours worked by general surgical registrars in Europe and the USA has been reduced so as to reduce fatigue and the possibility of errors. The impact of these restrictions on surgical training remains unresolved. To date there are no officially reported data on the number of hours worked by registrars in South Africa. The aim of this study was to document the hours worked by registrars in general surgery in Cape Town. Thirty-three general surgical registrars at the University of Cape Town were asked to complete a time sheet over a 2-week period, indicating hours spent in hospital as part of a normal working day, hours spent in hospital outside of a normal day, hours at home on 'cold call' and hours off duty. Of the 33 registrars, 25 completed the time sheet. Registrars at Groote Schuur Hospital worked an average of 105 hours per week (68 hours in hospital and 37 hours on call at home). Registrars at New Somerset Hospital worked 79 hours per week (70 hours on site), while registrars at Red Cross Children's Hospital, G. F. Jooste Hospital and the Trauma Unit worked 60 - 69 hours per week. In the Surgical Intensive Care Unit (SICU) registrars worked 75 hours per week. In conclusion, general surgical registrars at the University of Cape Town work hours in excess of European and American work-hour restrictions.

Multicentre evaluation of postoperative pain control after 24hours in three hospitals of Colombia.

PubMed

Machado-Alba, Jorge Enrique; Machado-Duque, Manuel Enrique; Ramírez-Sarmiento, Javier Orlando

To determine the intensity of pain in operated patients using a visual analogue scale and identify variables associated with lack of pain control in three cities in Colombia. A cross-sectional study in patients over the age of 18 years, between January 1 st and September 30 th 2014, in 3 clinics in Colombia. The intensity of postoperative pain using a visual analogue scale at 24hours after surgery was recorded. Socio-demographic, clinical and pharmacological variables were taken into account. SPSS 22.0 was used for the analysis. 460 patients were evaluated, mean age 47.6±17.4 years, and 63.3% were female. The mean pain level was 23.8±17.4mm, with 91 (19.8% of patients) with moderate or greater pain (i.e., lack of pain control). Tramadol was the most used analgesic, followed by dipyrone and diclofenac. 53.0% were treated with monotherapy. Compliance with the dosing regimen of the first analgesic (OR: 0.53; 95% CI: 0.294 to .988; p=.046) was statistically significantly associated with a decreased risk of poorly controlled pain. Pain intensity and the proportion of patients with uncontrolled pain at 24hours after surgery show better results than other studies previously published in the country. There must be insistence on the administration of analgesia within a suitable interval in order to improve pain control. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

29 CFR 778.421 - Offset hour for hour.

Code of Federal Regulations, 2010 CFR

2010-07-01

... hours standard, or in excess of the employees' normal working hours or regular working hours (as under... 29 Labor 3 2010-07-01 2010-07-01 false Offset hour for hour. 778.421 Section 778.421 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL...

Storage beyond three hours at ambient temperature alters the biochemical and nutritional qualities of breast milk.

PubMed

Eteng, M U; Ebong, P E; Eyong, E U; Ettarh, R R

2001-08-01

The effect of storage on stability of human breast milk was investigated in 30 lactating mothers. Samples stored for 3, 6 and 24 hours at ambient temperature of 302K (29 degrees) were analysed for protein, lactose, pH, and microbial content. There were significant (p < 0.01) decreases in protein, lactose and pH upon storage for 6 and 24 hours, compared with storage for 3 hours as control. The mean +/- SEM values for protein for 6 and 24 hours were 15.56 +/- 0.48 and 13.27 +/- 0.50, compared with 17.26 +/- 0.41 for 3 hours. For lactose, corresponding values for 6 and 24 hours were 0.08 +/- 0.005 and 0.07 +/- 0.006, compared with 3 hours (0.09 +/- 0.005). The pH values were 6.1 +/- 0.09, 5.9 +/- 0.07 in 3, 6 and 24 hour samples rspectively. The skin floras investigated were Streptococcus viridians, Straphylococcus aureus and Staphylococcus albus. The microbial content increased with increase in storage time from 3 to 24 hours. The predominant bacterial specie was S. Albus, followed by S.viridians and S. aureus. A positive correlation (r = 0.453, p < 0.01) between lactose level and pH were obtained. These results suggest that breast milk is stable for 3 hours, beyond which significant changes occur in its biochemical composition and nutritional quality. The implications of these findings are discussed with respect to its consequences on their child's survival.

[ERCP success after 72 hours of pre-cut].

PubMed

Peñaloza-Ramírez, Arecio; Murillo-Arias, Andrés; Rodríguez-Mongui, Jaison; Carvajal-Flechas, Ricardo; Aponte-Ordoñez, Pedro

2018-01-01

Despite the advances of bile duct catheterization, its success is still not guaranteed. Few studies have been published regarding a second ERCP attempt, however those reports enhance the catheterization success Objective: To determine whether an ERCP performed 72 hours after a first precut papillotomy enhances the bile duct catheterization. A cohort study was performed including all patients that had ERCP with precut papilotomy without catheterization of the bile duct and 72 hours later were programmed to a new ERCP between September 2015 and September 2016. These patients did not have any distinctive characteristic such as age, gender or anatomy that were associated with the failure to catheterize the bile duct, compared to the general population. 16 patients were included with a mean age of 61,3 years (SD: 10,6), bile duct catheterization was successful in 14 cases. No complications presented after precut papilotomy. Both failures went to surgery. Our experience about an 87% successful bile duct catheterization, 72 hours after precut papillotomy allows us to suggest it as an alternative before considering surgery.

17 CFR 10.4 - Business address; hours.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Business address; hours. 10.4 Section 10.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.4 Business address; hours. The Office of Proceedings is located at Three Lafayette...

17 CFR 10.4 - Business address; hours.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Business address; hours. 10.4 Section 10.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.4 Business address; hours. The Office of Proceedings is located at Three Lafayette...

17 CFR 10.4 - Business address; hours.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Business address; hours. 10.4 Section 10.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.4 Business address; hours. The Office of Proceedings is located at Three Lafayette...

17 CFR 10.4 - Business address; hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 10.4 Section 10.4 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES OF PRACTICE General Provisions § 10.4 Business address; hours. The Office of Proceedings is located at Three Lafayette...

A Study of a Two Hour Time Block in Industrial Education. Final Report.

ERIC Educational Resources Information Center

Gearhart, Robert E.; McMillen, Stephen

Hypotheses of a study of two-hour as opposed to three-hour training blocks for industrial vocational education students were as follows: (1) Achievement of students in a two-hour block for three years will be equal to that of students in a three-hour block for two years, (2) student attitudes toward themselves, school, and the world of work will…

Ultrasound-mediated microbubble enhancement of radiation therapy studied using three-dimensional high-frequency power Doppler ultrasound.

PubMed

Kwok, Sheldon J J; El Kaffas, Ahmed; Lai, Priscilla; Al Mahrouki, Azza; Lee, Justin; Iradji, Sara; Tran, William Tyler; Giles, Anoja; Czarnota, Gregory J

2013-11-01

Tumor responses to high-dose (>8 Gy) radiation therapy are tightly connected to endothelial cell death. In the study described here, we investigated whether ultrasound-activated microbubbles can locally enhance tumor response to radiation treatments of 2 and 8 Gy by mechanically perturbing the endothelial lining of tumors. We evaluated vascular changes resulting from combined microbubble and radiation treatments using high-frequency 3-D power Doppler ultrasound in a breast cancer xenograft model. We compared treatment effects and monitored vasculature damage 3 hours, 24 hours and 7 days after treatment delivery. Mice treated with 2 Gy radiation and ultrasound-activated microbubbles exhibited a decrease in vascular index to 48 ± 10% at 24 hours, whereas vascular indices of mice treated with 2 Gy radiation alone or microbubbles alone were relatively unchanged at 95 ± 14% and 78 ± 14%, respectively. These results suggest that ultrasound-activated microbubbles enhance the effects of 2 Gy radiation through a synergistic mechanism, resulting in alterations of tumor blood flow. This novel therapy may potentiate lower radiation doses to preferentially target endothelial cells, thus reducing effects on neighboring normal tissue and increasing the efficacy of cancer treatments. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Accelerated discharge within 72 hours of colorectal cancer resection using simple discharge criteria.

PubMed

Emmanuel, A; Chohda, E; Botfield, C; Ellul, J

2018-01-01

Introduction Short hospital stays and accelerated discharge within 72 hours following colorectal cancer resections have not been widely achieved. Series reporting on accelerated discharge involve heterogeneous patient populations and exclude important groups. Strict adherence to some discharge requirements may lead to delays in discharge. The aim of this study was to evaluate the safety and feasibility of accelerated discharge within 72 hours of all elective colorectal cancer resections using simple discharge criteria. Methods Elective colorectal cancer resections performed between August 2009 and December 2015 by a single surgeon were reviewed. Perioperative care was based on an enhanced recovery programme. A set of simplified discharge criteria were used. Outcomes including postoperative complications, readmissions and reoperations were compared between patients discharged within 72 hours and those with a longer postoperative stay. Results Overall, 256 colorectal cancer resections (90% laparoscopic) were performed. The mean patient age was 70.8 years. The median length of stay was 3 days. Fifty-eight per cent of all patients and sixty-three per cent of patients undergoing laparoscopic surgery were discharged within 72 hours. Accelerated discharge was not associated with adverse outcomes compared with delayed discharge. Patients discharged within 72 hours had significantly fewer postoperative complications, readmissions and reoperations. Open surgery and stoma formation were associated with discharge after 72 hours but not age, co-morbidities, neoadjuvant chemoradiation or surgical procedure. Conclusions Accelerated discharge within 72 hours of elective colorectal resection for cancer is safely achievable for the majority of patients without compromising short-term outcomes.

An Efficient VLSI Architecture of the Enhanced Three Step Search Algorithm

NASA Astrophysics Data System (ADS)

Biswas, Baishik; Mukherjee, Rohan; Saha, Priyabrata; Chakrabarti, Indrajit

2016-09-01

The intense computational complexity of any video codec is largely due to the motion estimation unit. The Enhanced Three Step Search is a popular technique that can be adopted for fast motion estimation. This paper proposes a novel VLSI architecture for the implementation of the Enhanced Three Step Search Technique. A new addressing mechanism has been introduced which enhances the speed of operation and reduces the area requirements. The proposed architecture when implemented in Verilog HDL on Virtex-5 Technology and synthesized using Xilinx ISE Design Suite 14.1 achieves a critical path delay of 4.8 ns while the area comes out to be 2.9K gate equivalent. It can be incorporated in commercial devices like smart-phones, camcorders, video conferencing systems etc.

Making residency work hour rules work.

PubMed

Cohen, I Glenn; Czeisler, Charles A; Landrigan, Christopher P

2013-01-01

In July 2011, the ACGME implemented new rules that limit interns to 16 hours of work in a row, but continue to allow 2nd-year and higher resident physicians to work for up to 28 consecutive hours. Whether the ACGME's 2011 work hour limits went too far or did not go far enough has been hotly debated. In this article, we do not seek to re-open the debate about whether these standards get matters exactly right. Instead, we wish to address the issue of effective enforcement. That is, now that new work hour limits have been established, and given that the ACGME has been unable to enforce work hour limits effectively on its own, what is the best way to make sure the new limits are followed in order to reduce harm to residents, patients, and others due to sleep-deprived residents? We focus on three possible national approaches to the problem, one rooted in funding, one rooted in disclosure, and one rooted in tort law. © 2013 American Society of Law, Medicine & Ethics, Inc.

Has the 80-hour work week increased faculty hours?

PubMed

Winslow, Emily R; Berger, Lisa; Klingensmith, Mary E

2004-01-01

The 80-hour work week has affected not only surgical residents but also faculty. The aim of this study was to determine the effect of resident hour restrictions on faculty hours and attitudes. Anonymous survey. A single, large academic medical center. All faculty in the Departments of Surgery, Neurosurgery, Orthopedics, and Otolaryngology. Faculty were surveyed 6 months before and 6 months after the institution of the resident 80-hour work week. Surgeons detailed hours worked over 1 week and answered yes/no questions about changes in patient care and resident education. P values were determined by Chi-square tests or Student t-tests as appropriate. Of the 118 surveys distributed, 88 were returned (75%). Respondents were evenly divided between general surgeons (GS) and subspecialists (SS). Initially, 70% of faculty predicted that resident work-hour restrictions would increase faculty hours; however, only 47% of faculty felt that this had occurred. When current faculty work hours were compared with previously collected data, no differences were found. Faculty reported working an average of 69.9 +/- 12.2 hours per week this year, compared with 70.4 +/- 12.5 hours last year. When asked about the global impact of the 80-hour work week on faculty, 46% viewed the changes as harmful to the faculty. More concerning, 50% of all faculty felt the care their patients received was worse than previously, with only 2% feeling patient care had improved. This perception was significantly more common among GS faculty (70% GS vs 37% SS; p < 0.01), 94% of whom felt that the current lack of continuity compromises patient care. When the data were stratified by faculty work hours, interesting differences are seen. Of those faculty with work weeks less than 60 hours, only 6% thought the changes were harmful to patients and 64% thought resident training had suffered. In contrast, of those faculty who worked greater than 80 hours per week, 56% thought patients were harmed (p = 0.03) and 100

Transparency-enhancing technology allows three-dimensional assessment of gastrointestinal mucosa: A porcine model.

PubMed

Mizutani, Hiroya; Ono, Satoshi; Ushiku, Tetsuo; Kudo, Yotaro; Ikemura, Masako; Kageyama, Natsuko; Yamamichi, Nobutake; Fujishiro, Mitsuhiro; Someya, Takao; Fukayama, Masashi; Koike, Kazuhiko; Onodera, Hiroshi

2018-02-01

Although high-resolution three-dimensional imaging of endoscopically resected gastrointestinal specimens can help elucidating morphological features of gastrointestinal mucosa or tumor, there are no established methods to achieve this without breaking specimens apart. We evaluated the utility of transparency-enhancing technology for three-dimensional assessment of gastrointestinal mucosa in porcine models. Esophagus, stomach, and colon mucosa samples obtained from a sacrificed swine were formalin-fixed and paraffin-embedded, and subsequently deparaffinized for analysis. The samples were fluorescently stained, optically cleared using transparency-enhancing technology: ilLUmination of Cleared organs to IDentify target molecules method (LUCID), and visualized using laser scanning microscopy. After observation, all specimens were paraffin-embedded again and evaluated by conventional histopathological assessment to measure the impact of transparency-enhancing procedures. As a result, microscopic observation revealed horizontal section views of mucosa at deeper levels and enabled the three-dimensional image reconstruction of glandular and vascular structures. Besides, paraffin-embedded specimens after transparency-enhancing procedures were all assessed appropriately by conventional histopathological staining. These results suggest that transparency-enhancing technology may be feasible for clinical application and enable the three-dimensional structural analysis of endoscopic resected specimen non-destructively. Although there remain many limitations or problems to be solved, this promising technology might represent a novel histopathological method for evaluating gastrointestinal cancers. © 2018 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.

New Approach To Hour-By-Hour Weather Forecast

NASA Astrophysics Data System (ADS)

Liao, Q. Q.; Wang, B.

2017-12-01

Fine hourly forecast in single station weather forecast is required in many human production and life application situations. Most previous MOS (Model Output Statistics) which used a linear regression model are hard to solve nonlinear natures of the weather prediction and forecast accuracy has not been sufficient at high temporal resolution. This study is to predict the future meteorological elements including temperature, precipitation, relative humidity and wind speed in a local region over a relatively short period of time at hourly level. By means of hour-to-hour NWP (Numeral Weather Prediction)meteorological field from Forcastio (https://darksky.net/dev/docs/forecast) and real-time instrumental observation including 29 stations in Yunnan and 3 stations in Tianjin of China from June to October 2016, predictions are made of the 24-hour hour-by-hour ahead. This study presents an ensemble approach to combine the information of instrumental observation itself and NWP. Use autoregressive-moving-average (ARMA) model to predict future values of the observation time series. Put newest NWP products into the equations derived from the multiple linear regression MOS technique. Handle residual series of MOS outputs with autoregressive (AR) model for the linear property presented in time series. Due to the complexity of non-linear property of atmospheric flow, support vector machine (SVM) is also introduced . Therefore basic data quality control and cross validation makes it able to optimize the model function parameters , and do 24 hours ahead residual reduction with AR/SVM model. Results show that AR model technique is better than corresponding multi-variant MOS regression method especially at the early 4 hours when the predictor is temperature. MOS-AR combined model which is comparable to MOS-SVM model outperform than MOS. Both of their root mean square error and correlation coefficients for 2 m temperature are reduced to 1.6 degree Celsius and 0.91 respectively. The

How extreme is extreme hourly precipitation?

NASA Astrophysics Data System (ADS)

Papalexiou, Simon Michael; Dialynas, Yannis G.; Pappas, Christoforos

2016-04-01

The importance of accurate representation of precipitation at fine time scales (e.g., hourly), directly associated with flash flood events, is crucial in hydrological design and prediction. The upper part of a probability distribution, known as the distribution tail, determines the behavior of extreme events. In general, and loosely speaking, tails can be categorized in two families: the subexponential and the hyperexponential family, with the first generating more intense and more frequent extremes compared to the latter. In past studies, the focus has been mainly on daily precipitation, with the Gamma distribution being the most popular model. Here, we investigate the behaviour of tails of hourly precipitation by comparing the upper part of empirical distributions of thousands of records with three general types of tails corresponding to the Pareto, Lognormal, and Weibull distributions. Specifically, we use thousands of hourly rainfall records from all over the USA. The analysis indicates that heavier-tailed distributions describe better the observed hourly rainfall extremes in comparison to lighter tails. Traditional representations of the marginal distribution of hourly rainfall may significantly deviate from observed behaviours of extremes, with direct implications on hydroclimatic variables modelling and engineering design.

Correlates of Three Year Transfer Student Retention Rates with Race, Gender, Age, Credit Hours, and Place of Residence at a Regional Public University

ERIC Educational Resources Information Center

Mills, Michael Thomas

2011-01-01

This dissertation examined the relationship between the three year academic success of transfer students and the variables of race, gender, age, number of transfer credit hours, and place of residence. The study was conducted at Midwestern State University, a public, regional four-year institution and followed the incoming transfer classes of the…

Enhancing thermoelectric properties through a three-terminal benzene molecule

NASA Astrophysics Data System (ADS)

Sartipi, Z.; Vahedi, J.

2018-05-01

The thermoelectric transport through a benzene molecule with three metallic terminals is discussed. Using general local and non-local transport coefficients, we investigated different conductance and thermopower coefficients within the linear response regime. Based on the Onsager coefficients which depend on the number of terminal efficiencies, efficiency at maximum power is also studied. In the three-terminal setup with tuning temperature differences, a great enhancement of the figure of merit is observed. Results also show that the third terminal model can be useful in improving the efficiency at maximum output power compared to the two-terminal model.

Clinical utility of three-dimensional contrast-enhanced ultrasound in the differentiation between noninvasive and invasive neoplasms of urinary bladder.

PubMed

Li, Qiu-yang; Tang, Jie; He, En-hui; Li, Yan-mi; Zhou, Yun; Zhang, Xu; Chen, Guangfu

2012-11-01

The purpose of this study was to evaluate the effectiveness of three-dimensional contrast-enhanced ultrasound in differentiating invasive and noninvasive neoplasms of urinary bladder. A total of 60 lesions in 60 consecutive patients with bladder tumors received three dimensional ultrasonography, low acoustic power contrast enhanced ultrasonography and low acoustic power three-dimensional contrast-enhanced ultrasound examination. The IU22 ultrasound scanner and a volume transducer were used and the ultrasound contrast agent was SonoVue. The contrast-specific sonographic imaging modes were PI (pulse inversion) and PM (power modulation). The three dimensional ultrasonography, contrast enhanced ultrasonography, and three-dimensional contrast-enhanced ultrasound images were independently reviewed by two readers who were not in the images acquisition. Images were analyzed off-site. A level of confidence in the diagnosis of tumor invasion of the muscle layer was assigned on a 5° scale. Receiver operating characteristic analysis was used to assess overall confidence in the diagnosis of muscle invasion by tumor. Kappa values were used to assess inter-readers agreement. Histologic diagnosis was obtained for all patients. Final pathologic staging revealed 44 noninvasive tumors and 16 invasive tumors. Three-dimensional contrast-enhanced ultrasound depicted all 16 muscle-invasive tumors. The diagnostic performance of three-dimensional contrast-enhanced ultrasound was better than those of three dimensional ultrasonography and contrast enhanced ultrasonography. The receiver operating characteristic curves were 0.976 and 0.967 for three-dimensional contrast-enhanced ultrasound, those for three dimensional ultrasonography were 0.881 and 0.869, those for contrast enhanced ultrasonography were 0.927 and 0.929. The kappa values in the three dimensional ultrasonography, contrast enhanced ultrasonography and three-dimensional contrast-enhanced ultrasound for inter-reader agreements

Are long physician working hours harmful to patient safety?

PubMed

Ehara, Akira

2008-04-01

Pediatricians of Japanese hospitals including not only residents but also attending physicians work long hours, and 8% work for >79 h per week. Most of them work consecutively for >or=32 h when they are on call. The aim of the present study was to evaluate the effect of long work hours on patient safety. The electronic databases MEDLINE and EMBASE to searched identify the English- and Japanese-language literature for studies on work hours, medical errors, patient safety, and malpractice for years 1966-2005. Studies that analyzed the relationship between physician work hours and outcomes directly related to patient safety were selected. Seven studies met the criteria. Four studies suggest that reduction of work hours has a favorable effect on patient safety indicators. In the other three studies no significant changes of the indicators were observed, but no report found that shorter work hours were harmful to patient safety. Decrease of physician work hours is not harmful but favorable to patient safety.

Changes in respiratory control after three hours of isocapnic hypoxia in humans

PubMed Central

Mahamed, Safraaz; Cunningham, David A; Duffin, James

2003-01-01

Despite the obvious role of hypoxia in eliciting respiratory acclimatisation in humans, the function of the peripheral chemoreflex is uncertain. We investigated this uncertainty using 3 h of isocapnic hypoxia as a stimulus (end-tidal PCO2, 0.5–1.0 mmHg above eucapnia; end-tidal PO2, 50 mmHg), hypothesising that this stimulus would induce an enhancement of the peripheral chemoreflex ventilatory response to hypoxia. Current evidence conflicts as to whether this enhancement is mediated by an increase in the sensitivity or a decrease in the threshold of the peripheral chemoreflex ventilatory response to carbon dioxide. Employing a modified rebreathing technique to assess chemoreflex function, we found evidence of the latter in nine healthy volunteers (six male, three female). Testing consisted of pairs of isoxic rebreathing tests at high and low levels of oxygen, performed before, immediately after and 1 h after a 3 h isocapnic hypoxic exposure. No parameters changed significantly in the high-oxygen rebreathing tests. In the low-oxygen rebreathing tests there were no changes in non-chemoreflex ventilatory drives, or in the sensitivity to carbon dioxide, but the carbon dioxide response threshold decreased (≈1.5 mmHg) immediately after exposure, and the decrease persisted for 1 h (one-way repeated-measures ANOVA; P < 0.05). We repeated the protocol in five of the original nine volunteers, but this time exposing them to isocapnic normoxia. No trends or significant changes were observed in any of the rebreathing test parameters. These findings demonstrate that in the earliest stages of acclimatisation, there is a decrease in the threshold of the peripheral chemoreflex response to carbon dioxide, which persists for at least 1 h after the return to normoxia. We suggest that ventilatory acclimatisation to hypoxia results from this decreased threshold, reflecting an increase in the activity of the peripheral chemoreflex. PMID:12562969

Integrating Instant Messenger into Online Office Hours to Enhance Synchronous Online Interaction in Teacher Education

ERIC Educational Resources Information Center

Lih-Ching, Chen Wang; Beasley, William

2006-01-01

Modern communication technologies have modified the tradition of instructor's office hours in numerous ways. This article explores the use of Instant Messenger (IM) software in the context of "online office hours". The authors discuss strengths and weaknesses of IM interactions for instructor/student communication, and examine a sample of such…

Three-photon absorption process in organic dyes enhanced by surface plasmon resonance

NASA Astrophysics Data System (ADS)

Cohanoschi, Ion

2006-07-01

Multi-photon absorption processes have received significant attention from the scientific community during the last decade, mainly because of their potential applications in optical limiting, data storage and biomedical fields. Perhaps, one of the most investigated processes studied so far has been two-photon absorption (2PA). These investigations have resulted in successful applications in all the fields mentioned above. However, 2PA present some limitations in the biomedical field when pumping at typical 2PA wavelengths. In order to overcome these limitations, three-photon absorption (3PA) process has been proposed. However, 3PA in organic molecules has a disadvantage, typical values of sigma3' are small (10-81 cm6s 2/photon2), therefore, 3PA excitation requires high irradiances to induce the promotion of electrons from the ground state to the final excited state. To overcome this obstacle, specific molecules that exhibit large 3PA cross-section must be designed. Thus far, there is a lack of systematic studies that correlate 3PA processes with the molecular structure of organic compounds. In order to fill the existent gap in 3PA molecular engineering, in this dissertation we have investigated the structure/property relationship for a new family of fluorene derivatives with very high three-photon absorption cross-sections. We demonstrated that the symmetric intramolecular charge transfer as well as the pi-electron conjugation length enhances the 3PA cross-section of fluorene derivatives. In addition, we showed that the withdrawing electron character of the attractor groups in a pull-pull geometry proved greater 3PA cross-section. After looking for alternative ways to enhance the effective sigma 3' of organic molecules, we investigated the enhancement of two- and three-photon absorption processes by means of Surface Plasmon. We demonstrated an enhancement of the effective two- and three-photon absorption cross-section of an organic compound of 480 and 30 folds

Neighborhood walkability, income, and hour-by-hour physical activity patterns.

PubMed

Arvidsson, Daniel; Eriksson, Ulf; Lönn, Sara Larsson; Sundquist, Kristina

2013-04-01

This study aimed to investigate both the mean daily physical activity and the hour-by-hour physical activity patterns across the day using accelerometry and how they are associated with neighborhood walkability and individual income. Moderate physical activity (MPA) was assessed by accelerometry in 2252 adults in the city of Stockholm, Sweden. Neighborhood walkability (residential density, street connectivity, and land use mix) was objectively assessed within 1000m network buffers around the participants' residence and individual income was self-reported. Living in a high walkability neighborhood was associated with more mean daily MPA compared with living in a low walkability neighborhood on weekdays and weekend days. Hour-by-hour analyses showed that this association appeared mainly in the afternoon/early evening during weekdays, whereas it appeared across the middle of the day during weekend days. Individual income was associated with mean daily MPA on weekend days. On weekdays, the hour-by-hour analyses showed that high income was associated with more MPA around noon and in late afternoon/early evening, whereas low income was associated with more MPA at the hours before noon and in the early afternoon. During the weekend, high income was more consistently associated with higher MPA. Hour-by-hour accelerometry physical activity patterns provides a more comprehensive picture of the associations between neighborhood walkability and individual income and physical activity and the variability of these associations across the day.

Dynamic Contrast-Enhanced MRI of Cervical Cancers: Temporal Percentile Screening of Contrast Enhancement Identifies Parameters for Prediction of Chemoradioresistance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Andersen, Erlend K.F.; Hole, Knut Hakon; Lund, Kjersti V.

Purpose: To systematically screen the tumor contrast enhancement of locally advanced cervical cancers to assess the prognostic value of two descriptive parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Methods and Materials: This study included a prospectively collected cohort of 81 patients who underwent DCE-MRI with gadopentetate dimeglumine before chemoradiotherapy. The following descriptive DCE-MRI parameters were extracted voxel by voxel and presented as histograms for each time point in the dynamic series: normalized relative signal increase (nRSI) and normalized area under the curve (nAUC). The first to 100th percentiles of the histograms were included in a log-rank survival test,more » resulting in p value and relative risk maps of all percentile-time intervals for each DCE-MRI parameter. The maps were used to evaluate the robustness of the individual percentile-time pairs and to construct prognostic parameters. Clinical endpoints were locoregional control and progression-free survival. The study was approved by the institutional ethics committee. Results: The p value maps of nRSI and nAUC showed a large continuous region of percentile-time pairs that were significantly associated with locoregional control (p < 0.05). These parameters had prognostic impact independent of tumor stage, volume, and lymph node status on multivariate analysis. Only a small percentile-time interval of nRSI was associated with progression-free survival. Conclusions: The percentile-time screening identified DCE-MRI parameters that predict long-term locoregional control after chemoradiotherapy of cervical cancer.« less

Health problems due to long working hours in Japan: working hours, workers' compensation (Karoshi), and preventive measures.

PubMed

Iwasaki, Kenji; Takahashi, Masaya; Nakata, Akinori

2006-10-01

Late in the 1970s, serious social concern over health problems due to long working hours has arisen in Japan. This report briefly summarizes the Japanese circumstances about long working hours and what the Government has achieved so far. The national statistics show that more than 6 million people worked for 60 h or more per week during years 2000 and 2004. Approximately three hundred cases of brain and heart diseases were recognized as labour accidents resulting from overwork (Karoshi) by the Ministry of Health, Labour and Welfare (MHLW) between 2002 and 2005. Consequently, the MHLW has been working to establish a more appropriate compensation system for Karoshi, as well as preventive measures for overwork related health problems. In 2001, the MHLW set the standards for clearly recognizing Karoshi in association with the amount of overtime working hours. These standards were based on the results of a literature review and medical examinations indicating a relationship between overwork and brain and heart diseases. In 2002, the MHLW launched the program for the prevention of health impairment due to overwork, and in 2005 the health guidance through an interview by a doctor for overworked workers has been enacted as law. Long working hours are controversial issues because of conflicts between health, safety, work-life balance, and productivity. It is obvious that we need to continue research regarding the impact on worker health and the management of long working hours.

Exotic superconductivity with enhanced energy scales in materials with three band crossings

NASA Astrophysics Data System (ADS)

Lin, Yu-Ping; Nandkishore, Rahul M.

2018-04-01

Three band crossings can arise in three-dimensional quantum materials with certain space group symmetries. The low energy Hamiltonian supports spin one fermions and a flat band. We study the pairing problem in this setting. We write down a minimal BCS Hamiltonian and decompose it into spin-orbit coupled irreducible pairing channels. We then solve the resulting gap equations in channels with zero total angular momentum. We find that in the s-wave spin singlet channel (and also in an unusual d-wave `spin quintet' channel), superconductivity is enormously enhanced, with a possibility for the critical temperature to be linear in interaction strength. Meanwhile, in the p-wave spin triplet channel, the superconductivity exhibits features of conventional BCS theory due to the absence of flat band pairing. Three band crossings thus represent an exciting new platform for realizing exotic superconducting states with enhanced energy scales. We also discuss the effects of doping, nonzero temperature, and of retaining additional terms in the k .p expansion of the Hamiltonian.

Three-dimensional hybrid silicon nanostructures for surface enhanced Raman spectroscopy based molecular detection

NASA Astrophysics Data System (ADS)

Vendamani, V. S.; Nageswara Rao, S. V. S.; Venugopal Rao, S.; Kanjilal, D.; Pathak, A. P.

2018-01-01

Three-dimensional silver nanoparticles decorated vertically aligned Si nanowires (Si NWs) are effective surface-enhanced Raman spectroscopy (SERS) substrates for molecular detection at low concentration levels. The length of Si NWs prepared by silver assisted electroless etching is increased with an increase in etching time, which resulted in the reduced optical reflection in the visible region. These substrates were tested and optimized by measuring the Raman spectrum of standard dye Rhodamine 6G (R6G) of 10 nM concentration. Further, effective SERS enhancements of ˜105 and ˜104 were observed for the cytosine protein (concentration of 50 μM) and ammonium perchlorate (oxidizer used in explosives composition with a concentration of 10 μM), respectively. It is established that these three-dimensional SERS substrates yielded considerably higher enhancement factors for the detection of R6G when compared to previous reports. The sensitivity can further be increased and optimized since the Raman enhancement was found to increase with an increase in the density of silver nanoparticles decorated on the walls of Si NWs.

75 FR 33664 - Hours of Service of Drivers: RockTenn, Application for Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... to 16 hours per day and be allowed to return to work with less than the mandatory 10 consecutive... required 10 hours off duty prior to returning to work and only allows them to work a maximum of 14 consecutive hours on any given day. They have three 8-hour shifts up to 7 days a week, and there are two...

Colleges Are Slashing Adjuncts' Hours to Skirt New Rules on Health-Insurance Eligibility

ERIC Educational Resources Information Center

Dunn, Sydni

2013-01-01

Allison G. Armentrout, an adjunct instructor at Stark State College, does not get paid by the hour. She earns $4,600 to teach two English composition courses. But now she carefully tracks how many hours she works on an electronic time sheet. During a recent week, she spent three hours preparing for her lectures, close to six hours in the…

Change from slowly rotating 8-hour shifts to rapidly rotating 8-hour and 12-hour shifts using participative shift roster design.

PubMed

Smith, P A; Wright, B M; Mackey, R W; Milsop, H W; Yates, S C

1998-01-01

The study examined the impact of change, from slowly rotating continuous 8-hour shifts to more rapidly rotating continuous 8-hour and 12-hour shifts, on the health and quality of life of shift workers. Self-report survey data were collected from 72 shift workers at 3 sewage treatment plants before and several months after roster change. After the change 1 plant first worked a rapidly rotating, 8-hour shift roster and then worked a 12-hour shift roster, and the other 2 plants worked continuous 12-hour shift rosters. After the change the shift workers at each plant reported increased satisfaction with roster design, a decrease in physical and psychological circadian malaise associated with shift work, improved day sleep quality, less tiredness, and improvements in the quality of home, social and work life. A between-plant comparison of the rapidly rotating 8-hour and 12-hour shift rosters showed greater improvements had been obtained with the 12-hour shift roster, and no significant differences in tiredness or sleep quality between the redesigned 8- and 12-hour shift rosters. However, a within-plant matched-pairs comparison at the 1st plant of the rapidly rotating 8-hour shift roster and the 12-hour shift roster showed no significant differences. The results show that the prior level of support for change may best explain the impact of roster redesign on individual well-being. They lend further support to shift worker participation in roster design.

Relationship Between Long Working Hours and Metabolic Syndrome Among Korean Workers.

PubMed

Yu, Jungok

2017-03-01

This study investigated gender differences in the relationship between long working hours and metabolic syndrome. Data based on the Sixth National Health and Nutrition Examination Survey (2014) pertaining to a total of 1,145 paid workers were analyzed. Working hours were divided into three groups (40-51 hours/week, 52-59 hours/week, ≥ 60 hours/week). The relationship between working hours and metabolic syndrome was then analyzed after adjusting for general and occupational characteristics, using a multiple logistic regression model. Working 40-51 hours per week was associated with the lowest metabolic syndrome among female workers (11.2%), whereas it was associated with the highest metabolic syndrome among male workers (28.0%). After adjusting for general and occupational characteristics, female workers working≥60 hours per week showed odds ratios of 2.21 [95% confidence interval (1.07, 4.57)], compared to those who worked 40-51 hours per week. However, no clear association between long working hours and metabolic syndrome was found among male workers. The results suggest that working long hours, especially≥60 hours per week, is related to metabolic syndrome among female Korean workers. Copyright © 2017. Published by Elsevier B.V.

Resident duty hours: a survey of internal medicine program directors.

PubMed

Garg, Megha; Drolet, Brian C; Tammaro, Dominick; Fischer, Staci A

2014-10-01

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) implemented new Common Program Requirements to regulate duty hours of resident physicians, with three goals: improved patient safety, quality of resident education and quality of life for trainees. We sought to assess Internal Medicine program director (IMPD) perceptions of the 2011 Common Program Requirements in July 2012, one year following implementation of the new standards. A cross-sectional study of all IMPDs at ACGME-accredited programs in the United States (N = 381) was performed using a 32-question, self-administered survey. Contact information was identified for 323 IMPDs. Three individualized emails were sent to each director over a 6-week period, requesting participation in the survey. Outcomes measured included approval of duty hours regulations, as well as perceptions of changes in graduate medical education and patient care resulting from the revised ACGME standards. A total of 237 surveys were returned (73% response rate). More than half of the IMPDs (52%) reported "overall" approval of the 2011 duty hour regulations, with greater than 70% approval of all individual regulations except senior resident daily duty periods (49% approval) and 16-hour intern shifts (17% approval). Although a majority feel resident quality of life has improved (55%), most IMPDs believe that resident education (60%) is worse. A minority report that quality (8%) or safety (11%) of patient care has improved. One year after implementation of new ACGME duty hour requirements, IMPDs report overall approval of the standards, but strong disapproval of 16-hour shift limits for interns. Few program directors perceive that the duty hour restrictions have resulted in better care for patients or education of residents. Although resident quality of life seems improved, most IMPDs report that their own workload has increased. Based on these results, the intended benefits of duty hour regulations may not yet

Effect of surface density silver nanoplate films toward surface-enhanced Raman scattering enhancement for bisphenol A detection

NASA Astrophysics Data System (ADS)

Bakar, N. A.; Salleh, M. M.; Umar, A. A.; Shapter, J. G.

2018-03-01

This paper reports a study on surface-enhanced Raman scattering (SERS) phenomenon of triangular silver nanoplate (NP) films towards bisphenol A (BPA) detection. The NP films were prepared using self-assembly technique with four different immersion times; 1 hour, 2 hours, 5 hours, and 8 hours. The SERS measurement was studied by observing the changes in Raman spectra of BPA after BPA absorbed on the NP films. It was found that the Raman intensity of BPA peaks was enhanced by using the prepared SERS substrates. This is clearly indicated that these SERS silver substrates are suitable to sense industrial chemical and potentially used as SERS detector. However, the rate of SERS enhancement is depended on the distribution of NP on the substrate surface.

The increased financial burden of further proposed orthopaedic resident work-hour reductions.

PubMed

Kamath, Atul F; Baldwin, Keith; Meade, Lauren K; Powell, Adam C; Mehta, Samir

2011-04-06

Increased funding for graduate medical education was not provided during implementation of the eighty-hour work week. Many teaching hospitals responded to decreased work hours by hiring physician extenders to maintain continuity of care. Recent proposals have included a further decrease in work hours to a total of fifty-six hours. The goal of this study was to determine the direct cost related to a further reduction in orthopaedic-resident work hours. A survey was delivered to 152 residency programs to determine the number of full-time equivalent (FTE) physician extenders hired after implementation of the eighty-hour work-week restriction. Thirty-six programs responded (twenty-nine university-based programs and seven community-based programs), encompassing 1021 residents. Previous published data were used to determine the change in resident work hours with implementation of the eighty-hour regulation. A ratio between change in full-time equivalent staff per resident and number of reduced hours was used to determine the cost of the proposed further decrease. After implementation of the eighty-hour work week, the average reduction among orthopaedic residents was approximately five work hours per week. One hundred and forty-three physician extenders (equal to 142 full-time equivalent units) were hired to meet compliance at a frequency-weighted average cost of $96,000 per full-time equivalent unit. A further reduction to fifty-six hours would increase the cost by $64,000 per resident. With approximately 3200 orthopaedic residents nationwide, sensitivity analyses (based on models of eighty and seventy-three-hour work weeks) demonstrate that the increased cost would be between $147 million and $208 million per fiscal year. For each hourly decrease in weekly work hours, the cost is $8 million to $12 million over the course of a fiscal year. Mandated reductions in resident work hours are a costly proposition, without a clear decrease in adverse events. The federal

Condensation Enhancement by Surface Porosity: Three-Stage Mechanism.

PubMed

Yarom, Michal; Marmur, Abraham

2015-08-18

Surface defects, such as pores, cracks, and scratches, are naturally occurring and commonly found on solid surfaces. However, the mechanism by which such imperfections promote condensation has not been fully explored. In the current paper we thermodynamically analyze the ability of surface porosity to enhance condensation on a hydrophilic solid. We show that the presence of a surface-embedded pore brings about three distinct stages of condensation. The first is capillary condensation inside the pore until it is full. This provides an ideal hydrophilic surface for continuing the condensation. As a result, spontaneous condensation and wetting can be achieved at lower vapor pressure than on a smooth surface.

Strong polarization enhancement in asymmetric three-component ferroelectric superlattices

NASA Astrophysics Data System (ADS)

Lee, Ho Nyung; Christen, Hans M.; Chisholm, Matthew F.; Rouleau, Christopher M.; Lowndes, Douglas H.

2005-01-01

Theoretical predictions-motivated by recent advances in epitaxial engineering-indicate a wealth of complex behaviour arising in superlattices of perovskite-type metal oxides. These include the enhancement of polarization by strain and the possibility of asymmetric properties in three-component superlattices. Here we fabricate superlattices consisting of barium titanate (BaTiO3), strontium titanate (SrTiO3) and calcium titanate (CaTiO3) with atomic-scale control by high-pressure pulsed laser deposition on conducting, atomically flat strontium ruthenate (SrRuO3) layers. The strain in BaTiO3 layers is fully maintained as long as the BaTiO3 thickness does not exceed the combined thicknesses of the CaTiO3 and SrTiO3 layers. By preserving full strain and combining heterointerfacial couplings, we find an overall 50% enhancement of the superlattice global polarization with respect to similarly grown pure BaTiO3, despite the fact that half the layers in the superlattice are nominally non-ferroelectric. We further show that even superlattices containing only single-unit-cell layers of BaTiO3 in a paraelectric matrix remain ferroelectric. Our data reveal that the specific interface structure and local asymmetries play an unexpected role in the polarization enhancement.

Optimal gadolinium dose level for magnetic resonance imaging (MRI) contrast enhancement of U87-derived tumors in athymic nude rats for the assessment of photodynamic therapy

NASA Astrophysics Data System (ADS)

Cross, Nathan; Varghai, Davood; Flask, Chris A.; Feyes, Denise K.; Oleinick, Nancy L.; Dean, David

2009-02-01

This study aims to determine the effect of varying gadopentetate dimeglumine (Gd-DTPA) dose on Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI) tracking of brain tumor photodynamic therapy (PDT) outcome. Methods: We injected 2.5 x 105 U87 cells (derived from human malignant glioma) into the brains of six athymic nude rats. After 9, 12, and 13 days DCE-MRI images were acquired on a 9.4 T micro-MRI scanner before and after administration of 100, 150, or 200 μL of Gd-DTPA. Results: Tumor region normalized DCE-MRI scan enhancement at peak was: 1.217 over baseline (0.018 Standard Error [SE]) at the 100 μL dose, 1.339 (0.013 SE) at the 150 μL dose, and 1.287 (0.014 SE) at the 200 μL dose. DCE-MRI peak tumor enhancement at the 150 μL dose was significantly greater than both the 100 μL dose (p < 3.323E-08) and 200 μL dose (p < 0.0007396). Discussion: In this preliminary study, the 150 μL Gd-DTPA dose provided the greatest T1 weighted contrast enhancement, while minimizing negative T2* effects, in DCE-MRI scans of U87-derived tumors. Maximizing Gd-DTPA enhancement in DCE-MRI scans may assist development of a clinically robust (i.e., unambiguous) technique for PDT outcome assessment.

Periodic self-rostering in shift work: correspondence between objective work hours, work hour preferences (personal fit), and work schedule satisfaction.

PubMed

Ingre, Michael; Åkerstedt, Torbjörn; Ekstedt, Mirjam; Kecklund, Göran

2012-07-01

The main objective of the present study was to investigate relative personal fit as the association between rated needs and preferences for work hours, on the one hand, and actual work hours, on the other hand, in three groups (hospital, call-center, and police) working with periodic self-rostering. We also examined the association between personal fit and satisfaction with the work schedule and preference for a fixed and regular shift schedule, respectively. We collected questionnaire data and objective work hour data over 6-12 months from the computerized self-rostering system. The response rate of the questionnaire was 69% at the hospital and call-center and 98% among the police. In total, 29 433 shifts for 285 shift workers were included in the study. Data was analyzed by means of mixed ANOVA, Kendal tau correlations and ordinal (proportional odds) logistic regression. The results show that evening types worked relatively more hours during the evening and night hours compared to morning types as an indication of relative personal fit. Relative personal fit was also found for long shift, short rest, and morning-, evening- and night-shift frequency, but only personal fit related to morning, evening and night-shift was associated with satisfaction with work hours. Reported conflicts at the workplace about work hours and problems with lack of predictability of time for family/leisure activities, was associated with poor satisfaction and a preference for a fixed shift schedule. The present study shows that periodic self-rostering is associated with relative personal fit, in particular with respect to night, evening, and morning work. Personal fit seems to be associated with satisfaction with work hours and may be a moderator of tolerance to shift work exposure.

Deep venous thrombophlebitis: detection with 4-hour versus 24-hour platelet scintigraphy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seabold, J.E.; Conrad, G.R.; Ponto, J.A.

Thirty-one nonheparinized patients with suspected deep venous thrombophlebitis (DVT) underwent contrast venography and indium-111 platelet scintigraphy (In-111 PS). Venography permitted identification of acute DVT in 12 of 31 cases (39%). One additional patient was considered to have acute DVT despite nonconclusive venography results. In-111 PS results were positive at 4 hours in nine of 13 cases (69%) and at 24 hours in 12 of 13 cases (92%). Two of four patients with false-negative 4-hour In-111 PS studies had received warfarin. Thus, the sensitivity of 4-hour In-111 PS in patients not receiving anticoagulants was 82%. Venography results were negative for acutemore » DVT in 18 cases, and 4-hour In-111 PS studies were negative or equivocal in each. In-111 PS is an alternative to contrast venography for detecting acute DVT. If 4-hour In-111 PS results are positive, anticoagulation can be initiated. Delayed images are necessary if the 4-hour images are negative or equivocal.« less

Improving compliance with requirements on junior doctors' hours

PubMed Central

Cass, Hilary D; Smith, Isabel; Unthank, Cheryl; Starling, Colin; Collins, Jane E

2003-01-01

Problem Compliance with UK regulations on junior doctors' working hours cannot be achieved by manipulating rotas that maintain existing tiers of cover and work practices. More radical solutions are needed. Design Audit of change. Setting Paediatric night rota in large children's hospital. Key measures for improvement Compliance with regulations on working hours assessed by diary cards; workload assessed by staff attendance on wards; patient safety assessed through critical incident reports. Strategies for change Development of new staff roles, followed by change from a partial shift rota comprising 11 doctors and one senior nurse, to a full shift night team comprising three middle grade doctors and two senior nurses. Effects of change Compliance with regulations on working hours increased from 33% to 77%. Workload changed little and was well within the capacity of the new night team. The effect on patient care and on medical staff requires further evaluation. Lessons learnt Reduction of junior doctors' working hours requires changes to roles, processes, and practices throughout the organisation. PMID:12896942

Comparison of 3D TOF-MRA and 3D CE-MRA at 3T for imaging of intracranial aneurysms.

PubMed

Cirillo, Mario; Scomazzoni, Francesco; Cirillo, Luigi; Cadioli, Marcello; Simionato, Franco; Iadanza, Antonella; Kirchin, Miles; Righi, Claudio; Anzalone, Nicoletta

2013-12-01

To compare 3T elliptical-centric CE MRA with 3T TOF MRA for the detection and characterization of unruptured intracranial aneurysms (UIAs), by using digital subtracted angiography (DSA) as reference. Twenty-nine patients (12 male, 17 female; mean age: 62 years) with 41 aneurysms (34 saccular, 7 fusiform; mean diameter: 8.85 mm [range 2.0-26.4mm]) were evaluated with MRA at 3T each underwent 3D TOF-MRA examination without contrast and then a 3D contrast-enhanced (CE-MRA) examination with 0.1mmol/kg bodyweight gadobenate dimeglumine and k-space elliptic mapping (Contrast ENhanced Timing Robust Angiography [CENTRA]). Both TOF and CE-MRA images were used to evaluate morphologic features that impact the risk of rupture and the selection of a treatment. Almost half (20/41) of UIAs were located in the internal carotid artery, 7 in the anterior communicating artery, 9 in the middle cerebral artery and 4 in the vertebro-basilar arterial system. All patients also underwent DSA before or after the MR examination. The CE-MRA results were in all cases consistent with the DSA dataset. No differences were noted between 3D TOF-MRA and CE-MRA concerning the detection and location of the 41 aneurysms or visualization of the parental artery. Differences were apparent concerning the visualization of morphologic features, especially for large aneurysms (>13 mm). An irregular sac shape was demonstrated for 21 aneurysms on CE-MRA but only 13/21 aneurysms on 3D TOF-MRA. Likewise, CE-MRA permitted visualization of an aneurismal neck and calculation of the sac/neck ratio for all 34 aneurysms with a neck demonstrated at DSA. Conversely, a neck was visible for only 24/34 aneurysms at 3D TOF-MRA. 3D CE-MRA detected 15 aneurysms with branches originating from the sac and/or neck, whereas branches were recognized in only 12/15 aneurysms at 3D TOF-MRA. For evaluation of intracranial aneurysms at 3T, 3D CE-MRA is superior to 3D TOF-MRA for assessment of sac shape, detection of aneurysmal neck, and

Three-dimensional numerical study of heat transfer enhancement in separated flows

NASA Astrophysics Data System (ADS)

Kumar, Saurav; Vengadesan, S.

2017-11-01

The flow separation appears in a wide range of heat transfer applications and causes poor heat transfer performance. It motivates the study of heat transfer enhancement in laminar as well as turbulent flows over a backward facing step by means of an adiabatic fin mounted on the top wall. Recently, we have studied steady, 2-D numerical simulations in laminar flow and investigated the effect of fin length, location, and orientation. It revealed that the addition of fin causes enhancement of heat transfer and it is very effective to control the flow and thermal behavior. The fin is most effective and sensitive when it is placed exactly above the step. A slight displacement of the fin in upstream of the step causes the complete change of flow and thermal behavior. Based on the obtained 2-D results it is interesting to investigate the side wall effect in three-dimensional simulations. The comparison of two-dimensional and three-dimensional numerical simulations with the available experimental results will be presented. Special attention has to be given to capture unsteadiness in the flow and thermal field.

A quality improvement program to enhance after-hours telephone communication between nurses and physicians in a long-term care facility.

PubMed

Whitson, Heather E; Hastings, S Nicole; Lekan, Deborah A; Sloane, Richard; White, Heidi K; McConnell, Eleanor S

2008-06-01

To determine whether satisfaction of on-site nurses with after-hours telephone communication with off-site physicians improved in one long-term care (LTC) facility after a nurse-oriented intervention. Longitudinal quality improvement study. Extended Care and Rehabilitation Center (ECRC), Durham Veterans Affairs Medical Center. Eighteen registered nurses. Communicating Health Assessments by Telephone (Project CHAT), a program of individualized training sessions and decision support tools to aid LTC nurses with symptom assessment and communication of health information over the telephone. Nurses completed six satisfaction surveys (three surveys in the 3 months before Project CHAT and three surveys in the 3 months after Project CHAT). The nurses' average satisfaction scores increased on several items, including those that assessed whether the nurse was pretty sure what pieces of information the physician was going to ask for (P=.04), felt that the amount of patient information the physician asked for seemed reasonable (P=.03), felt prepared to answer the questions the physician asked (P=.01), and felt that the process of gathering patient information for the physician was easy (P=.01). The percentage of calls that resulted in immediate evaluation by a physician (on-site or in the emergency department) increased from 2.0% in the period before Project CHAT to 8.6% in the period after Project CHAT (P=.01). Nurses' satisfaction with several aspects of after-hours telephone medicine improved after an inexpensive, education-based intervention in one LTC facility. Further research is needed to determine how similar interventions might affect other quality measures, including patient outcomes.

Realtime Hourly Data Table

Science.gov Websites

Tables View the latest hourly text summary CLICK ON UNDERLINED HOUR / SHADED BOX FOR THE LATEST CYCLE 00z Dump Tables View the latest rap text summary CLICK ON UNDERLINED HOUR / SHADED BOX FOR THE LATEST CYCLE Data Dump Tables View the latest model data text summary NAM GFS GDS CLICK ON UNDERLINED HOUR / SHADED

Enhancing work outcome for three persons with traumatic brain injury.

PubMed

Target, P; Wehman, P; Petersen, R; Gorton, S

1998-03-01

A case study approach is used to illustrate how three survivors of severe traumatic brain injury were able to gain and maintain employment with the assistance of a supported employment programme. Emphasis on the different types of accommodations, including the design and implementation of compensatory strategies, is provided for each case. Finally, on overview of steps that can be taken to enhance the use of such strategies on the job is presented.

Enhanced numerical analysis of three-color HgCdTe detectors

NASA Astrophysics Data System (ADS)

Jóźwikowski, K.; Rogalski, A.

2007-04-01

The performance of three-color HgCdTe photovoltaic heterostructure detector is examined theoretically. In comparison with two-color detectors with two back-to-back junctions, three-color structure contain an absorber of intermediate wavelength placed between two junctions, and electronic barriers are used to isolate this intermediate region. This structure was first proposed by British workers. Enhanced original computer programs are applied to solve the system of non-linear continuity equations for carriers and Poisson equations. In addition, the numerical analysis includes the dependence of absorption coefficient on Burstein effect as well as interference effects in heterostructure with metallic electrical contacts. Three detector structures with different localizations of separating barriers are analyzed. The calculations results are presented in the form of spatial distributions of bandgap energy and quantum efficiency. It is shown that the performance of the detector is critically dependent on the barrier's doping level and position in relation to the junction. This behavior is serious disadvantage of the considered three color detector. A small shift of the barrier location and doping level causes serious changes in spectral responsivity.

Adjacent DNA sequences modulate Sox9 transcriptional activation at paired Sox sites in three chondrocyte-specific enhancer elements

PubMed Central

Bridgewater, Laura C.; Walker, Marlan D.; Miller, Gwen C.; Ellison, Trevor A.; Holsinger, L. Daniel; Potter, Jennifer L.; Jackson, Todd L.; Chen, Reuben K.; Winkel, Vicki L.; Zhang, Zhaoping; McKinney, Sandra; de Crombrugghe, Benoit

2003-01-01

Expression of the type XI collagen gene Col11a2 is directed to cartilage by at least three chondrocyte-specific enhancer elements, two in the 5′ region and one in the first intron of the gene. The three enhancers each contain two heptameric sites with homology to the Sox protein-binding consensus sequence. The two sites are separated by 3 or 4 bp and arranged in opposite orientation to each other. Targeted mutational analyses of these three enhancers showed that in the intronic enhancer, as in the other two enhancers, both Sox sites in a pair are essential for enhancer activity. The transcription factor Sox9 binds as a dimer at the paired sites, and the introduction of insertion mutations between the sites demonstrated that physical interactions between the adjacently bound proteins are essential for enhancer activity. Additional mutational analyses demonstrated that although Sox9 binding at the paired Sox sites is necessary for enhancer activity, it alone is not sufficient. Adjacent DNA sequences in each enhancer are also required, and mutation of those sequences can eliminate enhancer activity without preventing Sox9 binding. The data suggest a new model in which adjacently bound proteins affect the DNA bend angle produced by Sox9, which in turn determines whether an active transcriptional enhancer complex is assembled. PMID:12595563

Reusable three-dimensional nanostructured substrates for surface-enhanced Raman scattering.

PubMed

Zhu, Zhendong; Li, Qunqing; Bai, Benfeng; Fan, Shoushan

2014-01-13

To date, fabricating three-dimensional (3D) nanostructured substrate with small nanogap was a laborious challenge by conventional fabrication techniques. In this article, we address a simple, low-cost, large-area, and spatially controllable method to fabricate 3D nanostructures, involving hemisphere, hemiellipsoid, and pyramidal pits based on nanosphere lithography (NSL). These 3D nanostructures were used as surface-enhanced Raman scattering (SERS) substrates of single Rhodamine 6G (R6G) molecule. The average SERS enhancement factor achieved up to 1011. The inevitably negative influence of the adhesion-promoting intermediate layer of Cr or Ti was resolved by using such kind of 3D nanostructures. The nanostructured quartz substrate is a free platform as a SERS substrate and is nondestructive when altering with different metal films and is recyclable, which avoids the laborious and complicated fabricating procedures.

Reusable three-dimensional nanostructured substrates for surface-enhanced Raman scattering

PubMed Central

2014-01-01

To date, fabricating three-dimensional (3D) nanostructured substrate with small nanogap was a laborious challenge by conventional fabrication techniques. In this article, we address a simple, low-cost, large-area, and spatially controllable method to fabricate 3D nanostructures, involving hemisphere, hemiellipsoid, and pyramidal pits based on nanosphere lithography (NSL). These 3D nanostructures were used as surface-enhanced Raman scattering (SERS) substrates of single Rhodamine 6G (R6G) molecule. The average SERS enhancement factor achieved up to 1011. The inevitably negative influence of the adhesion-promoting intermediate layer of Cr or Ti was resolved by using such kind of 3D nanostructures. The nanostructured quartz substrate is a free platform as a SERS substrate and is nondestructive when altering with different metal films and is recyclable, which avoids the laborious and complicated fabricating procedures. PMID:24417892

Virtual Office Hours as Cyberinfrastructure: The Case Study of Instant Messaging

ERIC Educational Resources Information Center

Balayeva, Jeren; Quan-Haase, Anabel

2009-01-01

Although out-of-class communication enhances students' learning experience, students' use of office hours has been limited. As the learning infrastructures of the social sciences and humanities have undergone a range of changes since the diffusion of digital networks, new opportunities emerge to increase out-of-class communication. Hence, it is…

Six and Three-Hourly Meteorological Observations From 223 Former U.S.S.R. Stations (NPD-048)

DOE Data Explorer

Razuvaev, V. N. [All-Russian Research Institute of Hydrometeorological Information, World Data Center, Russia; Apasova, E. B. [All-Russian Research Institute of Hydrometeorological Information, World Data Center, Russia; Martuganov, R. A. [All-Russian Research Institute of Hydrometeorological Information, World Data Center, Russia; Kaiser, D. P. [CDIAC, Oak Ridge National Laboratory; Marino, G. P. [CDIAC, Oak Ridge National Laboratory

2007-11-01

This database contains 6- and 3-hourly meteorological observations from a 223-station network of the former Soviet Union. These data have been made available through cooperation between the two principal climate data centers of the United States and Russia: the National Climatic Data Center (NCDC), in Asheville, North Carolina, and the All-Russian Research Institute of Hydrometeorological Information-World Data Centre (RIHMI-WDC) in Obninsk, Russia. The first version of this database extended through the mid-1980s (ending year dependent upon station) and was made available in 1995 by the Carbon Dioxide Information Analysis Center (CDIAC) as NDP-048. A second version of the database extended the data records through 1990. This third, and current version of the database includes data through 2000 for over half of the stations (mainly for Russia), whereas the remainder of the stations have records extending through various years of the 1990s. Because of the break up of the Soviet Union in 1991, and since RIHMI-WDC is a Russian institution, only Russain stations are generally available through 2000. The non-Russian station records in this database typically extend through 1991. Station records consist of 6- and 3-hourly observations of some 24 meteorological variables including temperature, past and present weather type, precipitation amount, cloud amount and type, sea level pressure, relative humidity, and wind direction and speed. The 6-hourly observations extend from 1936 through 1965; the 3-hourly observations extend from 1966 through 2000 (or through the latest year available). These data have undergone extensive quality assurance checks by RIHMI-WDC, NCDC, and CDIAC. The database represents a wealth of meteorological information for a large and climatologically important portion of the earth's land area, and should prove extremely useful for a wide variety of regional climate change studies.

Analysis Of Navy Hornet Squadron Mishap Costs With Regard To Previously Flown Flight Hours

DTIC Science & Technology

2017-06-01

mishaps occur more frequently in a squadron when flight hours are reduced. This thesis correlates F/A-18 Hornet and Super Hornet squadron previously... correlated to the flight hours flown during the previous three and six months. A linear multivariate model was developed and used to analyze a dataset...hours are reduced. This thesis correlates F/A-18 Hornet and Super Hornet squadron previously flown flight hours with mishap costs. It uses a macro

Extended hours hemodialysis and survival: extended hours, extended evidence?

PubMed

Wald, Ron; Perl, Jeffrey

2016-12-01

Extended-hours hemodialysis presents another approach to the intensification of therapy for maintenance hemodialysis recipients. Smaller studies have demonstrated several potential benefits with this modality, but the impact on patient-centered outcomes has been unclear. We review the largest published study to compare survival among patients who received extended-hours hemodialysis with those who received conventional hemodialysis. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Resident perspectives on duty hour limits and attributes of their learning environment.

PubMed

Philibert, Ingrid

2014-01-01

Residents are stakeholders in the debate surrounding duty hour restrictions, yet few studies have assessed their perspective on their programs' efforts to comply with them. This paper explores learners' perceptions of the attributes of their programs in relation to duty hour compliance, and looks for evidence whether residents view duty hour limits as important to patient safety. A grounded-theory framework was used to analyze learners' comments about programs' compliance with US duty hour limits. Data were collected by ACGME in 2011, using resident consensus lists of program strengths and opportunities for improvement generated prior to accreditation site visits. The data set for this analysis encompasses 112 core and 69 subspecialty programs where these lists mentioned duty hours. The analysis compared programs where residents viewed duty hour compliance as a strength, and programs where it was identified as an opportunity for improvement. Programs in the first group were characterized by clinical efficiency, responsiveness to problems, and a collegial environment that contributed to residents' ability to meet clinical and learning goals within the restrictions. These attributes were lacking in the second group, and residents also commented on onerous duty hour reporting. Learners did not associate duty hour compliance with patient safety, and the few comments in this area centred almost exclusively on the presence or absence of supervision when junior residents first assumed clinical duties. The findings have practical implications for programs that wish to enhance their learning and patient care environment, and suggest areas for future research.

The after breakfast 50-g, 1-hour glucose challenge test in urban Mexican pregnant women: its sensitivity and specificity evaluated by three diagnostic criteria for gestational diabetes mellitus.

PubMed

Espinosa de los Monteros, A; Parra, A; Hidalgo, R; Zambrana, M

1999-04-01

To study the sensitivity and specificity of the 50-g, 1-hour gestational glucose challenge test performed 1 to 2 hours after a non-standardized home breakfast in urban Mexican women by using three different gestational diabetes mellitus diagnostic criteria. Four hundred and forty-five consecutive women of 24-28 weeks gestation were studied. The glucose challenge test was performed in the fed state and a week later a fasting 100-g, 3-hours oral glucose tolerance test was carried out in all of them. Duplicate serum glucose concentrations were determined by a glucose-oxidase method. Sensitivity and specificity were calculated using three different diagnostic criteria for gestational diabetes mellitus. The glucose challenge test performed as indicated, with a cutoff of 7.8 mmol/L, had 88-89% sensitivity and 85-87% specificity when using as diagnostic criteria those proposed by the National Diabetes Data Group and by Carpenter & Coustan; by using Sacks et al. criteria, the values were 82% and 88%, respectively. Considering only pregnant women > or = 25 years of age, the sensitivity increased to 92% with the National Diabetes Data Group criteria. Pregnant women < 25 years of age had significantly lower blood glucose values than those with age > or = 25 years during the glucose tolerance test. For the general group the sensitivity of the glucose challenge test performed 1 to 2 hours after breakfast was similar, based on the National Diabetes Data Group and the Carpenter & Coustan's diagnostic criteria for gestational diabetes mellitus. However, when pregnant women > or = 25 years of age were considered, the use of the former criteria yielded a slightly better sensitivity.

Reconstruction of a Three Hourly 1-km Land Surface Air Temperature Dataset in the Qinghai-Tibet Plateau

NASA Astrophysics Data System (ADS)

Zhou, J.; Ding, L.

2017-12-01

Land surface air temperature (SAT) is an important parameter in the modeling of radiation balance and energy budget of the earth surface. Generally, SAT is measured at ground meteorological stations; then SAT mapping is possible though a spatial interpolation process. The interpolated SAT map relies on the spatial distribution of ground stations, the terrain, and many other factors; thus, it has great uncertainties in regions with complicated terrain. Instead, SAT map can also be obtained through physical modeling of interactions between the land surface and the atmosphere. Such dataset generally has coarse spatial resolution (e.g. coarser than 0.1°) and cannot satisfy the applications at fine scales, e.g. 1 km. This presentation reports the reconstruction of a three hourly 1-km SAT dataset from 2001 to 2015 over the Qinghai-Tibet Plateau. The terrain in the Qinghai-Tibet Plateau, especially in the eastern part, is extremely complicated. Two SAT datasets with good qualities are used in this study. The first one is from the 3h China Meteorological Forcing Dataset with a 0.1° resolution released by the Institute of Tibetan Plateau Research, Chinese Academy of Sciences (Yang et al., 2010); the second one is from the ERA-Interim product with the same temporal resolution and a 0.125° resolution. A statistical approach is developed to downscale the spatial resolution of the derived SAT to 1-km. The elevation and the normalized difference vegetation index (NDVI) are selected as two scaling factors in the downscaling approach. Results demonstrate there is significantly negative correlation between the SAT and elevation in all seasons; there is also significantly negative correlation between the SAT and NDVI in the vegetation growth seasons, while the correlation decreases in the other seasons. Therefore, a temporally dynamic downscaling approach is feasible to enhance the spatial resolution of the SAT. Compared with the SAT at the 0.1° or 0.125°, the reconstructed 1

Impact of states' nurse work hour regulations on overtime practices and work hours among registered nurses.

PubMed

Bae, Sung-Heui; Yoon, Jangho

2014-10-01

To examine the degree to which states' work hour regulations for nurses-policies regarding mandatory overtime and consecutive work hours-decrease mandatory overtime practice and hours of work among registered nurses. We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. © Health Research and Educational Trust.

Sleepiness and recovery in schedule change and the eighty-four hour workweek.

PubMed

Nordin, M; Knutsson, A

2001-12-01

The aims were to evaluate sleepiness and recovery during a schedule change, and during an 84-hours workweek. The control group (16 men) stayed on a six-week schedule, whereas the intervention group (12 men) transferred to a seven-week schedule. Sleepiness was estimated, using the KSS-scale, four times during the first and the third night in the fifth or sixth shift week. Recovery was assessed through four estimations on days one, three and five during the week off. Statistical testing was carried out using repeated measurement ANOVA. Sleepiness at night was affected by night (F = 4.90, p < 0.05) and hour (F = 33.64, p < 0.001) in both groups. The intervention group was sleepier during the first recovery day compared to the control group (F = 4.02, p < 0.05). Analysis of the 84-hour-week showed an effect of night (F = 8.98, p < 0.05) and hour (F = 71.60, p < 0.001) on night work, and day (F = 22.49, p < 0.01) and hour (F = 6.66, p < 0.05) on recovery. Sleepiness was more pronounced on the first recovery day (F = 23.08, p < 0.01). The seven-week schedule showed no effect that differed from that of the control group on sleepiness during the night shift. After the 84-hour workweek the workers recovered in about three days. The new schedules may affect the first recovery day negatively.

International Offshore Students' Perceptions of Virtual Office Hours

ERIC Educational Resources Information Center

Wdowik, Steven; Michael, Kathy

2013-01-01

Purpose: The main aim of this study is to gauge international offshore students' perceptions of virtual office hours (VOH) to consult with their offshore unit coordinators in Australia. Design/methodology/approach: This paper employs a quantitative and qualitative approach where data was sourced from three offshore campuses over a 12-month period…

Enhanced thermoelectric performance in three-dimensional superlattice of topological insulator thin films.

PubMed

Fan, Zheyong; Zheng, Jiansen; Wang, Hui-Qiong; Zheng, Jin-Cheng

2012-10-16

We show that certain three-dimensional (3D) superlattice nanostructure based on Bi2Te3 topological insulator thin films has better thermoelectric performance than two-dimensional (2D) thin films. The 3D superlattice shows a predicted peak value of ZT of approximately 6 for gapped surface states at room temperature and retains a high figure of merit ZT of approximately 2.5 for gapless surface states. In contrast, 2D thin films with gapless surface states show no advantage over bulk Bi2Te3. The enhancement of the thermoelectric performance originates from a combination of the reduction of lattice thermal conductivity by phonon-interface scattering, the high mobility of the topologically protected surface states, the enhancement of Seebeck coefficient, and the reduction of electron thermal conductivity by energy filtering. Our study shows that the nanostructure design of topological insulators provides a possible new way of ZT enhancement.

Enhancing Three-dimensional Movement Control System for Assemblies of Machine-Building Facilities

NASA Astrophysics Data System (ADS)

Kuzyakov, O. N.; Andreeva, M. A.

2018-01-01

Aspects of enhancing three-dimensional movement control system are given in the paper. Such system is to be used while controlling assemblies of machine-building facilities, which is a relevant issue. The base of the system known is three-dimensional movement control device with optical principle of action. The device consists of multi point light emitter and light receiver matrix. The processing of signals is enhanced to increase accuracy of measurements by switching from discrete to analog signals. Light receiver matrix is divided into four areas, and the output value of each light emitter in each matrix area is proportional to its luminance level. Thus, determing output electric signal value of each light emitter in corresponding area leads to determing position of multipoint light emitter and position of object tracked. This is done by using Case-based reasoning method, the precedent in which is described as integral signal value of each matrix area, coordinates of light receivers, which luminance level is high, and decision to be made in this situation.

Impact of States’ Nurse Work Hour Regulations on Overtime Practices and Work Hours among Registered Nurses

PubMed Central

Bae, Sung-Heui; Yoon, Jangho

2014-01-01

Objectives To examine the degree to which states’ work hour regulations for nurses—policies regarding mandatory overtime and consecutive work hours—decrease mandatory overtime practice and hours of work among registered nurses. Methods We analyzed a nationally representative sample of registered nurses from the National Sample Survey of Registered Nurses for years 2004 and 2008. We obtained difference-in-differences estimates of the effect of the nurse work hour policies on the likelihood of working mandatory overtime, working more than 40 hours per week, and working more than 60 hours per week for all staff nurses working in hospitals and nursing homes. Principal Findings The mandatory overtime and consecutive work hour regulations were significantly associated with 3.9 percentage-point decreases in the likelihood of working overtime mandatorily and 11.5 percentage-point decreases in the likelihood of working more than 40 hours per week, respectively. Conclusions State mandatory overtime and consecutive work hour policies are effective in reducing nurse work hours. The consecutive work hour policy appears to be a better regulatory tool for reducing long work hours for nurses. PMID:24779701

Work shift duration: a review comparing eight hour and 12 hour shift systems.

PubMed

Smith, L; Folkard, S; Tucker, P; Macdonald, I

1998-04-01

Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.

Three-dimensional TiO2/Au nanoparticles for plasmon enhanced photocatalysis

NASA Astrophysics Data System (ADS)

Yu, Jianyu; Zhou, Lin; Wang, Yang; Tan, Yingling; Wang, Zhenlin; Zhu, Shining; Zhu, Jia

2018-03-01

The mechanisms of plasmonic nanostructures assisted photocatalytic processes are fundamental and of great importance and interest for decades. Therefore, we adopt a unique porous structure of three-dimensional TiO2/Au nanoparticles to experimentally explore the potential mechanisms of rhodamine B (RhB) based photocatalytic degradation. The highly efficient absorbance measured across the entire ultraviolet and infrared regions shows the broadband light harvesting capability and photocatalytic activity, in which the direct bandgap transition, plasmon sensitization as well as the plasmonic photothermal effect can be beneficial for the photocatalytic reaction. The RhB photocatalytic degradation experiments were conducted systematically under solar irradiance with finely chosen optical filters. Apart from the ultraviolet-driven degradation of TiO2, the plasmon assisted photocatalytic rate of our TiO2/Au structure can be enhanced by >30% as compared to the referenced TiO2 structure (equivalent to 2-4 times promotion with respect to the same quantity of the active material TiO2). Detailed wavelength-dependent analyses have revealed that the visible-driven degradation rate can be enhanced by 10 times because of the plasmon sensitization effect; while infrared-driven degradation rate is enhanced by 4 times as well for the plasmonic photothermal effect, respectively. Our experimental results may provide a clear understanding for the wavelength-dependent plasmon enhanced photocatalytic processes.

Fixed Costs and Hours Constraints

ERIC Educational Resources Information Center

Johnson, William R.

2011-01-01

Hours constraints are typically identified by worker responses to questions asking whether they would prefer a job with more hours and more pay or fewer hours and less pay. Because jobs with different hours but the same rate of pay may be infeasible when there are fixed costs of employment or mandatory overtime premia, the constraint in those…

Enhanced thermoelectric performance in three-dimensional superlattice of topological insulator thin films

PubMed Central

2012-01-01

We show that certain three-dimensional (3D) superlattice nanostructure based on Bi2Te3 topological insulator thin films has better thermoelectric performance than two-dimensional (2D) thin films. The 3D superlattice shows a predicted peak value of ZT of approximately 6 for gapped surface states at room temperature and retains a high figure of merit ZT of approximately 2.5 for gapless surface states. In contrast, 2D thin films with gapless surface states show no advantage over bulk Bi2Te3. The enhancement of the thermoelectric performance originates from a combination of the reduction of lattice thermal conductivity by phonon-interface scattering, the high mobility of the topologically protected surface states, the enhancement of Seebeck coefficient, and the reduction of electron thermal conductivity by energy filtering. Our study shows that the nanostructure design of topological insulators provides a possible new way of ZT enhancement. PMID:23072433

Analysis and comparison of safety models using average daily, average hourly, and microscopic traffic.

PubMed

Wang, Ling; Abdel-Aty, Mohamed; Wang, Xuesong; Yu, Rongjie

2018-02-01

There have been plenty of traffic safety studies based on average daily traffic (ADT), average hourly traffic (AHT), or microscopic traffic at 5 min intervals. Nevertheless, not enough research has compared the performance of these three types of safety studies, and seldom of previous studies have intended to find whether the results of one type of study is transferable to the other two studies. First, this study built three models: a Bayesian Poisson-lognormal model to estimate the daily crash frequency using ADT, a Bayesian Poisson-lognormal model to estimate the hourly crash frequency using AHT, and a Bayesian logistic regression model for the real-time safety analysis using microscopic traffic. The model results showed that the crash contributing factors found by different models were comparable but not the same. Four variables, i.e., the logarithm of volume, the standard deviation of speed, the logarithm of segment length, and the existence of diverge segment, were positively significant in the three models. Additionally, weaving segments experienced higher daily and hourly crash frequencies than merge and basic segments. Then, each of the ADT-based, AHT-based, and real-time models was used to estimate safety conditions at different levels: daily and hourly, meanwhile, the real-time model was also used in 5 min intervals. The results uncovered that the ADT- and AHT-based safety models performed similar in predicting daily and hourly crash frequencies, and the real-time safety model was able to provide hourly crash frequency. Copyright © 2017 Elsevier Ltd. All rights reserved.

Work shift duration: a review comparing eight hour and 12 hour shift systems

PubMed Central

Smith, L.; Folkard, S.; Tucker, P.; Macdonald, I.

1998-01-01

OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.   PMID:9624275

Computer Code Gives Astrophysicists First Full Simulation of Star's Final Hours

ScienceCinema

Andy Nonaka

2017-12-09

The precise conditions inside a white dwarf star in the hours leading up to its explosive end as a Type Ia supernova are one of the mysteries confronting astrophysicists studying these massive stellar explosions. But now, a team of researchers, composed of three applied mathematicians at the U.S. Department of Energy's (DOE) Lawrence Berkeley National Laboratory and two astrophysicists, has created the first full-star simulation of the hours preceding the largest thermonuclear explosions in the universe.

Swimming Three Ice Miles within Fifteen Hours.

PubMed

Stjepanovic, Mirko; Nikolaidis, Pantelis T.; Knechtle, Beat

2017-08-31

Ice Mile swimming (1608 m in water of below 5 °Celsius) is becoming increasingly popular. This case study aimed to identify body core temperature and selected haematological and biochemical parameters before and after repeated Ice Miles. An experienced ice swimmer completed three consecutive Ice Miles within 15 h. Swim times, body core temperatures, and selected urinary and haematological parameters were recorded. Body core temperature reached its maximum between 5, 8 and 15 min after immersion (37.7°C, 38.1°C, and 38.0°C, respectively). The swimmer suffered hypothermia during the first Ice Mile (35.4°C) and body core temperature dropped furthermore to 34.5°C during recovery after the first Ice Mile. He developed a metabolic acidosis in both the first and the last Ice Mile (pH 7.31 and pH 7.34, respectively). We observed hyperkalaemia ([K⁺] > 5.5 mM) after the second Ice Mile (6.9 mM). This was followed by a drop in [K⁺] to3.7 mM after the third Ice Mile. Anticipatory thermogenesis (i.e. an initial increase of body core temperature after immersion in ice cold water) seems to be a physiological response in a trained athlete. The results suggest that swimming in ice-cold water leads to a metabolic acidosis, which the swimmer compensates with hyperventilation (i.e. leading to respiratory alkalosis). The shift of serum [K⁺] could increase the risk of a cardiac arrhythmia. Further studies addressing the physiology and potential risks of Ice Mile swimming are required to substantiate this finding.

The Swedish duty hour enigma.

PubMed

Sundberg, Kristina; Frydén, Hanna; Kihlström, Lars; Nordquist, Jonas

2014-01-01

The Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this "the Swedish duty hour enigma." This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions? A case study was conducted at Karolinska University Hospital, Stockholm--an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research. The residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility. According to Swedish residents' conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice.

The Swedish duty hour enigma

PubMed Central

2014-01-01

Background The Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this “the Swedish duty hour enigma.” This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions? Methods A case study was conducted at Karolinska University Hospital, Stockholm – an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research. Results The residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility. Conclusions According to Swedish residents’ conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice. PMID:25559074

Effects of Resident Work Hour Limitations on Faculty Professional Lives

PubMed Central

Shanafelt, Tait D.; Nathens, Avery B.; Curtis, J. Randall

2008-01-01

Background The Accreditation Council for Graduate Medical Education resident work hour limitations were implemented in July, 2003. Effects on faculty are not well understood. Objective The objective of this study was to determine the effects of the resident work hour limitations on the professional lives of faculty physicians. Design and Participants Survey of faculty physicians at three teaching hospitals associated with university-based internal medicine and surgery residency programs in Seattle, Washington. Physicians who attended on Internal Medicine and Surgery in-patient services during the 10 mo after implementation of work hour limitations were eligible for participation (N = 366); 282 physicians (77%) returned surveys. Measurements Participants were asked about the effects of resident work hour limitations on aspects of their professional lives, including clinical work, research, teaching, and professional satisfaction. Results Most attending physicians reported that, because of work hour limitations, they spent more time on clinical work (52%), felt more responsibility for supervising patient care (65%), and spent less time on research or other academic pursuits (51%) and teaching residents (72%). Reported changes in work content were independently associated with the self-reported probability of leaving academic medicine in the next 3 y. Conclusions Resident work hour limitations have had large effects on the professional lives of faculty. These findings may have important implications for recruiting and retaining faculty at academic medical centers. PMID:18612748

Out of hours ophthalmic surgery: a UK national survey.

PubMed

O'Colmain, U; Wright, M; Bennett, H; MacEwen, C J

2013-03-01

There have been significant changes in the management of out of hours services in ophthalmology recently. The European Working Time Directive (EWTD) and economic measures have anecdotally reduced the availability of staff and facilities outside normal working hours, and there have been various responses to the provision of emergency surgical care. There are disparate attitudes to the optimum management of the emergency surgical case. We sought to establish a nationwide picture of the management of out of hours surgery. A questionnaire was distributed to every consultant ophthalmologist working in the NHS and registered with the Royal College of Ophthalmologists (n=947). Information was requested regarding departmental and personal policies, local facilities, and personal beliefs regarding emergency surgery. A total of 440 (46.5%) questionnaires were returned from 155 units; 18.7% of the units had no out of hours services or no operating facilities. Sixty-three percent of units reported a local policy regarding a time after which patients should not be taken to theatre. For 57%, this time began between 2100 hours and midnight. The most common reasons for not operating after a certain time were 'belief that delay does not significantly affect the outcome' (41.6%), 'delayed access to theatre due to competition with other surgical specialities' (40%), and 'no specialist ophthalmic-theatre nursing input' (32.7%). We report the first nationwide study on out of hours ophthalmological surgical working practices. This demonstrates variation in work patterns. It is significant to patients and ophthalmologists that there should be units in United Kingdom without full local facilities and staff.

Effect of reducing interns' weekly work hours on sleep and attentional failures.

PubMed

Lockley, Steven W; Cronin, John W; Evans, Erin E; Cade, Brian E; Lee, Clark J; Landrigan, Christopher P; Rothschild, Jeffrey M; Katz, Joel T; Lilly, Craig M; Stone, Peter H; Aeschbach, Daniel; Czeisler, Charles A

2004-10-28

Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule. Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours. Copyright 2004 Massachusetts Medical Society.

Long working hours and pregnancy complications: women physicians survey in Japan.

PubMed

Takeuchi, Masumi; Rahman, Mahbubur; Ishiguro, Aya; Nomura, Kyoko

2014-07-23

Previous studies have investigated the impact of occupational risk factors on health outcomes among physicians. However, few studies have investigated the effects on pregnancy outcomes among physicians. In this study, we examined the association between working hours during pregnancy and pregnancy complications among physicians. A cross-sectional study was based on a survey conducted in 2009-2011 of 1,684 alumnae (mean age, 44 ± 8 years) who had graduated from 13 private medical schools in Japan. Data on threatened abortion (TA), preterm birth (PTB), and the number of working hours during the first trimester of pregnancy were obtained via retrospective assessments. Of the 939 physicians with a first pregnancy, 15% experienced TA and 12% experienced PTB. Women who experienced TA (mean weekly working hours: 62 h vs. 50 h, P < .0001) or PTB (62 h vs. 50 h, P < .0001) had longer weekly working hours during the first trimester than did those without pregnancy complications. Compared with women who worked 40 hours or less per week, women who worked 71 hours or more per week had a three-fold higher risk of experiencing TA (95% confidence interval (CI): 1.7-6.0) even after adjusting for medical specialty, maternal age, and current household income. The risk of experiencing PTB was 2.5 times higher (95% CI:1.2-5.2) in women who worked 51-70 hours and 4.2 times higher (95% CI: 1.9-9.2) in women who worked 71 hours or more even after adjusting for specialty, maternal age, and current household income. The trend in the P statistic reflecting the effect of the quartile of hours worked per week (40 hours, 41-50 hours, 51-70 hours, ≥ 71 hours) on TA or PTB was 0.0001 in the multivariate logistic regression models. These results suggest that working long hours during the first trimester of pregnancy is associated with TA and PTB.

Two Hours of Teamwork Training Improves Teamwork in Simulated Cardiopulmonary Arrest Events.

PubMed

Mahramus, Tara L; Penoyer, Daleen A; Waterval, Eugene M E; Sole, Mary L; Bowe, Eileen M

2016-01-01

Teamwork during cardiopulmonary arrest events is important for resuscitation. Teamwork improvement programs are usually lengthy. This study assessed the effectiveness of a 2-hour teamwork training program. A prospective, pretest/posttest, quasi-experimental design assessed the teamwork training program targeted to resident physicians, nurses, and respiratory therapists. Participants took part in a simulated cardiac arrest. After the simulation, participants and trained observers assessed perceptions of teamwork using the Team Emergency Assessment Measure (TEAM) tool (ratings of 0 [low] to 4 [high]). A debriefing and 45 minutes of teamwork education followed. Participants then took part in a second simulated cardiac arrest scenario. Afterward, participants and observers assessed teamwork. Seventy-three team members participated-resident physicians (25%), registered nurses (32%), and respiratory therapists (41%). The physicians had significantly less experience on code teams (P < .001). Baseline teamwork scores were 2.57 to 2.72. Participants' mean (SD) scores on the TEAM tool for the first and second simulations were 3.2 (0.5) and 3.7 (0.4), respectively (P < .001). Observers' mean (SD) TEAM scores for the first and second simulations were 3.0 (0.5) and 3.7 (0.3), respectively (P < .001). Program evaluations by participants were positive. A 2-hour simulation-based teamwork educational intervention resulted in improved perceptions of teamwork behaviors. Participants reported interactions with other disciplines, teamwork behavior education, and debriefing sessions were beneficial for enhancing the program.

Working Hours Mismatch, Macroeconomic Changes, and Mental Well-being in Europe.

PubMed

De Moortel, Deborah; Thévenon, Olivier; De Witte, Hans; Vanroelen, Christophe

2017-06-01

This study explores the association between involuntarily working less or more than the standard workweek and poor mental well-being, and whether this relationship is dependent upon (changing) national-level unemployment and gross domestic product growth rates. Data from the European Social Survey Round 2 (2004-2005) and Round 5 (2010) were analyzed. The sample included 16,224 male and 16,184 female employees. Mental well-being was assessed by the World Health Organization Well-being Index. Three-level linear multilevel modeling was used to account for clustering of employees within research years and countries. Working involuntary long hours was positively associated with poor mental well-being for men. For women, working voluntary long, involuntary long, and involuntary short hours were positively associated with poor mental well-being. The mental well-being of women working voluntary and involuntary long hours was negatively influenced by deteriorating economic conditions. This study suggests women are more vulnerable to the effects of long working hours and working hours mismatch on mental well-being, especially during difficult economic periods.

[Organization of socially acceptable working hours in nursing].

PubMed

Büssing, A; Glaser, J

1994-05-01

Three dimensions in the structure of the working hour system of nurses, rendering them socially acceptable, are becoming important: duration of the working day, the time of day which is being worked and the distribution of working hours. The latter two are of particular importance because flexible shift is becoming the dominant pattern in nursing. Six indicators are discussed as criteria for social acceptability: security of employment which includes access to the labour-market, level of income, health, opportunity for social relationships, social participation, and autonomy. Responses of 297 nurses in one General Hospital taking part in a study, were analysed to examine empirically the concept of 'socially acceptable structure of the working hours'. Ideal and factual patterns are considered first. Secondly aspects of autonomy are considered and the way this depends on time, thirdly the criteria used to define 'social acceptability' are examined for validity. Results show firstly the cross contrast between the hospital's expectation and the nurses' wishes with regard to working hours. Furthermore, inspite of the demand for flexibility, staff have very little choice and there is little sign of joint decision making. Thirdly results show that health, interpersonal and social aspects are of special importance and that, correspondingly, in the view of nurses, financial and practical problems are of lesser importance in their every day life.

Three-dimensional mechanisms of macro-to-micro-scale transport and absorption enhancement by gut villi motions

NASA Astrophysics Data System (ADS)

Wang, Yanxing; Brasseur, James G.

2017-06-01

We evaluate the potential for physiological control of intestinal absorption by the generation of "micromixing layers" (MMLs) induced by coordinated motions of mucosal villi coupled with lumen-scale "macro" eddying motions generated by gut motility. To this end, we apply a three-dimensional (3D) multigrid lattice-Boltzmann model of a lid-driven macroscale cavity flow with microscale fingerlike protuberances at the lower surface. Integrated with a previous 2D study of leaflike villi, we generalize to 3D the 2D mechanisms found there to enhance nutrient absorption by controlled villi motility. In three dimensions, increased lateral spacing within villi within groups that move axially with the macroeddy reduces MML strength and absorptive enhancement relative to two dimensions. However, lateral villi motions create helical 3D particle trajectories that enhance absorption rate to the level of axially moving 2D leaflike villi. The 3D enhancements are associated with interesting fundamental adjustments to 2D micro-macro-motility coordination mechanisms and imply a refined potential for physiological or pharmaceutical control of intestinal absorption.

Stereoscopic Three-Dimensional Neuroanatomy Lectures Enhance Neurosurgical Training: Prospective Comparison with Traditional Teaching.

PubMed

Clark, Anna D; Guilfoyle, Mathew R; Candy, Nicholas G; Budohoski, Karol P; Hofmann, Riikka; Barone, Damiano G; Santarius, Thomas; Kirollos, Ramez W; Trivedi, Rikin A

2017-12-01

Stereoscopic three-dimensional (3D) imaging is increasingly used in the teaching of neuroanatomy and although this is mainly aimed at undergraduate medical students, it has enormous potential for enhancing the training of neurosurgeons. This study aims to assess whether 3D lecturing is an effective method of enhancing the knowledge and confidence of neurosurgeons and how it compares with traditional two-dimensional (2D) lecturing and cadaveric training. Three separate teaching sessions for neurosurgical trainees were organized: 1) 2D course (2D lecture + cadaveric session), 2) 3D lecture alone, and 3) 3D course (3D lecture + cadaveric session). Before and after each session, delegates were asked to complete questionnaires containing questions relating to surgical experience, anatomic knowledge, confidence in performing procedures, and perceived value of 3D, 2D, and cadaveric teaching. Although both 2D and 3D lectures and courses were similarly effective at improving self-rated knowledge and understanding, the 3D lecture and course were associated with significantly greater gains in confidence reported by the delegates for performing a subfrontal approach and sylvian fissure dissection. Stereoscopic 3D lectures provide neurosurgical trainees with greater confidence for performing standard operative approaches and enhances the benefit of subsequent practical experience in developing technical skills in cadaveric dissection. Copyright © 2017. Published by Elsevier Inc.

Resident Physician Duty-hour Requirements: What Does the Public Think?

PubMed

Mercuri, John J; Okey, Neil E; Karia, Raj J; Gross, Richard H; Zuckerman, Joseph D

2016-11-01

To date, no study has reported on the public's opinion of orthopaedic resident duty-hour requirements (DHR). A survey was administered to people in orthopaedic waiting rooms and at three senior centers. Responses were analyzed to evaluate seven domains: knowledge of duty hours; opinions about duty hours; attitudes regarding shift work; patient safety concerns; and the effects of DHRs on continuity of care, on resident training, and on resident professionalism. Respondents felt that fatigue was unsafe and duty hours were beneficial in preventing resident physician fatigue. They supported the idea of residents working in shifts but did not support shifts for attending physicians. However, respondents wanted the same resident to provide continuity of care, even if that violated DHRs. They were supportive of increasing the length of residency to complete training. DHRs were not believed to affect professionalism. Half of the respondents believed that patient opinion should influence policy on this topic. Orthopaedic patients and those likely to require orthopaedic care have inconsistent opinions regarding DHRs, making it potentially difficult to incorporate their preferences into policy.

Working hours and cardiovascular disease in Korean workers: a case-control study.

PubMed

Jeong, Inchul; Rhie, Jeongbae; Kim, Inah; Ryu, Innshil; Jung, Pil Kyun; Park, Yoo Seok; Lim, Yong-Su; Kim, Hyoung-Ryoul; Park, Shin-Goo; Im, Hyoung-June; Lee, Mi-Young; Won, Jong-Uk

2014-01-01

Long working hours can negatively impact a worker's health. The objective of this study was to examine the association between working hours and cardiovascular diseases (CVDs) and compare the degree of risk based on CVD subtypes in Korean workers. This study was a case-control study of the patients registered in the Occupational Cardiovascular Diseases Surveillance 2010. The cases included 348 patients diagnosed with a CVD (123 cerebral infarction, 69 intracerebral hemorrhage, 57 subarachnoid hemorrhage, 99 acute myocardial infarction). Controls were 769 participants with no history of CVDs matched for gender, age, type of occupation, and region. Participants' working hours in the previous week and the average working hours over the past three months were assessed to examine short-term and long-term effects. After adjusting for confounding factors, the odds ratios (ORs) for CVDs in the short-term were 2.66 (95% Confidence interval (CI) :1.78-3.99) for working ≤40 hours, 1.85 (95% CI: 1.22-2.81) for working 50.1-60 hours and 4.23 (95% CI: 2.81-6.39) for working >60 hours compared with the 40.1-50-hour working group. The ORs in the long-term were 2.90 (95% CI: 1.86-4.52) for working ≤40 hours, 1.73 (95% CI: 1.03-2.90) for working 48.1-52 hours and 3.46 (95% CI: 2.38-5.03) for working >52 hours compared with the 40.1-48-hour working group. Long working hours are related to an increased risk of CVDs, and the degree of risk differs based on CVD subtype. Short working hours are also related to an increased risk for CVDs. More prospective studies targeting specific disease risks are required.

Bodyweight loss in predicting neonatal hyperbilirubinemia 72 hours after birth in term newborn infants.

PubMed

Yang, Wen-Chieh; Zhao, Lu-Lu; Li, Yu-Cheng; Chen, Chi-Hua; Chang, Yu-Jun; Fu, Yun-Ching; Wu, Han-Ping

2013-09-21

Severe dehydration is generally believed to be a cause of significant hyperbilirubinemia in newborn babies. This study aimed to analyze the weight loss of healthy term newborn infants at 24, 48 and 72 hours after birth to predict significant hyperbilirubinemia at 72 hours. From January 2007 to December 2008, we conducted this retrospective chart review by measuring total bilirubin (transcutaneous and serum) in 343 healthy, term newborns with a birth body weight of more than 2500 g. We then analyzed the association between body weight loss (BWL) and significant hyperbilirubinemia (total bilirubin more than 15 mg/dL) 72 hours after birth. Receiver operating characteristic curves were used to evaluate the appropriate cutoff BWL percentages on the first three days after birth for the prediction of neonatal hyperbilirubinemia 72 hours after birth. A total of 115 (33.5%) neonates presented with significant hyperbilirubinemia 72 hours after birth, and the percentages of BWL on the first three days were all higher than those in the non-significant hyperbilirubinemia group (all p < 0.05). Breastfeeding was not statistically correlated with significant hyperbilirubinemia (p=0.86). To predict significant hyperbilirubinemia 72 hours after birth, receiver operating characteristic curve analysis showed that the optimum cutoff BWL percentages were 4.48% on the first day of life (sensitivity: 43%, specificity: 70%, positive likelihood ratio [LR+]: 1.43, and negative likelihood ratio [LR-]: 0.82), 7.60% on day 2 (sensitivity: 47%, specificity: 74%, LR+: 1.81, LR-: 0.72), and 8.15% on day 3 (sensitivity: 57%, specificity: 70%, LR+: 1.92, LR-: 0.61) (all p < 0.05). BWL on the first three days after birth may be a predisposing factor for neonatal hyperbilirubinemia, and may also serve as a helpful clinical factor to prevent significant hyperbilirubinemia 72 hours after birth. The optimal BWL cutoff percentages on the first three days after birth presented in this

Long working hours and emotional well-being in korean manufacturing industry employees.

PubMed

Lee, Kyoung-Hye; Kim, Jong-Eun; Kim, Young-Ki; Kang, Dong-Mug; Yun, Myeong-Ja; Park, Shin-Goo; Song, Jae-Seok; Lee, Sang-Gil

2013-12-05

Korea is well known for its long work hours amongst employees. Because workers of the manufacturing industry are constantly exposed to extended work hours, this study was based on how long work hours affect their emotional well-being. The analysis was done using the secondary Korean Working Condition Survey (KWCS). Long work hours were defined to be more than 48 hours, and they were subcategorized into units of 52 hours and 60 hours. Based on the WHO (five) well-being index, emotional state was subdivided into three groups - reference group, low-mood group, and possible depression group- where 28 points and 50 points were division points, and two groups were compared at a time. Association between long work hours and emotional state was analyzed using binary and multinomial logistic regression analysis. Working for extended working hours in the manufacturing industry showed a statistically significant increase (t test p < 0.001) in trend among the possible depression group when compared to the reference group and the low-mood group. When demographical characteristics, health behaviors, socioeconomic state, and work-related characteristics were fixed as controlled variables, as work hours increased the odds ratio of the possible depression group increased compared to the reference group, and especially the odds ratio was 2.73 times increased for work hours between 48-52 and 4.09 times increased for 60 hours or more and both were statistically significant. In comparing the low-mood group and possible depression group, as work hours increased the odds ratio increased to 1.73, 2.39, and 4.16 times, and all work hours from working 48-52 hours, 53-60 hours, and 60 hours or more were statistically significant. Multinomial logistic regression analysis also showed that among the reference group and possible group, the possible depression group was statistically significant as odds ratio increased to 2.94 times in working 53-60 hours, and 4.35 times in 60 hours or more

Application of a biodegradable macromolecular contrast agent in dynamic contrast enhanced MRI for assessing the efficacy of indocyanine green enhanced photothermal cancer therapy

PubMed Central

Feng, Yi; Emerson, Lyska; Jeong, Eun-Kee; Parker, Dennis L.; Lu, Zheng-Rong

2009-01-01

Purpose To investigate the effectiveness of a polydisulfide-based biodegradable macromolecular contrast agent, (Gd-DTPA)-cystamine copolymers (GDCC), in assessing the efficacy of indocyanine green enhanced photothermal cancer therapy using dynamic contrast enhanced MRI (DCE-MRI). Materials and Methods Breast cancer xenografts in mice were injected with indocyanine green and irradiated with laser. The efficacy was assessed using DCE-MRI with GDCC of 40 KDa (GDCC-40) at 4 hours and 7 days after the treatment. The uptake of GDCC-40 by the tumors was fit to a two-compartment model to obtain tumor vascular parameters, including fractional plasma volume (fPV), endothelium transfer coefficient (KPS), and permeability surface area product (PS). Results GDCC-40 resulted in similar tumor vascular parameters at three doses with larger standard deviations at lower doses. The values of fPV, KPS and PS of the treated tumors were smaller (p < 0.05) than those of untreated tumors at 4 hours after the treatment and recovered to pretreatment values (p > 0.05) at 7 days after the treatment. Conclusion DCE-MRI with GDCC-40 is effective for assessing tumor early response to dye-enhanced photothermal therapy and detecting tumor relapse after the treatment. GDCC-40 has a potential to non-invasively monitor anticancer therapies with DCE-MRI. PMID:19629979

Work and family life of childrearing women workers in Japan: comparison of non-regular employees with short working hours, non-regular employees with long working hours, and regular employees.

PubMed

Seto, Masako; Morimoto, Kanehisa; Maruyama, Soichiro

2006-05-01

This study assessed the working and family life characteristics, and the degree of domestic and work strain of female workers with different employment statuses and weekly working hours who are rearing children. Participants were the mothers of preschoolers in a large Japanese city. We classified the women into three groups according to the hours they worked and their employment conditions. The three groups were: non-regular employees working less than 30 h a week (n=136); non-regular employees working 30 h or more per week (n=141); and regular employees working 30 h or more a week (n=184). We compared among the groups the subjective values of work, financial difficulties, childcare and housework burdens, psychological effects, and strains such as work and family strain, work-family conflict, and work dissatisfaction. Regular employees were more likely to report job pressures and inflexible work schedules and to experience more strain related to work and family than non-regular employees. Non-regular employees were more likely to be facing financial difficulties. In particular, non-regular employees working longer hours tended to encounter socioeconomic difficulties and often lacked support from family and friends. Female workers with children may have different social backgrounds and different stressors according to their working hours and work status.

Computer Code Gives Astrophysicists First Full Simulation of Star's Final Hours

ScienceCinema

Applin, Bradford; Almgren, Ann S.; Nonaka, Andy

2018-05-11

The precise conditions inside a white dwarf star in the hours leading up to its explosive end as a Type Ia supernova are one of the mysteries confronting astrophysicists studying these massive stellar explosions. But now, a team of researchers, composed of three applied mathematicians at the U.S. Department of Energy's (DOE) Lawrence Berkeley National Laboratory and two astrophysicists, has created the first full-star simulation of the hours preceding the largest thermonuclear explosions in the universe. http://www.lbl.gov/cs/Archive/news091509.html

A Remarkable Three Hour Thermonuclear Burst from 4U 1820-30

NASA Technical Reports Server (NTRS)

Strohmayer, Tod E.; Brown, Edward F.; White, Nicholas E. (Technical Monitor)

2002-01-01

We present a detailed observational and theoretical study of an approximately three hour long X-ray burst (the "super burst") observed by the Rossi X-ray Timing Explorer (RXTE) from the low mass X-ray binary (LMXB) 4U 1820-30. This is the longest X-ray burst ever observed from this source, and perhaps one of the longest ever observed in great detail from any source. We show that the super burst is thermonuclear in origin. Its peak luminosity of approximately 3.4 x 10(exp 38) ergs s(exp -1) is consistent with the helium Eddington limit for a neutron star at approximately 7 kpc, as well as the peak luminosity of other, shorter, thermonuclear bursts from the same source. The super burst begins in the decaying tail of a more typical (approximately equal to 20 s duration) thermonuclear burst. These shorter, more frequent bursts are well known helium flashes from this source. The level of the accretion driven flux as well as the observed energy release of upwards of 1.5 x 10(exp 42) ergs indicate that helium could not be the energy source for the super burst. We outline the physics relevant to carbon production and burning on helium accreting neutron stars and present calculations of the thermal evolution and stability of a carbon layer and show that this process is the most likely explanation for the super burst. Ignition at the temperatures in the deep carbon "ocean" requires greater than 30 times the mass of carbon inferred from the observed burst energetics unless the He flash is able to trigger a deflagration from a much smaller mass of carbon. We show, however, that for large columns of accreted carbon fuel, a substantial fraction of the energy released in the carbon burning layer is radiated away as neutrinos, and the heat that is conducted from the burning layer in large part flows inward, only to be released on timescales longer than the observed burst. Thus the energy released during the event possibly exceeds that observed in X-rays by more than a factor of

An ACGME Duty Hour Compliant 3-Person Night Float System for Neurological Surgery Residency Programs.

PubMed

Ragel, Brian T; Piedra, Mark; Klimo, Paul; Burchiel, Kim J; Waldo, Heidi; McCartney, Shirley; Selden, Nathan R

2014-06-01

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted the 24+6-hour work schedule and 80-hour workweek, and in 2011, it enhanced work hour and supervision standards. In response, Oregon Health & Science University's (OHSU) neurological surgery residency instituted a 3-person night float system. We analyzed work hour records and operative experience for 1 year before and after night float implementation in a model that shortened a combined introductory research and basic clinical neurosciences rotation from 12 to 6 months. We analyzed residents' perception of the system using a confidential survey. The ACGME 2011 work hour standards were applied to both time periods. AFTER NIGHT FLOAT IMPLEMENTATION, THE NUMBER OF DUTY HOUR VIOLATIONS WAS REDUCED: 28-hour shift (11 versus 235), 8 hours off between shifts (2 versus 20), 80 hours per week (0 versus 17), and total violations (23 versus 275). Violations increased only for the less than 4 days off per 4-week interval rule (10 versus 3). No meaningful difference was seen in the number of operative cases performed per year at any postgraduate year (PGY) training level: PGY-2 (336 versus 351), PGY-3 (394 versus 354), PGY-4 (803 versus 802), PGY-5 (1075 versus 1040), PGY-7 (947 versus 913), and total (3555 versus 3460). Residents rated the new system favorably. To meet 2011 ACGME duty hour standards, the OHSU neurological surgery residency instituted a 3-person night float system. A nearly complete elimination of work hour violations did not affect overall resident operative experience.

After-hours coverage

PubMed Central

Bordman, Risa; Wheler, David; Drummond, Neil; White, David; Crighton, Eric

2005-01-01

OBJECTIVE To determine the prevalence and content of existing or developing policies and guidelines of medical associations and colleges regarding after-hours care by family physicians and general practitioners, especially legal requirements. DESIGN Telephone survey in fall 2002, updated in fall 2004. SETTING Canada. PARTICIPANTS All national and provincial medical associations, Colleges of Family Physicians, Colleges of Physicians and Surgeons, local government offices for the north, and the Canadian Medical Protective Association (CMPA). MAIN OUTCOME MEASURE Response to the question: “Does your agency have a policy in place regarding after-hours health care coverage by FPs/GPs, or are there active discussions regarding such a policy?” RESULTS The College of Physicians and Surgeons of British Columbia was the first to institute a policy, in 1995, requiring physicians to make “specific arrangements” for after-hours care of their patients. The College of Physicians and Surgeons of Alberta adopted a similar policy in 1996 along with a guideline to aid implementation. In 2002, the College of Physicians and Surgeons of Nova Scotia approved a guideline on the Availability of Physicians After Hours. The Saskatchewan Medical Association and the College of Physicians and Surgeons of Saskatchewan formulated a joint policy on medical practice coverage that was released in 2003. Many agencies actively discussed the topic. Provincial and national Colleges of Family Physicians did not have any policies in place. The CMPA does not generate guidelines but released in an information letter in May 2000 a section entitled “Reducing your risk when you’re not available.” CONCLUSION There is increasing interest Canada-wide in setting policy for after-hours care. While provincial Colleges of Physicians and Surgeons have traditionally led the way, a trend toward more collaboration between associations was identified. The effect of policy implementation on physicians�

Meeting the Canadian 24-Hour Movement Guidelines for Children and Youth.

PubMed

Roberts, Karen C; Yao, Xiaoquan; Carson, Valerie; Chaput, Jean-Philippe; Janssen, Ian; Tremblay, Mark S

2017-10-18

The Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep , provide specific recommendations on the amount of time over a typical 24-hour day that children and youth aged 5 to 17 should spend in moderate-to-vigorous physical activity (at least 60 minutes), recreational screen time (no more than 2 hours), and sleep (9 to 11 hours for 5- to 13-year-olds; 8 to 10 hours for 14- to 17-year-olds). Based on combined results of cycles 2 (2009-to-2011) and 3 (2012-to-2013) of the Canadian Health Measures Survey, this analysis examines average daily moderate-to-vigorous physical activity, screen time and sleep duration of 5- to 11-year-olds and 12- to 17-year-olds, and the percentages meeting the 24-Hour Guidelines' recommendations. Findings are presented overall and by age group and sex. Differences in average daily times between groups were tested for statistical significance, as weredifferences between groups in the percentages meeting each recommendation and combination of recommendations. Overall, 17.5% of children and youth met the 24-Hour Guidelines' specific time recommendations. Higher percentages of children than youth (29.6% versus 5.5%) and boys than girls (22.9% versus 11.8%) met the recommendations. About a third (36.3%) met two of the three recommendations. Recommendations for moderate-to-vigorous physical activity, sedentary behaviour, and sleep have higher levels of adherence among children than youth.

Long-Term Priming by Three Small Molecules Is a Promising Strategy for Enhancing Late Endothelial Progenitor Cell Bioactivities.

PubMed

Kim, Yeon-Ju; Ji, Seung Taek; Kim, Da Yeon; Jung, Seok Yun; Kang, Songhwa; Park, Ji Hye; Jang, Woong Bi; Yun, Jisoo; Ha, Jongseong; Lee, Dong Hyung; Kwon, Sang-Mo

2018-06-12

Endothelial progenitor cells (EPCs) and outgrowth endothelial cells (OECs) play a pivotal role in vascular regeneration in ischemic tissues; however, their therapeutic application in clinical settings is limited due to the low quality and quantity of patient-derived circulating EPCs. To solve this problem, we evaluated whether three priming small molecules (tauroursodeoxycholic acid, fucoidan, oleuropein) could enhance the angiogenic potential of EPCs. Such enhancement would promote the cellular bioactivities and help to develop functionally improved EPC therapeutics for ischemic diseases by accelerating the priming effect of the defined physiological molecules. We found that preconditioning of each of the three small molecules significantly induced the differentiation potential of CD34+ stem cells into EPC lineage cells. Notably, long-term priming of OECs with the three chemical cocktail (OEC-3C) increased the proliferation potential of EPCs via ERK activation. The migration, invasion, and tube-forming capacities were also significantly enhanced in OEC-3Cs compared with unprimed OECs. Further, the cell survival ratio was dramatically increased in OEC-3Cs against H2O2-induced oxidative stress via the augmented expression of Bcl-2, a prosurvival protein. In conclusion, we identified three small molecules for enhancing the bioactivities of ex vivo-expanded OECs for vascular repair. Long-term 3C priming might be a promising methodology for EPC-based therapy against ischemic diseases.

Analysis of Office/Laboratory Staying Hour and Home Working Hour of Japanese Scientists and Engineers

NASA Astrophysics Data System (ADS)

Ejiri, A.

The second questionnaire for scientists and engineers was carried out in 2007, and status of Japanese scientists and engineers were analyzed and reported. A part of the data was reanalyzed from the viewpoint of work life balance. In particular, office/laboratory staying hour and home working hour were analyzed and dependences on various factors were investigated. It was found that these hours depend on gender, marital status, number of child, employment status and age. In addition, the total hours tend to be kept constant regardless of various factors.

The Perceived Effect of Duty Hour Restrictions on Learning Opportunities in the Intensive Care Unit.

PubMed

Sabri, Nessrine; Sun, Ning-Zi; Cummings, Beth-Ann; Jayaraman, Dev

2015-03-01

Many countries have reduced resident duty hours in an effort to promote patient safety and enhance resident quality of life. There are concerns that reducing duty hours may impact residents' learning opportunities. We (1) evaluated residents' perceptions of their current learning opportunities in a context of reduced duty hours, and (2) explored the perceived change in resident learning opportunities after call length was reduced from 24 continuous hours to 16 hours. We conducted an anonymous, cross-sectional online survey of 240 first-, second-, and third-year residents rotating through 3 McGill University-affiliated intensive care units (ICUs) in Montreal, Quebec, Canada, between July 1, 2012, and June 30, 2013. The survey investigated residents' perceptions of learning opportunities in both the 24-hour and 16-hour systems. Of 240 residents, 168 (70%) completed the survey. Of these residents, 63 (38%) had been exposed to both 24-hour and 16-hour call schedules. The majority of respondents (83%) reported that didactic teaching sessions held by ICU staff physicians were useful. However, of the residents trained in both approaches to overnight call, 44% reported a reduction in learner attendance at didactic teaching sessions, 48% reported a reduction in attendance at midday hospital rounds, and 40% reported a perceived reduction in self-directed reading after the implementation of the new call schedule. A substantial proportion of residents perceived a reduction in the attendance of instructor-directed and self-directed reading after the implementation of a 16-hour call schedule in the ICU.

Two- and 4-hour bright-light exposures differentially effect sleepiness and performance the subsequent night.

PubMed

Thessing, V C; Anch, A M; Muehlbach, M J; Schweitzer, P K; Walsh, J K

1994-03-01

The effect of two durations of bright light upon sleepiness and performance during typical night shift hours was assessed. Thirty normal, healthy young adults participated in a 2-night protocol. On the 1st night subjects were exposed to bright or dim light beginning at 2400 hours, under one of the following three conditions: bright light for 4 hours, dim light for 2 hours followed by bright light for 2 hours or dim light for 4 hours. Following light exposure, subjects remained awake until 0800 hours in a dimly lit room and slept in the laboratory between 0800 and 1600 hours, during which time sleep was estimated with actigraphy. Throughout the 2nd night, the multiple sleep latency test (MSLT), simulated assembly line task (SALT) performance, and subjective sleepiness were recorded. The single, 4-hour exposure to bright light was found to significantly increase MSLT scores and improve SALT performance during the early morning hours on the night following bright-light exposure. No significant effects were noted with a 2-hour exposure. The most likely explanation for these findings is a phase delay in the circadian rhythm of sleepiness-alertness.

75 FR 2467 - Hours of Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... many hours per day and per week would be safe and healthy for a truck driver to work? 4. Would an hours... given scheduling flexibility--the ability to borrow an hour from another driving day once a week, for... No. FMCSA-2004-19608] RIN 2126-AB26 Hours of Service AGENCY: Federal Motor Carrier Safety...

75 FR 9376 - Hours of Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-02

... or adversely impact driver health? 3. How many hours per day and per week would be safe and healthy for a truck driver to work? 4. Would an hours-of-service rule that allows drivers to drive an hour... No. FMCSA-2004-19608] RIN 2126-AB26 Hours of Service AGENCY: Federal Motor Carrier Safety...

Long working hours and health status among employees in Europe: between-country differences.

PubMed

Artazcoz, Lucía; Cortès, Imma; Escribà-Agüir, Vicenta; Bartoll, Xavier; Basart, Helena; Borrell, Carme

2013-07-01

This study aimed to (i) identify family responsibilities associated with moderately long working hours (41-60 hours a week); (ii) examine the relationship between moderately long working hours and three health outcomes; and (iii) analyze whether patterns differ by welfare state regimes. The sample was composed of all employees aged 16-64 years working 30-60 hours a week interviewed in the 2005 European Working Conditions Survey (9288 men and 6295 women). We fitted multiple logistic regression models separated by sex and welfare state regime typologies. Married males were more likely to work long hours in countries with male breadwinner models whereas family responsibilities were related to long working hours among both sexes in countries with dual breadwinner models. The association between long working hours and health was (i) stronger among men in countries with male breadwinner models, primarily in Anglo-Saxon countries [adjusted odds ratio (OR adj) associated with working 51-60 hours of 6.43, 6.04 and 9.60 for work-related poor health status, stress and psychological distress, respectively); (ii) similar among both sexes in Nordic countries; and (iii) stronger among women in Eastern European countries. In the European Union of 25 members (EU-25), working moderately long hours is associated with poor health outcomes with different patterns depending on welfare state regimes. The findings from this study suggest that the family responsibilities and breadwinner models can help explain the relationship between long working hours and health status.

Increased energy density of the home-delivered lunch meal improves 24-hour nutrient intakes in older adults.

PubMed

Silver, Heidi J; Dietrich, Mary S; Castellanos, Victoria H

2008-12-01

As food intake declines with aging, older adults develop energy and nutrient inadequacies. It is important to design practical approaches to combat insufficient dietary intakes to decrease risk for acute and chronic diseases, illness, and injury. Manipulating the energy density of meals has improved energy intakes in institutional settings, but the effects on community-residing older adults who are at nutrition risk have not been investigated. The aim of this study was to determine whether enhancing the energy density of food items regularly served in a home-delivered meals program would increase lunch and 24-hour energy and nutrient intakes. In a randomized crossover counterbalanced design, 45 older adult Older American Act Nutrition Program participants received a regular and enhanced version of a lunch meal on alternate weeks. The types of foods, portion sizes (gram weight), and appearance of the lunch meal was held constant. Consumption of the enhanced meal increased average lunch energy intakes by 86% (P<0.001) and 24-hour energy intakes by 453 kcal (from 1,423.1+/-62.2 to 1,876.2+/-78.3 kcal, P<0.001). The 24-hour intakes of several key macronutrients and micronutrients also improved. These data suggest that altering the energy density of regularly served menu items is an effective strategy to improve dietary intakes of free-living older adults.

Atrial Fibrillation Detection During 24-Hour Ambulatory Blood Pressure Monitoring: Comparison With 24-Hour Electrocardiography.

PubMed

Kollias, Anastasios; Destounis, Antonios; Kalogeropoulos, Petros; Kyriakoulis, Konstantinos G; Ntineri, Angeliki; Stergiou, George S

2018-07-01

This study assessed the diagnostic accuracy of a novel 24-hour ambulatory blood pressure (ABP) monitor (Microlife WatchBP O3 Afib) with implemented algorithm for automated atrial fibrillation (AF) detection during each ABP measurement. One hundred subjects (mean age 70.6±8.2 [SD] years; men 53%; hypertensives 85%; 17 with permanent AF; 4 paroxysmal AF; and 79 non-AF) had simultaneous 24-hour ABP monitoring and 24-hour Holter monitoring. Among a total of 6410 valid ABP readings, 1091 (17%) were taken in ECG AF rhythm. In reading-to-reading ABP analysis, the sensitivity, specificity, and accuracy of ABP monitoring in detecting AF were 93%, 87%, and 88%, respectively. In non-AF subjects, 12.8% of the 24-hour ABP readings indicated false-positive AF, of whom 27% were taken during supraventricular premature beats. There was a strong association between the proportion of false-positive AF readings and that of supraventricular premature beats ( r =0.67; P <0.001). Receiver operating characteristic curve revealed that in paroxysmal AF and non-AF subjects, AF-positive readings at 26% during 24-hour ABP monitoring had 100%/85% sensitivity/specificity (area under the curve 0.91; P <0.01) for detecting paroxysmal AF. These findings suggest that in elderly hypertensives, a novel 24-hour ABP monitor with AF detector has high sensitivity and moderate specificity for AF screening during routine ABP monitoring. Thus, in elderly hypertensives, a 24-hour ABP recording with at least 26% of the readings suggesting AF indicates a high probability for AF diagnosis and should be regarded as an indication for performing 24-hour Holter monitoring. © 2018 American Heart Association, Inc.

The hourly updated US High-Resolution Rapid Refresh (HRRR) storm-scale forecast model

NASA Astrophysics Data System (ADS)

Alexander, Curtis; Dowell, David; Benjamin, Stan; Weygandt, Stephen; Olson, Joseph; Kenyon, Jaymes; Grell, Georg; Smirnova, Tanya; Ladwig, Terra; Brown, John; James, Eric; Hu, Ming

2016-04-01

The 3-km convective-allowing High-Resolution Rapid Refresh (HRRR) is a US NOAA hourly updating weather forecast model that use a specially configured version of the Advanced Research WRF (ARW) model and assimilate many novel and most conventional observation types on an hourly basis using Gridpoint Statistical Interpolation (GSI). Included in this assimilation is a procedure for initializing ongoing precipitation systems from observed radar reflectivity data (and proxy reflectivity from lightning and satellite data), a cloud analysis to initialize stable layer clouds from METAR and satellite observations, and special techniques to enhance retention of surface observation information. The HRRR is run hourly out to 15 forecast hours over a domain covering the entire conterminous United States using initial and boundary conditions from the hourly-cycled 13km Rapid Refresh (RAP, using similar physics and data assimilation) covering North America and a significant part of the Northern Hemisphere. The HRRR is continually developed and refined at NOAA's Earth System Research Laboratory, and an initial version was implemented into the operational NOAA/NCEP production suite in September 2014. Ongoing experimental RAP and HRRR model development throughout 2014 and 2015 has culminated in a set of data assimilation and model enhancements that will be incorporated into the first simultaneous upgrade of both the operational RAP and HRRR that is scheduled for spring 2016 at NCEP. This presentation will discuss the operational RAP and HRRR changes contained in this upgrade. The RAP domain is being expanded to encompass the NAM domain and the forecast lengths of both the RAP and HRRR are being extended. RAP and HRRR assimilation enhancements have focused on (1) extending surface data assimilation to include mesonet observations and improved use of all surface observations through better background estimates of 2-m temperature and dewpoint including projection of 2-m temperature

Cracking the Credit Hour

ERIC Educational Resources Information Center

Laitinen, Amy

2012-01-01

The basic currency of higher education--the credit hour--represents the root of many problems plaguing America's higher education system: the practice of measuring time rather than learning. "Cracking the Credit Hour" traces the history of this time-based unit, from the days of Andrew Carnegie to recent federal efforts to define a credit…

Hourly simulation of a Ground-Coupled Heat Pump system

NASA Astrophysics Data System (ADS)

Naldi, C.; Zanchini, E.

2017-01-01

In this paper, we present a MATLAB code for the hourly simulation of a whole Ground-Coupled Heat Pump (GCHP) system, based on the g-functions previously obtained by Zanchini and Lazzari. The code applies both to on-off heat pumps and to inverter-driven ones. It is employed to analyse the effects of the inverter and of the total length of the Borehole Heat Exchanger (BHE) field on the mean seasonal COP (SCOP) and on the mean seasonal EER (SEER) of a GCHP system designed for a residential house with 6 apartments in Bologna, North-Center Italy, with dominant heating loads. A BHE field with 3 in line boreholes is considered, with length of each BHE either 75 m or 105 m. The results show that the increase of the BHE length yields a SCOP enhancement of about 7%, while the SEER remains nearly unchanged. The replacement of the on-off heat pump by an inverter-driven one yields a SCOP enhancement of about 30% and a SEER enhancement of about 50%. The results demonstrate the importance of employing inverter-driven heat pumps for GCHP systems.

Transient arterial phase respiratory motion-related artifact in MR imaging of the liver: an analysis of four different gadolinium-based contrast agents.

PubMed

Shah, Mansi R; Flusberg, Milana; Paroder, Viktoriya; Rozenblit, Alla M; Chernyak, Victoria

The purpose was to compare hepatic arterial phase (HAP) respiratory motion artifact (RMA) between gadoxetate, gadobutrol, gadopentetate, and gadobenate. Two hundred cases of each gadolinium agent were included. RMA was assigned using 5-point Likert scale (1=no motion, 5=extreme motion) on precontrast and HAP. RMA increase (increase ≥1 on HAP from precontrast) was the outcome in logistic regression. Odds of RMA increase for gadoxetate were 5.5 (P<.001), 3.6 (P=.034), and 9.5 (P<.001) times higher than gadobutrol, gadopentetate, and gadobenate, respectively. Gadolinium volume and dose were not independent predictors of RMA increase. Gadoxetate has increased odds of RMA compared with other gadolinium agents; tight contrast bolus is not a contributor. Copyright © 2016 Elsevier Inc. All rights reserved.

Depth-enhanced three-dimensional-two-dimensional convertible display based on modified integral imaging.

PubMed

Park, Jae-Hyeung; Kim, Hak-Rin; Kim, Yunhee; Kim, Joohwan; Hong, Jisoo; Lee, Sin-Doo; Lee, Byoungho

2004-12-01

A depth-enhanced three-dimensional-two-dimensional convertible display that uses a polymer-dispersed liquid crystal based on the principle of integral imaging is proposed. In the proposed method, a lens array is located behind a transmission-type display panel to form an array of point-light sources, and a polymer-dispersed liquid crystal is electrically controlled to pass or to scatter light coming from these point-light sources. Therefore, three-dimensional-two-dimensional conversion is accomplished electrically without any mechanical movement. Moreover, the nonimaging structure of the proposed method increases the expressible depth range considerably. We explain the method of operation and present experimental results.

12 hour shifts the Nambour Hospital experience.

PubMed

2007-08-01

Union members have a lengthy history of campaigning for fair working hours and conditions. The success of such campaigns has led to the implementation of the eight hour working day and the 40 hour and then 38 hour week as industrial standards. More recently though, calls for greater flexibility in their shift arrangements by nurses at Nambour Hospital have led to a voluntary 12 hour shift being implemented in their Intensive Care Unit. While union members are protective of their hard won gains in achieving reduced working hours through the 8 hour day--ICU nurses at Nambour Hospital say the voluntary 12 hour shift initiative goes a way in addressing their work/life balance issues.

Development of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial Protocol: A National Cluster-Randomized Trial of Resident Duty Hour Policies.

PubMed

Bilimoria, Karl Y; Chung, Jeanette W; Hedges, Larry V; Dahlke, Allison R; Love, Remi; Cohen, Mark E; Tarpley, John; Mellinger, John; Mahvi, David M; Kelz, Rachel R; Ko, Clifford Y; Hoyt, David B; Lewis, Frank H

2016-03-01

estimate the effectiveness of assignment to the intervention arm on patient outcomes, resident education, and resident well-being compared with the usual care arm. Several sensitivity analyses will be performed to determine whether there were differential effects when examining only inpatients, high-risk patients, and emergent/urgent cases. To our knowledge, the FIRST Trial is the first national randomized clinical trial of duty hour policies. Results of this study may be informative to policymakers and other stakeholders engaged in restructuring graduate medical training to enhance the quality of patient care and resident education. clinicaltrials.org Identifier: NCT02050789.

Quasi-periodic 1-hour pulsations in the Saturn's outer magnetosphere

NASA Astrophysics Data System (ADS)

Rusaitis, L.; Khurana, K. K.; Walker, R. J.; Kivelson, M.

2017-12-01

Pulsations in the Saturn's magnetic field and particle fluxes of approximately 1-hour periodicity have been frequently detected in the outer Saturnian magnetosphere by the Cassini spacecraft since 2004. These particle and magnetic field enhancements have been typically observed more often in the dusk sector of the planet, and mid to high latitudes. We investigate nearly 200 of these events as detected by the magnetometer and the Cassini Low-Energy Magnetospheric Measurement System detector (LEMMS) data during the 2004-2015 time frame to characterize these pulsations and suggest their origin. The mechanism needed to produce these observed enhancements needs to permit the acceleration of the energetic electrons to a few MeV and a variable periodicity of enhancements from 40 to 90 minutes. We examine the relation of the oscillations to the periodic power modulations in Saturn kilometric radiation (SKR), using the SKR phase model of Kurth et al. [2007] and Provan et al. [2011]. Finally, we show that similar pulsations can also be observed at 2.5-D MHD simulations of Saturn's magnetosphere.

77 FR 28423 - Final Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

...The EPA is revising the rules for implementing the 1997 8-hour ozone national ambient air quality standards (NAAQS) to address certain limited portions of the rules vacated by the U.S. Court of Appeals for the District of Columbia Circuit. This final rule assigns Clean Air Act (CAA or Act) classifications and associated state planning and control requirements to selected ozone nonattainment areas. This final rule also addresses three vacated provisions of the 1997 8-hour NAAQS--Phase 1 Implementation Rule (April 30, 2004) that provided exemptions from the anti-backsliding requirements relating to nonattainment area New Source Review (NSR), CAA section 185 penalty fees, and contingency measures, as these three requirements applied for the 1-hour standard. This rule also reinstates the 1-hour contingency measures as applicable requirements that must be retained until the area attains the 1997 8- hour ozone standard. Finally, this rule deletes an obsolete provision that stayed the EPA's authority to revoke the 1-hour ozone standard pending the Agency's issuance of a final rule that revises or reinstates its revocation authority and considers and addresses certain other issues. That rule has now been issued.

Can generic paediatric mortality scores calculated 4 hours after admission be used as inclusion criteria for clinical trials?

PubMed Central

Leteurtre, Stéphane; Leclerc, Francis; Wirth, Jessica; Noizet, Odile; Magnenant, Eric; Sadik, Ahmed; Fourier, Catherine; Cremer, Robin

2004-01-01

Introduction Two generic paediatric mortality scoring systems have been validated in the paediatric intensive care unit (PICU). Paediatric RISk of Mortality (PRISM) requires an observation period of 24 hours, and PRISM III measures severity at two time points (at 12 hours and 24 hours) after admission, which represents a limitation for clinical trials that require earlier inclusion. The Paediatric Index of Mortality (PIM) is calculated 1 hour after admission but does not take into account the stabilization period following admission. To avoid these limitations, we chose to conduct assessments 4 hours after PICU admission. The aim of the present study was to validate PRISM, PRISM III and PIM at the time points for which they were developed, and to compare their accuracy in predicting mortality at those times with their accuracy at 4 hours. Methods All children admitted from June 1998 to May 2000 in one tertiary PICU were prospectively included. Data were collected to generate scores and predictions using PRISM, PRISM III and PIM. Results There were 802 consecutive admissions with 80 deaths. For the time points for which the scores were developed, observed and predicted mortality rates were significantly different for the three scores (P < 0.01) whereas all exhibited good discrimination (area under the receiver operating characteristic curve ≥0.83). At 4 hours after admission only the PIM had good calibration (P = 0.44), but all three scores exhibited good discrimination (area under the receiver operating characteristic curve ≥0.82). Conclusions Among the three scores calculated at 4 hours after admission, all had good discriminatory capacity but only the PIM score was well calibrated. Further studies are required before the PIM score at 4 hours can be used as an inclusion criterion in clinical trials. PMID:15312217

Pediatric residents' perspectives on reducing work hours and lengthening residency: a national survey.

PubMed

Gordon, Mary Beth; Sectish, Theodore C; Elliott, Marc N; Klein, David; Landrigan, Christopher P; Bogart, Laura M; Amrock, Stephen; Burke, Ann; Chiang, Vincent W; Schuster, Mark A

2012-07-01

In 2011, the Accreditation Council on Graduate Medical Education increased restrictions on resident duty-hours. Additional changes have been considered, including greater work-hours restrictions and lengthening residency. Program directors tend to oppose further restrictions; however, residents' views are unclear. We sought to determine whether residents support these proposals, and if so why. We surveyed US pediatric residents from a probability sample of 58 residency programs. We used multivariate logistic regression to determine predictors of support for (1) a 56-hour workweek and (2) the addition of 1 year to residency to achieve a 56-hour week. Fifty-seven percent of sampled residents participated (n = 1469). Forty-one percent of respondents supported a 56-hour week, with 28% neutral and 31% opposed. Twenty-three percent of all residents would be willing to lengthen training to reduce hours. The primary predictors of support for a 56-hour week were beliefs that it would improve education (odds ratio [OR] 8.6, P < .001) and quality of life (OR 8.7, P < .001); those who believed patient care would suffer were less likely to support it (OR 0.10, P < .001). Believing in benefits to education without decrement to patient care also predicted support for a 56-hour-week/4-year program. Pediatric residents who support further reductions in work-hours believe reductions have positive effects on patient care, education, and quality of life. Most would not lengthen training to reduce hours, but a minority prefers this schedule. If evidence mounts showing that reducing work-hours benefits education and patient care, pediatric residents' support for the additional year may grow.

Work hours and sleep/wake behavior of Australian hospital doctors.

PubMed

Ferguson, Sally A; Thomas, Matthew J W; Dorrian, Jillian; Jay, Sarah M; Weissenfeld, Adrian; Dawson, Drew

2010-07-01

The objective of the study was to describe the work and sleep patterns of doctors working in Australian hospitals. Specifically, the aim was to examine the influence of work-related factors, such as hospital type, seniority, and specialty on work hours and their impact on sleep. A total of 635 work periods from 78 doctors were analyzed together with associated sleep history. Work and sleep diary information was validated against an objective measure of sleep/wake activity to provide the first comprehensive database linking work and sleep for individual hospital doctors in Australia. Doctors in large and small facilities had fewer days without work than those doctors working in medium-sized facilities. There were no significant differences in the total hours worked across these three categories of seniority; however, mid-career and senior doctors worked more overnight and weekend on-call periods than junior doctors. With respect to sleep, although higher work hours were related to less sleep, short sleeps (< 5 h in the 24 h prior to starting work) were observed at all levels of prior work history (including no work). In this population of Australian hospital doctors, total hours worked do impact sleep, but the pattern of work, together with other nonwork factors are also important mediators.

Comparative evaluation of three heat transfer enhancement strategies in a grooved channel

NASA Astrophysics Data System (ADS)

Herman, C.; Kang, E.

Results of a comparative evaluation of three heat transfer enhancement strategies for forced convection cooling of a parallel plate channel populated with heated blocks, representing electronic components mounted on printed circuit boards, are reported. Heat transfer in the reference geometry, the asymmetrically heated parallel plate channel, is compared with that for the basic grooved channel, and the same geometry enhanced by cylinders and vanes placed above the downstream edge of each heated block. In addition to conventional heat transfer and pressure drop measurements, holographic interferometry combined with high-speed cinematography was used to visualize the unsteady temperature fields in the self-sustained oscillatory flow. The locations of increased heat transfer within one channel periodicity depend on the enhancement technique applied, and were identified by analyzing the unsteady temperature distributions visualized by holographic interferometry. This approach allowed gaining insight into the mechanisms responsible for heat transfer enhancement. Experiments were conducted at moderate flow velocities in the laminar, transitional and turbulent flow regimes. Reynolds numbers were varied in the range Re=200-6500, corresponding to flow velocities from 0.076 to 2.36m/s. Flow oscillations were first observed between Re=1050 and 1320 for the basic grooved channel, and around Re=350 and 450 for the grooved channels equipped with cylinders and vanes, respectively. At Reynolds numbers above the onset of oscillations and in the transitional flow regime, heat transfer rates in the investigated grooved channels exceeded the performance of the reference geometry, the asymmetrically heated parallel plate channel. Heat transfer in the grooved channels enhanced with cylinders and vanes showed an increase by a factor of 1.2-1.8 and 1.5-3.5, respectively, when compared to data obtained for the basic grooved channel; however, the accompanying pressure drop penalties also

Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK

PubMed Central

Carroll, C; Zajicek, J

2004-01-01

Objectives: The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500 000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. Methods: All admissions to the neurology department were analysed prospectively for a three month period (March to May 2002). Results: There were 629 admissions (equating to 2500 per year); data were collected for 93%. 78% of admissions were emergency, 16% elective. The mean number of neurology inpatients at any time was 76, with three (4%) being elective. The main diagnostic categories were stroke (29%), headache syndrome (13%), and epilepsy or seizures (12%). With regard to emergency admissions, 94% were seen by a neurology SHO within 6 hours and 81% by an SpR or consultant within 24 hours. Twenty five percent of emergency admissions were not seen by a consultant. 55% of patients were cared for on non-neurological wards for their entire admission. Median length of stay for stroke patients was 9.5 days, compared with 4 days for other patients. 37% of patients received a neurology follow up appointment. Currently each SpR spends 18 hours per week involved in the care of acute neurology admissions. Conclusion: Meeting the ABN guidelines will require an increase in total neurology bed provision to at least 15 per 100 000 population, with the equivalent of 3 consultant sessions (11 hours/week). Meeting the European Working Time Directive will require a minimum of 8–10 SpRs working a full shift system, which will have a significant impact on training and other aspects of service delivery. PMID:14966156

Provision of 24 hour acute neurology care by neurologists: manpower requirements in the UK.

PubMed

Carroll, C; Zajicek, J

2004-03-01

The ABN has published standards of care for patients with acute neurological disease. Derriford Hospital provides a 24 hour neurology intake service to a population of 500,000 with the equivalent of four consultants, three specialist registrars (SpRs), and four senior house officers (SHOs) with a 37 bed ward. The authors undertook a prospective study of all neurology admissions to enable calculation of manpower necessary to meet the ABN guidelines. All admissions to the neurology department were analysed prospectively for a three month period (March to May 2002). There were 629 admissions (equating to 2500 per year); data were collected for 93%. 78% of admissions were emergency, 16% elective. The mean number of neurology inpatients at any time was 76, with three (4%) being elective. The main diagnostic categories were stroke (29%), headache syndrome (13%), and epilepsy or seizures (12%). With regard to emergency admissions, 94% were seen by a neurology SHO within 6 hours and 81% by an SpR or consultant within 24 hours. Twenty five percent of emergency admissions were not seen by a consultant. 55% of patients were cared for on non-neurological wards for their entire admission. Median length of stay for stroke patients was 9.5 days, compared with 4 days for other patients. 37% of patients received a neurology follow up appointment. Currently each SpR spends 18 hours per week involved in the care of acute neurology admissions. Meeting the ABN guidelines will require an increase in total neurology bed provision to at least 15 per 100,000 population, with the equivalent of 3 consultant sessions (11 hours/week). Meeting the European Working Time Directive will require a minimum of 8-10 SpRs working a full shift system, which will have a significant impact on training and other aspects of service delivery.

Health associations with meeting new 24-hour movement guidelines for Canadian children and youth.

PubMed

Carson, Valerie; Chaput, Jean-Philippe; Janssen, Ian; Tremblay, Mark S

2017-02-01

The study objective was to examine whether meeting the new Canadian 24-hour movement guidelines was associated with health indicators in a representative sample of Canadian children and youth. Cross-sectional findings are based on 4157 (1239 fasting subsample) children and youth aged 6-17years from cycles 1-3 of the Canadian Health Measures Survey (CHMS). Sleep and screen time were subjectively measured while moderate- to vigorous-intensity physical activity (MVPA) was accelerometer-determined. Health indicators in the full sample (body mass index (BMI) z-scores, waist circumference, blood pressure, behavioral strengths and difficulties score (lower=better), and aerobic fitness) and fasting subsample (triglycerides, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, and insulin) were measured. Meeting the overall guidelines was defined as: 9-11 hour/night (5-13years) or 8-10 hour/day (14-17years) of sleep, ≤2 hour/day of screen time, and ≥60 minute/day of MVPA. Compared to meeting all three recommendations, meeting none, one, and two recommendations were associated with a higher BMI z-score, waist circumference, and behavioral strengths and difficulties score and lower aerobic fitness in a gradient pattern (P trend <0.05). Additionally, compared to meeting all three recommendations, meeting none and one recommendation were associated with higher systolic blood pressure and insulin (P trend <0.05). Finally, compared to meeting all three recommendations, meeting no recommendations was associated with higher triglycerides and lower HDL-cholesterol (P trend <0.05). Collectively, meeting more recommendations within the 24-hour movement guidelines was associated with better overall health. Since a small proportion (17%) of this representative sample was meeting the overall guidelines, efforts to promote adoption are needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter?

PubMed

Ala-Mursula, L; Vahtera, J; Kouvonen, A; Väänänen, A; Linna, A; Pentti, J; Kivimäki, M

2006-09-01

To explore the associations of working hours (paid, domestic, commuting, and total) with sickness absence, and to examine whether these associations vary according to the level of employee control over daily working hours. Prospective cohort study among 25 703 full-time public sector employees in 10 towns in Finland. A survey of working hours and control over working hours was carried out in 2000-01. The survey responses were linked with register data on the number of self-certified (< or =3 days) and medically certified (>3 days) sickness absences until the end of 2003. Poisson regression analyses with generalised estimating equations were used to take into account the fact that the employees were nested within work units. Adjustments were made for work and family characteristics and health behaviour. The mean follow-up period was 28.1 (SD 8.1) months. Long domestic and total working hours were associated with higher rates of medically certified sickness absences among both genders. In contrast, long paid working hours were associated with lower rates of subsequent self-certified sickness absences. Long commuting hours were related to increased rates of sickness absence of both types. Low control over daily working hours predicted medically certified sickness absences for both the women and men and self-certified absences for the men. In combinations, high control over working hours reduced the adverse associations of long domestic and total working hours with medically certified absences. Employee control over daily working hours may protect health and help workers successfully combine a full-time job with the demands of domestic work.

24-hour urine copper test

MedlinePlus

... medlineplus.gov/ency/article/003604.htm 24-hour urine copper test To use the sharing features on this page, please enable JavaScript. The 24-hour urine copper test measures the amount of copper in ...

Best Practice for After-Hours Hospice Symptom Management: A Literature Review.

PubMed

Slack, Cheryl

2015-10-01

Medicare-certified hospice home care agencies must provide a 24/7 on-call system to respond to patient and caregiver concerns. How these calls are handled impacts patient and family outcomes and satisfaction. Ideally, hospice nurses provide adequate caregiver education during routine visits to minimize the need for after-hours calls. A literature review provided evidence that hospice nurse education and appropriate telephone support improves symptom management, enhances family support, provides a sense of security, reduces anxiety, and promotes comfort.

Long Working Hours and Cognitive Function

PubMed Central

Singh-Manoux, Archana; Ferrie, Jane E.; Gimeno, David; Marmot, Michael G.; Elovainio, Marko; Jokela, Markus; Vahtera, Jussi; Kivimäki, Mika

2009-01-01

This study examined the association between long working hours and cognitive function in middle age. Data were collected in 1997–1999 (baseline) and 2002–2004 (follow-up) from a prospective study of 2,214 British civil servants who were in full-time employment at baseline and had data on cognitive tests and covariates. A battery of cognitive tests (short-term memory, Alice Heim 4-I, Mill Hill vocabulary, phonemic fluency, and semantic fluency) were measured at baseline and at follow-up. Compared with working 40 hours per week at most, working more than 55 hours per week was associated with lower scores in the vocabulary test at both baseline and follow-up. Long working hours also predicted decline in performance on the reasoning test (Alice Heim 4-I). Similar results were obtained by using working hours as a continuous variable; the associations between working hours and cognitive function were robust to adjustments for several potential confounding factors including age, sex, marital status, education, occupation, income, physical diseases, psychosocial factors, sleep disturbances, and health risk behaviors. This study shows that long working hours may have a negative effect on cognitive performance in middle age. PMID:19126590

Heart Rate Variability in Obstetricians Working 14-Hour Call Compared to 24-Hour Call in Labour and Delivery.

PubMed

Thurman, Robin H; Yoon, Eugene; Murphy, Kellie E; Windrim, Rory; Farrugia, M Michéle

2017-12-01

Obstetricians have stressful and demanding jobs that may impact their health. A physiological measurement of cardiac function which varies with stress is heart rate variability (HRV). By measuring the cyclic variations in R-R intervals, or beat-to-beat differences, HRV reflects the continuous interplay of the controlling forces in the autonomic nervous system. Studies have shown HRV to be reduced during periods of work-induced stress, including 24-hour shifts. Our study aimed to determine if there was a correlation between length of shift worked and HRV. We hypothesised that working for a full 24-hour period is more stressful than a shorter, nighttime-only period, and HRV analyses were used to measure this objectively. Obstetricians wore an HRV monitor for 24 hours during both a regular day followed by a 14-hour night shift and a continuous 24-hour shift in labour and delivery. The 24-hour samples were analysed using standard HRV measurements. HRV measurements obtained from each physician were then compared according to shift type, with each physician acting as his or her own comparator. There were no statistically significant differences in the most important measures of HRV between 24-hour periods which included either a 14-hour overnight shift or a continuous 24-hour shift on labour and delivery. We found no significant differences in key HRV measures in obstetricians working 14 hours versus 24 hours in labour and delivery. An anecdotal increase in physician awareness of his/her own health related to working conditions was noted during the study. Future studies should attempt to control for the hours prior to a night shift, assess associated endocrine variations, and focus upon HRV in the post-shift period. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Working hours and health in nurses of public hospitals according to gender

PubMed Central

Fernandes, Juliana da Costa; Portela, Luciana Fernandes; Griep, Rosane Härter; Rotenberg, Lúcia

2017-01-01

ABSTRACT OBJECTIVE To assess the association between weekly working hours and self-rated health of nurses in public hospitals in Rio de Janeiro, State of Rio de Janeiro, Brazil. METHODS A total of 3,229 nurses (82.7% of the eligible group) participated in this cross-sectional study, carried out between April 2010 and December 2011. The collection instrument consisted of a self-administered multidimensional questionnaire. The weekly working hours were calculated from a recall of the daily hours worked over seven consecutive days; this variable was categorized according to tertiles of distribution for men and women. The outcome of interest, self-rated health, was categorized into three levels: good (very good and good), regular, and poor (poor and very poor). The statistical analysis of the data included bivariate and multivariate analyses, having as reference group those with short working hours (first tertile). All the analyses were stratified by gender and elaborated using the program SPSS. RESULTS Among women, the group corresponding to the longest working week (more than 60.5 hours per week) were more likely to report regular self-rated health, compared with those with shorter working hours, after adjusting for confounding factors (OR = 1.30; 95%CI 1.02–1.67). Among men, those with average working hours (49.5–70.5 hours per week) were more than twice as likely to rate their health as regular (OR = 2.17; 95%CI 1.08–4.35) compared to those with shorter working hours (up to 49.5 hours). There was no significant association between long working hours and poor self-rated health. CONCLUSIONS The results point to the urgent need to promote interventions in the organization of work and appreciation of the nursing profession, in order to reduce the number of multiple jobs and thus contribute to mitigate potential effects on the health of workers and the quality of care in hospitals. PMID:28678910

The 2.8-hour flux modulation of the cataclysmic variable PG1711 + 336

NASA Astrophysics Data System (ADS)

Rosen, S. R.; Branduardi-Raymont, G.; Mason, K. O.; Murdin, P. G.

1989-04-01

High-speed optical photometry of the cataclysmic variable PG1711 + 336 is used to confirm the presence of a 2.8-hour periodic modulation in the light curve of the star and to improve its ephemeris. Pronounced flickering on time-scales between 10 and 20 minutes is found superimposed on the 2.8-hour variation. Three hours of time-resolved spectroscopy of PG1711 + 336 yields evidence for a radial velocity variation in the He II 4686-A emission line at a period consistent with the 2.8-hour photometric modulation. This is in contrast with observations of the H-alpha line reported in the literature which indicate a 15-hour radial velocity modulation period. The issue of which, if either, of these periods is the orbital period of the system remains unresolved. However, an observation made using the Exosat satellite failed to detect X-ray emission from PG1711 + 336 in the 0.1-10 keV range, which argues against this object being a member of the Intermediate Polar class of magnetic cataclysmic variables.

Increase in whole-body peripheral vascular resistance during three hours of air or oxygen prebreathing

NASA Technical Reports Server (NTRS)

Waligora, J. M.; Horrigan, D. J., Jr.; Conkin, J.; Dierlam, J. J.; Stanford, J., Jr.; Riddle, J. R.

1984-01-01

Male and female subjects prebreathed air or 100% oxygen through a mask for 3.0 hours while comfortably reclined. Blood pressures, heart rate, and cardiac output were collected before and after the prebreathe. Peripheral vascular resistance (PVR) was calculated from these parameters and increased by 29% during oxygen prebreathing and 15% during air prebreathing. The oxygen contributed substantially to the increase in PVR. Diastolic blood pressure increased by 18% during the oxygen prebreathe while stystolic blood pressure showed no change under either procedure. The increase in PVR during air prebreathing was attributed to procedural stress common to air and oxygen prebreathing.

Absence from work in relation to length and distribution of shift hours

PubMed Central

Walker, J.; Mare, Gwynneth de la

1971-01-01

Walker, J., and de la Mare, Gwynneth (1971). Brit. J. industr. Med., 28, 36-44. Absence from work in relation to length and distribution of shift hours. A long period on night shift or even permanent night work has sometimes been suggested for those on continuous shift work to allow circadian rhythms to adapt. As the weekly hours of work have been reduced there is some evidence that a permanent night shift is practical, and about 12% of all shift workers are on this type of work. However, the case for permanent night shift must be established on grounds of both effectiveness and acceptability. The present study compares the absence experience, including sickness absence, of permanent day workers and permanent night workers matched for age and job in three undertakings which contained a range of working conditions. The question of the relationship between absence from work and total hours worked including overtime has been reopened, and in comparing absence from work according to the type of shift the total hours worked must also be taken into account. The relationship between the average hours when a man was at work and the amount of absence was tested. The men in the three undertakings worked a wide range of voluntary overtime. The results showed that in two undertakings long-term absence, mainly sickness absence, was higher on the night shift than on the day shift; and, in the third, absence was about the same on the two shifts. As the work load was less in the two undertakings with a higher absence on the night shift it was suggested that selective factors were operating. These results may be contrasted to studies which have compared the absence of rotating shift workers and day workers. In all three undertakings there was a tendency for absence to be less among high overtime workers than among those who worked medium or small amounts of overtime, although the trends were not consistent. There was no evidence at all that high overtime and absence from work were

Duty Hour Reporting: Conflicting Values in Professionalism.

PubMed

Byrne, John M; Loo, Lawrence K; Giang, Dan W

2015-09-01

Duty hour limits challenge professional values, sometimes forcing residents to choose between patient care and regulatory compliance. This may affect truthfulness in duty hour reporting. We assessed residents' reasons for falsifying duty hour reports. We surveyed residents in 1 sponsoring institution to explore the reasons for noncompliance, frequency of violations, falsification of reports, and the residents' awareness of the option to extend hours to care for a single patient. The analysis used descriptive statistics. Linear regression was used to explore falsification of duty hour reports by year of training. The response rate was 88% (572 of 650). Primary reasons for duty hour violations were number of patients (19%) and individual patient acuity/complexity (19%). Junior residents were significantly more likely to falsify duty hours (R = -0.966). Of 124 residents who acknowledged falsification, 51 (41%) identified the primary reason as concern that the program will be in jeopardy of violating the Accreditation Council for Graduate Medical Education (ACGME) duty hour limits followed by fear of punishment (34, 27%). This accounted for more than two-thirds of the primary reasons for falsification. Residents' falsification of duty hour data appears to be motivated by concerns about adverse actions from the ACGME, and fear they might be punished. To foster professionalism, we recommend that sponsoring institutions educate residents about professionalism in duty hour reporting. The ACGME should also convey the message that duty hour limits be applied in a no-blame systems-based approach, and allow junior residents to extend duty hours for the care of individual patients.

Application of XGBoost algorithm in hourly PM2.5 concentration prediction

NASA Astrophysics Data System (ADS)

Pan, Bingyue

2018-02-01

In view of prediction techniques of hourly PM2.5 concentration in China, this paper applied the XGBoost(Extreme Gradient Boosting) algorithm to predict hourly PM2.5 concentration. The monitoring data of air quality in Tianjin city was analyzed by using XGBoost algorithm. The prediction performance of the XGBoost method is evaluated by comparing observed and predicted PM2.5 concentration using three measures of forecast accuracy. The XGBoost method is also compared with the random forest algorithm, multiple linear regression, decision tree regression and support vector machines for regression models using computational results. The results demonstrate that the XGBoost algorithm outperforms other data mining methods.

Long hours in paid and domestic work and subsequent sickness absence: does control over daily working hours matter?

PubMed Central

Ala‐Mursula, L; Vahtera, J; Kouvonen, A; Väänänen, A; Linna, A; Pentti, J; Kivimäki, M

2006-01-01

Objectives To explore the associations of working hours (paid, domestic, commuting, and total) with sickness absence, and to examine whether these associations vary according to the level of employee control over daily working hours. Methods Prospective cohort study among 25 703 full‐time public sector employees in 10 towns in Finland. A survey of working hours and control over working hours was carried out in 2000–01. The survey responses were linked with register data on the number of self‐certified (⩽3 days) and medically certified (>3 days) sickness absences until the end of 2003. Poisson regression analyses with generalised estimating equations were used to take into account the fact that the employees were nested within work units. Adjustments were made for work and family characteristics and health behaviour. The mean follow‐up period was 28.1 (SD 8.1) months. Results Long domestic and total working hours were associated with higher rates of medically certified sickness absences among both genders. In contrast, long paid working hours were associated with lower rates of subsequent self‐certified sickness absences. Long commuting hours were related to increased rates of sickness absence of both types. Low control over daily working hours predicted medically certified sickness absences for both the women and men and self‐certified absences for the men. In combinations, high control over working hours reduced the adverse associations of long domestic and total working hours with medically certified absences. Conclusions Employee control over daily working hours may protect health and help workers successfully combine a full‐time job with the demands of domestic work. PMID:16728502

Tracking and Explaining Credit-Hour Completion

ERIC Educational Resources Information Center

Kwenda, Maxwell Ndigume

2014-01-01

This study highlights factors associated with changes in earned hours for two cohorts of incoming freshmen during their first year. The objectives of this study are twofold: (a) to derive model(s) regressing the cumulative hours earned and differential hours earned on student demographic, socioeconomic, and academic characteristics; and (b) to…

[Is It Time to Implement a 12-Hour Shift for Nurses in Taiwan?

PubMed

Lin, Yi-Fung; Chang, Shiow-Ru; Wang, Li-Ting

2017-04-01

The twelve-hour shift system, first introduced in the U.S. in 1967 to address a nursing shortage, is now the main system of shift rotation used in numerous countries. In recent years, several hospitals in Taiwan have implemented the 12-hour shift model as one initiative to improve the problems of overtime and high turnover rate among nursing staff. Under this model, nurses work only three to four days per week for 12-hour shifts per day. Despite the increase in numbers of days off, there is growing concern that long shift hours may harm both the safety of patients and the well being of the nurses. The aim of the present article is to explain the application of the 12-hour shift system and to review the potential impacts of this model. Benefits of the 12-hour shift system include improving quality of life for nursing staff, reducing the turnover rate, and increasing job satisfaction. Primary concerns regarding this system include patient safety, nurse fatigue, and the potential negative effects on the sleep quality of nurses. These findings may be referenced by policymakers considering the development / implementation of flexible work schedules in Taiwan. The government must set a ceiling on work hours allowed per week and impose limits on overtime in order to prevent burnout in nursing staff.

10 CFR 26.205 - Work hours.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Managing Fatigue § 26.205 Work hours. (a) Individuals subject to work hour controls. Any individual who performs duties identified in § 26.4(a)(1) through (a)(5... paragraphs (b)(1) through (b)(5) of this section, the calculated work hours must include all time performing...

10 CFR 26.205 - Work hours.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Managing Fatigue § 26.205 Work hours. (a) Individuals subject to work hour controls. Any individual who performs duties identified in § 26.4(a)(1) through (a)(5... paragraphs (b)(1) through (b)(5) of this section, the calculated work hours must include all time performing...

10 CFR 26.205 - Work hours.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Managing Fatigue § 26.205 Work hours. (a) Individuals subject to work hour controls. Any individual who performs duties identified in § 26.4(a)(1) through (a)(5... paragraphs (b)(1) through (b)(5) of this section, the calculated work hours must include all time performing...

[Relationships between walking hours, sleeping hours, meaningfulness of life (ikigai) and mortality in the elderly: prospective cohort study].

PubMed

Seki, N

2001-07-01

The purpose of this study was to determine lifestyle factors in the elderly that affected longevity, using a population-based prospective study. The participants were 440 men and 625 women aged 60 to 74 living in a rural Japanese community. The baseline data such as age, sex, present illness, walking hours per day, sleeping hours per day, alcohol consumption, a history of smoking, and "ikigai" (meaningfulness of life) were collected in July 1990. During 90 months of follow-up from July 1990 to December 31 1997, there were 123 deaths. By Cox's multivariate hazard model adjusted age, sex, and medical histories, walking > or = 1 hour/day (HR = 0.63, 95% CI 0.44-0.91) and an "ikigai" (HR = 0.66, 95% CI 0.44-0.99) lowered the risk for all-cause mortality independently. In regard to hours of sleep, the cumulative survival curve showed that 7 hours/day was the border and sleeping > or = 7 hours/day lowered the risk (HR = 0.49 95% CI 0.33-0.74). Based on the findings in this study, walking > or = 1 hour/day, sleeping > or = 7 hours/day, and "ikigai" are important factors for longevity in the elderly.

Quantification and Assessment of the Chemical Form of Residual Gadolinium in the Brain After Repeated Administration of Gadolinium-Based Contrast Agents: Comparative Study in Rats.

PubMed

Frenzel, Thomas; Apte, Chirag; Jost, Gregor; Schöckel, Laura; Lohrke, Jessica; Pietsch, Hubertus

2017-07-01

Multiple clinical and preclinical studies have reported a signal intensity increase and the presence of gadolinium (Gd) in the brain after repeated administration of Gd-based contrast agents (GBCAs). This bioanalytical study in rat brain tissue was initiated to investigate whether the residual Gd is present as intact GBCA or in other chemical forms by using tissue fractionation and chromatography. Rats were divided randomly in 6 groups of 10 animals each. They received 10 daily injections of 2.5 mmol/kg bodyweight of 1 of 5 different GBCAs: linear GBCAs such as gadodiamide (Omniscan; GE Healthcare), gadopentetate dimeglumine (Gd-DTPA, Magnevist; Bayer), or gadobenate dimeglumine (Multihance; Bracco) and macrocyclic GBCAs such as gadobutrol (Gadovist; Bayer) and gadoterate meglumine (Gd-DOTA, Dotarem; Guerbet) or saline. On days 3 and 24 after the last injection (p.i.), 5 randomly chosen animals of each group were killed by exsanguination, and their brains were excised and divided into cerebrum, pons, and cerebellum. The brain sections were homogenized by sonication in ice-cold buffer at pH 7.4. Soluble and insoluble fractions were separated by centrifugation, and the soluble fractions were further separated by gel permeation chromatography (GPC). The Gd concentration in all tissue fractions and in the GPC eluate was measured by inductively coupled plasma-mass spectrometry. In a recovery control experiment, all GBCAs were spiked to blank brain tissue and more than 94% recovery of Gd in the tissue fractions was demonstrated. Only traces of the administered Gd were found in the rat brain tissue on day 3 and day 24 p.i. In the animals treated with macrocyclic GBCAs, Gd was found only in the soluble brain fraction and was present solely as low molecular weight molecules, most likely the intact GBCA. In the animals treated with linear GBCAs Gd was found to a large extent in the insoluble tissue fraction. The Gd concentration in the soluble fraction was comparable to the

Quantification and Assessment of the Chemical Form of Residual Gadolinium in the Brain After Repeated Administration of Gadolinium-Based Contrast Agents

PubMed Central

Frenzel, Thomas; Apte, Chirag; Jost, Gregor; Schöckel, Laura; Lohrke, Jessica; Pietsch, Hubertus

2017-01-01

Objective Multiple clinical and preclinical studies have reported a signal intensity increase and the presence of gadolinium (Gd) in the brain after repeated administration of Gd-based contrast agents (GBCAs). This bioanalytical study in rat brain tissue was initiated to investigate whether the residual Gd is present as intact GBCA or in other chemical forms by using tissue fractionation and chromatography. Materials and Methods Rats were divided randomly in 6 groups of 10 animals each. They received 10 daily injections of 2.5 mmol/kg bodyweight of 1 of 5 different GBCAs: linear GBCAs such as gadodiamide (Omniscan; GE Healthcare), gadopentetate dimeglumine (Gd-DTPA, Magnevist; Bayer), or gadobenate dimeglumine (Multihance; Bracco) and macrocyclic GBCAs such as gadobutrol (Gadovist; Bayer) and gadoterate meglumine (Gd-DOTA, Dotarem; Guerbet) or saline. On days 3 and 24 after the last injection (p.i.), 5 randomly chosen animals of each group were killed by exsanguination, and their brains were excised and divided into cerebrum, pons, and cerebellum. The brain sections were homogenized by sonication in ice-cold buffer at pH 7.4. Soluble and insoluble fractions were separated by centrifugation, and the soluble fractions were further separated by gel permeation chromatography (GPC). The Gd concentration in all tissue fractions and in the GPC eluate was measured by inductively coupled plasma–mass spectrometry. In a recovery control experiment, all GBCAs were spiked to blank brain tissue and more than 94% recovery of Gd in the tissue fractions was demonstrated. Results Only traces of the administered Gd were found in the rat brain tissue on day 3 and day 24 p.i. In the animals treated with macrocyclic GBCAs, Gd was found only in the soluble brain fraction and was present solely as low molecular weight molecules, most likely the intact GBCA. In the animals treated with linear GBCAs Gd was found to a large extent in the insoluble tissue fraction. The Gd concentration in

Duty Hour Reporting: Conflicting Values in Professionalism

PubMed Central

Byrne, John M.; Loo, Lawrence K.; Giang, Dan W.

2015-01-01

Background Duty hour limits challenge professional values, sometimes forcing residents to choose between patient care and regulatory compliance. This may affect truthfulness in duty hour reporting. Objective We assessed residents' reasons for falsifying duty hour reports. Methods We surveyed residents in 1 sponsoring institution to explore the reasons for noncompliance, frequency of violations, falsification of reports, and the residents' awareness of the option to extend hours to care for a single patient. The analysis used descriptive statistics. Linear regression was used to explore falsification of duty hour reports by year of training. Results The response rate was 88% (572 of 650). Primary reasons for duty hour violations were number of patients (19%) and individual patient acuity/complexity (19%). Junior residents were significantly more likely to falsify duty hours (R = −0.966). Of 124 residents who acknowledged falsification, 51 (41%) identified the primary reason as concern that the program will be in jeopardy of violating the Accreditation Council for Graduate Medical Education (ACGME) duty hour limits followed by fear of punishment (34, 27%). This accounted for more than two-thirds of the primary reasons for falsification. Conclusions Residents' falsification of duty hour data appears to be motivated by concerns about adverse actions from the ACGME, and fear they might be punished. To foster professionalism, we recommend that sponsoring institutions educate residents about professionalism in duty hour reporting. The ACGME should also convey the message that duty hour limits be applied in a no-blame systems-based approach, and allow junior residents to extend duty hours for the care of individual patients. PMID:26457145

10 CFR 26.205 - Work hours.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Work hours. 26.205 Section 26.205 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Managing Fatigue § 26.205 Work hours. (a) Individuals subject to work hour controls. Any individual who performs duties identified in § 26.4(a)(1) through (a)(5...

10 CFR 26.205 - Work hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Work hours. 26.205 Section 26.205 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Managing Fatigue § 26.205 Work hours. (a) Individuals subject to work hour controls. Any individual who performs duties identified in § 26.4(a)(1) through (a)(5...

48 CFR 16.602 - Labor-hour contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Labor-hour contracts. 16... METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Time-and-Materials, Labor-Hour, and Letter Contracts 16.602 Labor-hour contracts. Description. A labor-hour contract is a variation of the time-and-materials...

Extended working hours and health.

PubMed

Raediker, Britta; Janssen, Daniela; Schomann, Carsten; Nachreiner, Friedhelm

2006-01-01

Statistical analyses of the relation between the amount of working hours and impairments to health, based on data from a European survey on working conditions in 2000, clearly reveal that there is a substantial correlation between the number of working hours per week and the frequencies of health complaints. This applies to both musculo-skeletal disorders as well as to psycho-vegetative complaints. The relationship of the duration of the exposure to working conditions to health impairments is moderated by a great number of individual (e.g., age) and situational (e.g., shift-work) variables, showing additive or interactive effects for which selected examples have been presented. In general, however, there is a consistent functional relationship between the number or working hours and their effects on the workers that holds over a great variety of conditions. It is argued that requests for extending working hours should thus be handled with care.

48 CFR 552.236-74 - Working Hours.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Working Hours. 552.236-74... Hours. As prescribed in 536.570-5, insert the following clause: Working Hours (APR 1984) (a) It is contemplated that all work will be performed during the customary working hours of the trades involved unless...

Three-dimensional nanometre localization of nanoparticles to enhance super-resolution microscopy

NASA Astrophysics Data System (ADS)

Bon, Pierre; Bourg, Nicolas; Lécart, Sandrine; Monneret, Serge; Fort, Emmanuel; Wenger, Jérôme; Lévêque-Fort, Sandrine

2015-07-01

Meeting the nanometre resolution promised by super-resolution microscopy techniques (pointillist: PALM, STORM, scanning: STED) requires stabilizing the sample drifts in real time during the whole acquisition process. Metal nanoparticles are excellent probes to track the lateral drifts as they provide crisp and photostable information. However, achieving nanometre axial super-localization is still a major challenge, as diffraction imposes large depths-of-fields. Here we demonstrate fast full three-dimensional nanometre super-localization of gold nanoparticles through simultaneous intensity and phase imaging with a wavefront-sensing camera based on quadriwave lateral shearing interferometry. We show how to combine the intensity and phase information to provide the key to the third axial dimension. Presently, we demonstrate even in the occurrence of large three-dimensional fluctuations of several microns, unprecedented sub-nanometre localization accuracies down to 0.7 nm in lateral and 2.7 nm in axial directions at 50 frames per second. We demonstrate that nanoscale stabilization greatly enhances the image quality and resolution in direct stochastic optical reconstruction microscopy imaging.

Structure of health-enhancing behavior in adolescence: a latent-variable approach.

PubMed

Donovan, J E; Jessor, R; Costa, F M

1993-12-01

The structure of the interrelations among a variety of health-enhancing behaviors was examined using structural equation modeling analyses of questionnaire data from 1,280 middle school students and 2,219 high school students. The health-enhancing behaviors included seat belt use, adequate hours of sleep, attention to healthy diet, adequate exercise, low sedentary behavior, and regular toothbrushing. In the middle school sample, all of the health-enhancing behaviors correlated significantly but modestly with each other, except for sleep with toothbrushing. In the high school sample, all but three of the 15 correlations among the behaviors were significant. The results further show that a single underlying factor can account for the modest correlations among these health-enhancing behaviors in both samples. The generality of the single-factor model was also established for male, female, White, Hispanic, and Black students at each school level. These findings provide some support for the existence of health-related lifestyles in adolescence.

Contrast-enhanced ultrasound evaluation of pancreatic cancer xenografts in nude mice after irradiation with sub-threshold focused ultrasound for tumor ablation

PubMed Central

Wang, Rui; Guo, Qian; Chen, Yi Ni; Hu, Bing; Jiang, Li Xin

2017-01-01

We evaluated the efficacy of contrast-enhanced ultrasound for assessing tumors after irradiation with sub-threshold focused ultrasound (FUS) ablation in pancreatic cancer xenografts in nude mice. Thirty tumor-bearing nude mice were divided into three groups: Group A received sham irradiation, Group B received a moderate-acoustic energy dose (sub-threshold), and Group C received a high-acoustic energy dose. In Group B, B-mode ultrasound (US), color Doppler US, and dynamic contrast-enhanced ultrasound (DCE-US) studies were conducted before and after irradiation. After irradiation, tumor growth was inhibited in Group B, and the tumors shrank in Group C. In Group A, the tumor sizes were unchanged. In Group B, contrast-enhanced ultrasound (CEUS) images showed a rapid rush of contrast agent into and out of tumors before irradiation. After irradiation, CEUS revealed contrast agent perfusion only at the tumor periphery and irregular, un-perfused volumes of contrast agent within the tumors. DCE-US perfusion parameters, including peak intensity (PI) and area under the curve (AUC), had decreased 24 hours after irradiation. PI and AUC were increased 48 hours and 2weeks after irradiation. Time to peak (TP) and sharpness were increased 24 hours after irradiation. TP decreased at 48 hours and 2 weeks after irradiation. CEUS is thus an effective method for early evaluation after irradiation with sub-threshold FUS. PMID:28402267

Extended working hours: Impacts on workers

Treesearch

D. Mitchell; T. Gallagher

2010-01-01

Some logging business owners are trying to manage their equipment assets by increasing the scheduled machine hours. The intent is to maximize the total tons produced by a set of equipment. This practice is referred to as multi-shifting, double-shifting, or extended working hours. One area often overlooked is the impact that working non-traditional hours can have on...

Sonothrombolysis of Intra-Catheter Aged Venous Thrombi Using Microbubble Enhancement and Guided Three Dimensional Ultrasound Pulses

PubMed Central

Kutty, Shelby; Xie, Feng; Gao, Shunji; Drvol, Lucas K; Lof, John; Fletcher, Scott E; Radio, Stanley J; Danford, David A; Hammel, James M; Porter, Thomas R

2010-01-01

Central venous and arterial catheters are a major source of thrombo-embolic disease in children. We hypothesized that guided high mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. An in vitro system simulating intra-catheter thrombi was created and then treated with guided high MI impulses from 3D ultrasound, utilizing low MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles (Perflutren Lipid Microsphere, Definity®, Lantheus). Ten aged thrombi over 24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (Group A), and ten with 3D ultrasound alone (Group B). Mean thrombus age was 28.6 hours (range 26.6–30.3). Groups A exhibited a 55 ± 19 % reduction in venous thrombus size, compared to 31±10 % for Group B (p=0.008). Feasibility testing was performed in 4 pigs, establishing a model to further investigate the efficacy. Sonothrombolysis of aged intra-catheter venous thrombi can be achieved with commercially available microbubbles and guided high MI ultrasound from a diagnostic 3D transducer. PMID:20696549

Changing the formula of residents' work hours in internal medicine: moving from "years in training" to "hours in training".

PubMed

Mansi, Ishak A

2011-03-01

In a recent report, the Institute of Medicine recommended more restrictions on residents' working hours. Several problems exist with a system that places a weekly limit on resident duty hours: (1) it assumes the presence of a linear relationship between hours of work and patient safety; (2) it fails to consider differences in intensity among programs; and (3) it does not address increases in the scientific content of medicine, and it places the burden of enforcing the duty hour limits on the Accreditation Council for Graduate Medical Education. An innovative method of calculating credit hours for graduate medical education would shift the focus from "years of residency" to "hours of residency." For example, internal medicine residents would be requested to spend 8640 hours of total training hours (assuming 60 hours per week for 48 weeks annually) instead of the traditional 3 years. This method of counting training hours is used by other professions, such as the Intern Development Program of the National Council of Architectural Registration Boards. The proposed approach would allow residents and program directors to pace training based on individual capabilities. Standards for resident education should include the average number of patients treated in each setting (inpatient or outpatient). A possible set of "multipliers" based on these parameters, and possibly others such as resident evaluation, is devised to calculate the "final adjusted accredited hours" that count toward graduation. Substituting "years of training" with "hours of training" may resolve many of the concerns with the current residency education model, as well as adapt to the demands of residents' personal lives. It also may allow residents to pace their training according to their capabilities and learning styles, and contribute to reflective learning and better quality education.

Relapses in three patients with Takayasu arteritis under tocilizumab treatment detected by contrast enhanced ultrasound.

PubMed

Czihal, Michael; Lottspeich, Christian; Schröttle, Angelika; Treitl, Karla Maria; Treitl, Marcus; Leipe, Jan; Schulze-Koops, Hendrik; Hoffmann, Ulrich; Dechant, Claudia

2018-02-01

Takayasu arteritis (TA) is a rare large vessel vasculitis, affecting the aorta and its major branches, typically in young women. In this case report, we present three cases of young women of Caucasian descent who experienced relapses while under treatment with the monoclonal humanized antibody to the interleukin 6 receptor, tocilizumab. Active vasculitic lesions of the supraaortic (common carotid and axillary) arteries were detected and characterized via high resolution contrast enhanced ultrasound. Based on these cases, we discuss the potential role of contrast enhanced ultrasound in the diagnosis and follow-up of TA as well as the current data on the efficacy of tocilizumab in the treatment of TA.

Long Hours and Premium Pay, May 1979.

ERIC Educational Resources Information Center

Stamas, George D.

1980-01-01

From 1978-79 incidence of long hours among full-time wage and salary workers dropped for the first time since the 1974-75 recession. Of those who worked long hours, about 43% received premium pay (time and one-half the regular wage for hours worked in excess of forty per week). Employers used overtime hours to cope with disequilibrium phenomena…

Comparison of the CME-associated shock arrival times at the earth using the WSA-ENLIL model with three cone models

NASA Astrophysics Data System (ADS)

Jang, S.; Moon, Y.; Na, H.

2012-12-01

We have made a comparison of CME-associated shock arrival times at the earth based on the WSA-ENLIL model with three cone models using 29 halo CMEs from 2001 to 2002. These halo CMEs have cone model parameters from Michalek et al. (2007) as well as their associated interplanetary (IP) shocks. For this study we consider three different cone models (an asymmetric cone model, an ice-cream cone model and an elliptical cone model) to determine CME cone parameters (radial velocity, angular width and source location), which are used for input parameters of the WSA-ENLIL model. The mean absolute error (MAE) of the arrival times for the elliptical cone model is 10 hours, which is about 2 hours smaller than those of the other models. However, this value is still larger than that (8.7 hours) of an empirical model by Kim et al. (2007). We are investigating several possibilities on relatively large errors of the WSA-ENLIL cone model, which may be caused by CME-CME interaction, background solar wind speed, and/or CME density enhancement.

A study examining the impact of 12-hour shifts on critical care staff.

PubMed

Richardson, Annette; Turnock, Christopher; Harris, Liz; Finley, Alison; Carson, Sarah

2007-11-01

Twelve-hour shifts contribute to flexible patterns of work, but the effects on delivery of direct care and staff fatigue are important topics for deeper examination. To examine the impact and implications of 12-hour shifts on critical care staff. A staged dual approach using two focus groups (n = 16) and questionnaires (n = 147) with critical care staff from three critical care units. Positive effects were found with planning and prioritizing care, improved relationships with patients/relatives, good-quality time off work and ease of travelling to work. Less favourable effects were with caring for patients in isolation cubicles and the impact on staff motivation and tiredness. Acceptable patterns of work were suggested for 'numbers of consecutive shifts' and 'rest periods between shifts'. Most participants believed 12-hour shifts should continue. The challenge is to ensure existing systems and practices develop to improve on the less positive effects of working 12-hour shifts. This study provides nurse managers with important and relevant staff views on the impact of working 12-hour shifts. In particular to those working within a critical care environment and suggests the challenge is to ensure existing systems and practices develop to improve on the less encouraging effects of working 12-hour shifts. It adds an understanding of the senior nurse's view on the positive and negative effects of managing and organizing staff off duty to safely run a department with 12-hour shifts.

16 CFR 0.3 - Hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Hours. 0.3 Section 0.3 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.3 Hours. Principal and field offices are open on each business day from 8:30 a.m. to 5 p.m. ...

Muscle damage and repeated bout effect induced by enhanced eccentric squats.

PubMed

Coratella, Giuseppe; Chemello, Alessandro; Schena, Federico

2016-12-01

Muscle damage and repeated bout effect have been studied after pure eccentric-only exercise. The aim of this study was to evaluate muscle damage and repeated bout effect induced by enhanced eccentric squat exercise using flywheel device. Thirteen healthy males volunteered for this study. Creatine kinase blood activity (CK), quadriceps isometric peak torque and muscle soreness were used as markers of muscle damage. The dependent parameters were measured at baseline, immediately after and each day up to 96 hours after the exercise session. The intervention consisted of 100 repetitions of enhanced eccentric squat exercise using flywheel device. The same protocol was repeated after 4 weeks. After the first bout, CK and muscle soreness were significantly greater (P<0.05) than baseline respectively up to 72 and 96 hours. Isometric peak torque was significantly lower (P<0.05) up to 72 hours. After the second bout, CK showed no significant increase (P>0.05), while isometric peak torque and muscle soreness returned to values similar to baseline after respectively 48 and 72 hours. All muscle damage markers were significantly lower after second compared to first bout. The enhanced eccentric exercise induced symptoms of muscle damage up to 96 hours. However, it provided muscle protection after the second bout, performed four weeks later. Although it was not eccentric-only exercise, the enhancement of eccentric phase provided muscle protection.

76 FR 6056 - Additional Air Quality Designations for the 2006 24-Hour Fine Particle National Ambient Air...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-03

...-9261-3] RIN 2060-AQ30 Additional Air Quality Designations for the 2006 24-Hour Fine Particle National..., and Decisions Related to the 1997 Air Quality Designations and Classifications for the Annual Fine... nationwide for all but three areas for the 2006 24-hour fine particle (PM 2.5 ) National Ambient Air Quality...

Visiting hours policies in New England intensive care units: strategies for improvement.

PubMed

Lee, Melissa D; Friedenberg, Allison S; Mukpo, David H; Conray, Kayla; Palmisciano, Amy; Levy, Mitchell M

2007-02-01

Dying patients often feel isolated and alone, and restricted visiting hours in the intensive care unit (ICU) has been shown to increase anxiety and dissatisfaction in both critically ill patients and their families. Unrestricted visiting has been identified as a top-ten need by families of patients in the ICU. Because emotional distress experienced by patients and families may persist well beyond the ICU stay, an open visiting policy, by meeting the needs of patients and families, may improve the quality of end-of-life care in the ICU. This two-part study included a survey to determine the visiting hours policies of New England-area hospital ICUs, and nursing focus groups to describe challenges and barriers that nursing staff working in an open ICU have experienced and to provide solutions that will facilitate implementation of an open visiting hours policy. Two-part study: survey and focus groups. ICUs in New England and one medical ICU in a tertiary care hospital. Registered nurses employed in medical ICUs. Adult ICUs in the six New England states were located using a library listing of all regional hospitals. A telephone questionnaire interview was used to ascertain visiting hours policies in each ICU. Six focus-group sessions were conducted with nursing staff who work in an urban, northeastern ICU with 8 yrs of experience with an unrestricted visiting hours policy. A total of 171 hospitals completed the questionnaire (96%). From all ICUs surveyed, 62 (32%) had unrestricted, open visiting hours. Out of these, 57 (92%) were medical ICUs or mixed medical/surgical ICUs. Nursing staff identified three major areas of concern with an open visiting hours policy: space, conflict, and burden. Strategies for resolution that are either employed or advocated by nursing staff are described. The majority of ICUs in New England have restricted visiting hours. Only one third of ICUs have open visiting policies. Nursing concerns with an unrestricted ICU were identified and

48 CFR 1316.602 - Labor-hour contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Labor-hour contracts. 1316... AND CONTRACT TYPES TYPES OF CONTRACTS Time-and-Materials, Labor-Hour, and Letter Contracts 1316.602 Labor-hour contracts. ...

Hourly Updated GNSS Orbit and Clock

NASA Astrophysics Data System (ADS)

Song, S.; Xue, J.

2016-12-01

With the development of the performance of GNSS, the hourly updated orbit and clock of GNSS are paid much more attention and used by more and more users because of the timeliness and high accuracy. The hourly GNSS orbit and clock are produced routinely in Shanghai Analysis Center(AC) of the International GNSS Monitoring and Assessment Service (iGMAS).In this article, the accuracy of hourly and 6-hourly updated ultra-rapid GPS,GLONASS,GALILEO,BDS orbit and clock (SHU1 and SHU6) are analyzed relative to the final production in detail. The analysis show that, in calculation session, there's no much difference between the mean SHU1 and SHU6 RMS and STD for GNSS orbit and clock. However, for BDS clock in prediction session, the RMS and STD of BDS SHU1 are 2.6ns and 0.5ns respectively, the RMS of BDS SHU6 increase from 2.7ns to 4.5ns from the 1st to the 6th hour prediction session, but there's no much changes of STD. For GPS clock in prediction session, the RMS and STD of GPS SHU1 is quite stable with 0.5ns and 0.2ns.The RMS of GPS SHU6 clock increase from 0.6ns to 1.0ns from the 1st to the 6th hour, but STD is stable at about 0.2ns.For the orbit in calculate session, the RMS of BDS SHU1 is a little less than that of SHU6,the RMS of GPS SHU1 and SHU6 orbit are approximately at the same level. In prediction session, the RMS of IGSO/MEO for BDS SHU1 is relative stable, but the RMS of SHU6 1st-6th hour prediction session increase from about 26.5cm to 32.7cm. The RMS of GPS SHU1 orbit's prediction session is about 3.4cm,but which increase from 3.3cm to 4.3cm for GPS SHU6 1st-6th hour prediction session.The comparison of GLONASS and GALILEO orbit and clock also will be described.The results show that the hourly update is more important for BDS at this stage.Moreover,some problems appearing in satellites and stations can be found earlier by 1 hourly updated frequency.

Measuring the attitudes and impact of the eighty-hour workweek rules on orthopaedic surgery residents.

PubMed

Kusuma, Sharat K; Mehta, Samir; Sirkin, Michael; Yates, Adolph J; Miclau, Theodore; Templeton, Kimberly J; Friedlaender, Gary E

2007-03-01

The literature on graduate medical education contains anecdotal reports of some effects of the new eighty-hour workweek on the attitudes and performance of residents. However, there are relatively few studies detailing the attitudes of large numbers of residents in a particular surgical specialty toward the new requirements. Between July and November 2004, a survey created by the Academic Advocacy Committee of the American Academy of Orthopaedic Surgeons was distributed by mail, fax, and e-mail to a total of 4207 orthopaedic residents at the postgraduate year-1 through year-6 levels of training. The survey responses were tabulated electronically, and the results were recorded. The survey response rate was 13.2% (554 residents). Sixty-eight percent (337) of the 495 respondents whose postgraduate-year level was known were at the postgraduate year-4 level or higher. Attitudes concerning the duty rules were mixed. Twenty-three percent of the 554 respondents thought that eighty hours constituted an appropriate number of duty hours per week; 41% believed that eighty hours were too many, and 34% thought that eighty hours were not sufficient. Thirty-three percent of the respondents had worked greater than eighty hours during at least a single one-week period since the new rules were implemented; this occurred more commonly among the postgraduate year-3 and more junior residents. Orthopaedic trauma residents had the most difficulty adhering to the new duty-hour restrictions. Eighty-two percent of the respondents indicated that their residency programs have been forced to make changes to their call schedules or to hire ancillary staff to address the rules. The use of physician assistants, night-float systems, and so-called home-call assignments were the most common strategies used to achieve compliance. Resident attitudes toward the work rules are mixed. The rules have forced residency programs to restructure. Junior residents have more favorable attitudes toward the new

Breaking the Long Hours Culture.

ERIC Educational Resources Information Center

Kodz, J.; Kersley, B.; Strebler, M. T.; O'Regan, S.

Case studies of 12 leading British employers were driven by employers' interest in issues related to working long hours in light of introduction of the Working Time Directive, a European Community initiative enacted into British law that sets limits on working hours per week. Data showed over one-fourth of full-time employees worked over 48 hours…

Urinary tract infection (UTI) multi-bacteria multi-antibiotic testing using surface enhanced Raman spectroscopy (SERS)

NASA Astrophysics Data System (ADS)

Hadjigeorgiou, Katerina; Kastanos, Evdokia; Pitris, Costas

2013-02-01

Antibiotic resistance is a major health care problem mostly caused by the inappropriate use of antibiotics. At the root of the problem lies the current method for determination of bacterial susceptibility to antibiotics which requires overnight cultures. Physicians suspecting an infection usually prescribe an antibiotic without waiting for the results. This practice aggravates the problem of bacterial resistance. In this work, a rapid method of diagnosis and antibiogram for a bacterial infection was developed using Surface Enhanced Raman Spectroscopy (SERS) with silver nanoparticles. SERS spectra of three species of gram negative bacteria, Escherichia coli, Proteus spp., and Klebsiella spp. were obtained after 0 and 4 hour exposure to the seven different antibiotics. Even though the concentration of bacteria was low (2x105 cfu/ml), species classification was achieved with 94% accuracy using spectra obtained at 0 hours. Sensitivity or resistance to antibiotics was predicted with 81%-100% accuracy from spectra obtained after 4 hours of exposure to the different antibiotics. With the enhancement provided by SERS, the technique can be applied directly to urine or blood samples, bypassing the need for overnight cultures. This technology can lead to the development of rapid methods of diagnosis and antibiogram for a variety of bacterial infections.

24-hour urinary aldosterone excretion test

MedlinePlus

Aldosterone - urine; Addison disease - urine aldosterone; Cirrhosis - serum aldosterone ... A 24-hour urine sample is needed. You will need to collect your urine over 24 hours . Your health care provider will tell ...

2,445 Hours of Code: What I Learned from Facilitating Hour of Code Events in High School Libraries

ERIC Educational Resources Information Center

Colby, Jennifer

2015-01-01

This article describes a school librarian's experience with initiating an Hour of Code event for her school's student body. Hadi Partovi of Code.org conceived the Hour of Code "to get ten million students to try one hour of computer science" (Partovi, 2013a), which is implemented during Computer Science Education Week with a goal of…

Is the Office Hour Obsolete?

ERIC Educational Resources Information Center

Behrens, Susan

2013-01-01

A colleague can't make a coffee date at a time the author proposes because it would conflict with his office hour. No student has actually made an appointment with him during the hour, but he is committed to being in his office as promised in case someone drops by. The author's reaction to her colleague's faithfulness to his posted office hour…

Strategies to accommodate resident work-hour restrictions: impact on surgical education.

PubMed

Freiburg, Carter; James, Ted; Ashikaga, Takamura; Moalem, Jacob; Cherr, Greg

2011-01-01

The introduction of duty-hour restrictions has impacted surgical training. Several strategies were introduced by training programs in response to these restrictions. The purpose of this study was to assess the various strategies employed by residency programs to comply with work-hour restrictions with respect to the impact on the quality of surgical education. A national survey was developed and distributed to resident members of the Resident and Associate Society of the American College of Surgeons in all accredited residency programs across North America. Questions in the survey addressed 10 separate accommodation strategies used by training programs to adhere to resident work-hour restrictions. Resident respondents completed a 5-point Likert scale rating each strategy according to its impact on surgical education (detrimental, not very helpful, neutral, somewhat helpful, and very helpful). A total of 599 (9.7%) responses were received from 6186 members of the Resident Associate Society. The use of health information technology (IT), nurse practitioners, and physician assistants were most highly rated. Hiring clinical fellows, establishing nonteaching services, and shift-work scheduling were the three most poorly rated accommodations to work-hour restrictions with respect to resident education. Hospital IT and nonphysician care providers were rated by residents to optimize surgical education in the current work-hour limitation environment. We infer that strategies which lead to increased efficiency and redistribution of resident workload allow surgical trainees to spend more time on activities perceived to have higher educational value. Copyright © 2011 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel.

PubMed

Rotenberg, Lúcia; Portela, Luciana Fernandes; Banks, Bahby; Griep, Rosane Harter; Fischer, Frida Marina; Landsbergis, Paul

2008-09-01

The association between working hours and work ability was examined in a cross-sectional study of male (N=156) and female (N=1092) nurses in three public hospitals. Working hours were considered in terms of their professional and domestic hours per week and their combined impact; total work load. Logistic regression analysis showed a significant association between total work load and inadequate work ability index (WAI) for females only. Females reported a higher proportion of inadequate WAI, fewer professional work hours but longer domestic work hours. There were no significant differences in total work load by gender. The combination of professional and domestic work hours in females seemed to best explain their lower work ability. The findings suggest that investigations into female well-being need to consider their total work load. Our male sample may have lacked sufficient power to detect a relationship between working hours and work ability.

Change from an 8-hour shift to a 12-hour shift, attitudes, sleep, sleepiness and performance.

PubMed

Lowden, A; Kecklund, G; Axelsson, J; Akerstedt, T

1998-01-01

The present study sought to evaluate the effect of a change from a rotating 3-shift (8-hour) to a 2-shift shift (12 hour) schedule on sleep, sleepiness, performance, perceived health, and well-being. Thirty-two shift workers at a chemical plant (control room operators) responded to a questionnaire a few months before a change was made in their shift schedule and 10 months after the change. Fourteen workers also filled out a diary, carried activity loggers, and carried out reaction-time tests (beginning and end of shift). Fourteen day workers served as a reference group for the questionnaires and 9 were intensively studied during a week with workdays and a free weekend. The questionnaire data showed that the shift change increased satisfaction with workhours, sleep, and time for social activities. Health, perceived accident risk, and reaction-time performance were not negatively affected. Alertness improved and subjective recovery time after night work decreased. The quick changes in the 8-hour schedule greatly increased sleep problems and fatigue. Sleepiness integrated across the entire shift cycle showed that the shift workers were less alert than the day workers, across workdays and days off (although alertness increased with the 12-hour shift). The change from 8-hour to 12-hour shifts was positive in most respects, possibly due to the shorter sequences of the workdays, the longer sequences of consecutive days off, the fewer types of shifts (easier planning), and the elimination of quick changes. The results may differ in groups with a higher work load.

Comparison of carprofen and meloxicam for 72 hours following ovariohysterectomy in dogs.

PubMed

Leece, Elizabeth A; Brearley, Jacqueline C; Harding, Edward F

2005-07-01

To compare the peri- and post-operative (72 hours) analgesic effects of injectable and orally administered carprofen and meloxicam for ovariohysterectomy in dogs. Prospective, randomized clinical study. Forty-three dogs undergoing elective ovariohysterectomy. Dogs were randomly assigned to receive pre-operative carprofen, meloxicam or sterile saline by subcutaneous injection. Pre-anaesthetic medication was intramuscular acepromazine (0.02 mg kg(-1)) and methadone (0.2 mg kg(-1)). Anaesthesia was induced with either thiopentone or propofol injected to effect, and maintained with isoflurane in oxygen. Visual analogue scores (VAS) for pain and sedation were recorded at 1, 2, 3, 4 and 6 hours following tracheal extubation. Oral medication with the same treatment was continued post-operatively for 3 days, with VAS scores for pain being recorded before, and 2 hours after treatment on each day. Differences between group age, body mass, duration of general anaesthesia, time from treatment injection to tracheal extubation and time from treatment injection to first oral treatment were analysed using one-way analysis of variance and Kruskal-Wallis test. Visual analogue scores for pain and sedation were analysed using a re-randomization method. The significance level was set at p < 0.05. Meloxicam-treated subjects had lower mean VAS than the control group at 2 and 6 hours following tracheal extubation. Control group VAS were more varied than meloxicam scores (at 6 hours) and carprofen scores (at 3 and 6 hours). On the first post-operative day, pre- to post-treatment VAS scores decreased significantly after meloxicam. On day 3, scores in the meloxicam-treated group were significantly lower than control values after treatment. Changes in pre- to post-treatment VAS were greater in animals receiving either meloxicam or carprofen compared with those given saline. Both carprofen and meloxicam provided satisfactory analgesia for 72 hours following ovariohysterectomy in dogs.

48 CFR 536.570-5 - Working hours.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Working hours. 536.570-5... CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-5 Working hours. Insert 552.236-74, Working Hours, in solicitations and contracts if construction, dismantling...

Self-Solicited Feedback: Effects of Hourly Pay and Individual Monetary Incentive Pay

ERIC Educational Resources Information Center

Slowiak, Julie M.; Dickinson, Alyce M.; Huitema, Bradley E.

2011-01-01

The frequency of feedback solicitation under hourly pay and individual monetary incentive pay conditions was examined. A between-subjects design was used with 30 college students in the two groups. Participants attended three experimental sessions and entered the cash value of simulated bank checks presented on a computer screen. Performance was…

50 CFR 20.23 - Shooting hours.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PLANTS (CONTINUED) MIGRATORY BIRD HUNTING Taking § 20.23 Shooting hours. No person shall take migratory game birds except during the hours open to shooting as prescribed in subpart K of this part and subpart...

5 CFR 550.183 - Substantial hours requirement.

Code of Federal Regulations, 2010 CFR

2010-01-01

....184. This average is computed by dividing the total unscheduled duty hours for the annual period... workday means each day in the criminal investigator's basic workweek during which the investigator works at least 4 hours, excluding— (1) Overtime hours compensated under 5 U.S.C. 5542 and § 550.111; (2...

48 CFR 2816.602 - Labor-hour contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Labor-hour contracts. 2816... and Contract Types TYPES OF CONTRACTS Time-and-Materials, Labor-Hour, and Letter Contracts 2816.602 Labor-hour contracts. The limitations set forth in 2816.601 for time-and-material contracts also apply...

Can zero-hour cortical biopsy predict early graft outcomes after living donor renal transplantation?

PubMed

Rathore, Ranjeet Singh; Mehta, Nisarg; Mehta, Sony Bhaskar; Babu, Manas; Bansal, Devesh; Pillai, Biju S; Sam, Mohan P; Krishnamoorthy, Hariharan

2017-11-01

The aim of this study was to identify relevance of subclinical pathological findings in the kidneys of living donors and correlate these with early graft renal function. This was a prospective study on 84 living donor kidney transplant recipients over a period of two years. In all the donors, cortical wedge biopsy was taken and sent for assessment of glomerular, mesangial, and tubule status. The graft function of patients with normal histology was compared with those of abnormal histological findings at one, three, and six months, and one year post-surgery. Most abnormal histological findings were of mild degree. Glomerulosclerosis (GS, 25%), interstitial fibrosis (IF, 13%), acute tubular necrosis (ATN 5%), and focal tubal atrophy (FTA, 5%) were the commonly observed pathological findings in zero-hour biopsies. Only those donors who had histological changes of IF and ATN showed progressive deterioration of renal function at one month, three months, six months, and one year post-transplantation. In donors with other histological changes, no significant effect on graft function was observed. Zero-hour cortical biopsy gave us an idea of the general status of the donor kidney and presence or absence of subclinical pathological lesions. A mild degree of subclinical and pathological findings on zero-hour biopsy did not affect early graft renal function in living donor kidney transplantation. Zero-hour cortical biopsy could also help in discriminating donor-derived lesions from de novo alterations in the kidney that could happen subsequently.

Three-Dimensional Superhydrophobic Nanowire Networks for Enhancing Condensation Heat Transfer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Ronggui; Wen, Rongfu; Xu, Shanshan

Spontaneous droplet jumping on nanostructured surfaces can potentially enhance condensation heat transfer by accelerating droplet removal. However, uncontrolled nucleation in the micro-defects of nanostructured superhydrophobic surfaces could lead to the formation of large pinned droplets, which greatly degrades the performance. Here, we experimentally demonstrate for the first time stable and efficient jumping droplet condensation on a superhydrophobic surface with three-dimensional (3D) copper nanowire networks. Due to the formation of interconnections among nanowires, the micro-defects are eliminated while the spacing between nanowires is reduced, which results in the formation of highly mobile droplets. By preventing flooding on 3D nanowire networks, wemore » experimentally demonstrate a 100% higher heat flux compared with that on the state-of-the-art hydrophobic surface over a wide range of subcooling (up to 28 K). The remarkable water repellency of 3D nanowire networks can be applied to a broad range of water-harvesting and phase-change heat transfer applications.« less

Controlled enhancement of spin-current emission by three-magnon splitting.

PubMed

Kurebayashi, Hidekazu; Dzyapko, Oleksandr; Demidov, Vladislav E; Fang, Dong; Ferguson, A J; Demokritov, Sergej O

2011-07-03

Spin currents--the flow of angular momentum without the simultaneous transfer of electrical charge--play an enabling role in the field of spintronics. Unlike the charge current, the spin current is not a conservative quantity within the conduction carrier system. This is due to the presence of the spin-orbit interaction that couples the spin of the carriers to angular momentum in the lattice. This spin-lattice coupling acts also as the source of damping in magnetic materials, where the precessing magnetic moment experiences a torque towards its equilibrium orientation; the excess angular momentum in the magnetic subsystem flows into the lattice. Here we show that this flow can be reversed by the three-magnon splitting process and experimentally achieve the enhancement of the spin current emitted by the interacting spin waves. This mechanism triggers angular momentum transfer from the lattice to the magnetic subsystem and modifies the spin-current emission. The finding illustrates the importance of magnon-magnon interactions for developing spin-current based electronics.

5 CFR 551.421 - Regular working hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Regular working hours. 551.421 Section... Activities § 551.421 Regular working hours. (a) Under the Act there is no requirement that a Federal employee... distinction based on whether the activity is performed by an employee during regular working hours or outside...

The hour-to-hour influence of weather conditions on walking and cycling among Dutch older adults.

PubMed

Prins, Richard G; van Lenthe, F J

2015-09-01

physical activity (PA) is an important factor to promote healthy ageing. However, older adults are not physically active enough. Socio-ecological models suggest that weather conditions are determinants of PA and may bias relations between other environmental factors and PA. This may especially be the case for the most vulnerable and inactive older persons. Understanding the role of weather conditions is based on daily or seasonal variation in weather, but it can be improved by using hour-to-hour measured weather conditions. to study the hour-to-hour relationships between weather factors and objectively measured walking and cycling in a sample of Dutch older adults. baseline data (2013) of a sub-sample of older adults (3,248 observations clustered in 43 adults) participating in The Neighborhood Walking in Rotterdam Older ADultS (NEW.ROADS) trial were used. Participants wore a GPS logger for 7 consecutive days. Hour-to-hour weather data (temperature, wind speed, rain and sun time) for the city of Rotterdam were retrieved from the Royal Netherlands Meteorological Institute. Multilevel linear regression models were fitted with minutes walked and minutes cycled as dependent variables and the weather variables as independent variables. the time older adults walked increased with higher temperature, higher wind speed and the absence of rain. The time cycled increased with higher temperature. this study improves the evidence of weather factors as a determinant for walking and cycling in older adults. Studies on the relation between environmental factors and PA should consider adjustment for weather factors. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Sleep deprivation in resident physicians, work hour limitations, and related outcomes: a systematic review of the literature.

PubMed

Mansukhani, Meghna P; Kolla, Bhanu Prakash; Surani, Salim; Varon, Joseph; Ramar, Kannan

2012-07-01

Extended work hours, interrupted sleep, and shift work are integral parts of medical training among all specialties. The need for 24-hour patient care coverage and economic factors have resulted in prolonged work hours for resident physicians. This has traditionally been thought to enhance medical educational experience. These long and erratic work hours lead to acute and chronic sleep deprivation and poor sleep quality, resulting in numerous adverse consequences. Impairments may occur in several domains, including attention, cognition, motor skills, and mood. Resident performance, professionalism, safety, and well-being are affected by sleep deprivation, causing potentially adverse implications for patient care. Studies have shown adverse health consequences, motor vehicle accidents, increased alcohol and medication use, and serious medical errors to occur in association with both sleep deprivation and shift work. Resident work hour limitations have been mandated by the Accreditation Council for Graduate Medical Education in response to patient safety concerns. Studies evaluating the impact of these regulations on resident physicians have generated conflicting reports on patient outcomes, demonstrating only a modest increase in sleep duration for resident physicians, along with negative perceptions regarding their education. This literature review summarizes research on the effects of sleep deprivation and shift work, and examines current literature on the impact of recent work hour limitations on resident physicians and patient-related outcomes.

Future provision of out of hours primary medical care: a survey with two general practitioner research networks.

PubMed Central

Lattimer, V.; Smith, H.; Hungin, P.; Glasper, A.; George, S.

1996-01-01

OBJECTIVE--To ascertain general practitioners' views about the future provision of out of hours primary medical care. DESIGN--Self completing postal questionnaire survey. SETTING--Wessex and north east England. SUBJECTS--116 general practitioners in the Wessex Primary Care Research Network and 83 in the Northern Primary Care Research Network. MAIN OUTCOME MEASURES--Intention to reduce or opt out of on call; plans for changing out of hours arrangements; the three most important changes needed to out of hours care; willingness to try, and perceived strengths and limitations of, three alternative out of hours care models--primary care emergency centres, telephone triage services, and cooperatives. RESULTS--The overall response rate was 74% (Wessex research network 77% (89/116), northern research network 71% (59/83)). Eighty three per cent of respondents (123/148) were willing to try at least one service model, primary care emergency centres being the most popular option. Key considerations were the potential for a model to reduce time on call and workload, to maintain continuity of care, and to fit the practice context. Sixty one per cent (91/148) hoped to reduce time on call and 25% (37/148) hoped to opt out completely. CONCLUSIONS--General practitioners were keen to try alternative arrangements for out of hours care delivery, despite the lack of formal trials. The increased flexibility in funding brought about by the recent agreement between the General Medical Services Committee and the Department of Health is likely to lead to a proliferation of different schemes. Careful monitoring will be necessary, and formal trials of new service models are needed urgently. PMID:8611835

MRI cisternography with gadolinium-containing contrast medium: its role, advantages and limitations in the investigation of rhinorrhoea.

PubMed

Aydin, K; Guven, K; Sencer, S; Jinkins, J R; Minareci, O

2004-01-01

Our purpose was to evaluate the utility of intrathecal gadopentetate dimeglumine -enhanced magnetic resonance cisternography (GdMRC). We injected 0.5 ml contrast medium into the subarachnoid space via lumbar puncture in 20 patients with suspected cerebrospinal fluid (CSF) rhinorrhoea. MRC showed CSF leakage in 14 patients with rhinorrhoea at the time of the examination, into the ethmoid air cells in nine, the sphenoid sinus in three and the frontal sinus in two cases. In 12 of these the site leakage was confirmed during surgical repair of the fistula. No leakage was observed in four patients with intermittent rhinorrhoea, not present at the time of the examination. GdMRC showed leakage in two patients with negative CT cisternography. GdMRC may prove better than CT cisternography, especially with slow CSF flow. We also showed low-dose GdMRC to be a feasible and relative safe way of confirming the presence of and localising active CSF leaks prior to surgical repair.

Receptivity of African American Adolescents to an HIV-Prevention Curriculum Enhanced by Text Messaging

PubMed Central

Cornelius, Judith B.; St Lawrence, Janet S.

2013-01-01

PURPOSE This study assessed African American adolescents’ receptivity to an HIV-prevention curriculum enhanced by text messaging. DESIGN AND METHODS Two focus groups were conducted with 14 African American adolescents regarding how an HIV-prevention curriculum could be enhanced for text messaging delivery. RESULTS The adolescents were receptive to the idea of text messaging HIV-prevention information but wanted to receive a maximum of three messages per day during the hours of 4:00–6:00 p.m. PRACTICE IMPLICATIONS By taking the findings of this study, nurses, other healthcare providers, and community-based organizations can adapt evidence-based interventions for text messaging delivery to individuals at high risk for HIV infection. PMID:19356206

The working hours of general practitioners 2000-2008.

PubMed

Aasland, Olaf G; Rosta, Judith

2011-06-03

There is little reliable information available on the working hours of general practitioners (GPs). The purpose of our study is to describe the development of weekly working hours of Norwegian general practitioners in the period from 2000 to 2008, as well as the length of their patient lists and their perceived workload. General practitioners in the reference panel of the Research Institute of the Norwegian Medical Association have reported their weekly working hours for 2000, 2002, 2004, 2006 and 2008, and the length of their patient lists for 2002 and 2008. We used non-overlapping 95 per cent confidence intervals for testing inter-group differences in interval variables and proportions. From 227 to 316 general practitioners responded to each survey round. Average weekly working hours constituted 45.1 hours (95 per cent CI: 43.6-46.5 hours) in 2000 and 46.4 hours (95 per cent CI: 45.2-47.6 hours) in 2008. The number of hours increased for women GPs, while the number of hours remained basically unchanged for men from 2000 to 2008. Average length of the patient lists in 2002 and 2008 constituted 1,325 and 1,278 for men, and 1,155 and 1,144 for women GPs respectively. The proportion of GPs who responded that they perceived their workload as unacceptable decreased significantly, from 38.1 per cent in 2000 to 25.5 per cent in 2008. Average weekly working hours for GPs increased by approximately one hour from 2000 to 2008, and this increase is found mainly among women GPs. We believe that the reduction in the proportion reporting to have an unacceptable workload can be explained by the introduction of the list-patient system, which has given the doctors better control of their own workload.

19 CFR 101.6 - Hours of business.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 1 2011-04-01 2011-04-01 false Hours of business. 101.6 Section 101.6 Customs... GENERAL PROVISIONS § 101.6 Hours of business. Except as specified in paragraphs (a) through (g) of this section, each CBP office shall be open for the transactions of general CBP business between the hours of 8...

19 CFR 101.6 - Hours of business.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 1 2013-04-01 2013-04-01 false Hours of business. 101.6 Section 101.6 Customs... GENERAL PROVISIONS § 101.6 Hours of business. Except as specified in paragraphs (a) through (g) of this section, each CBP office shall be open for the transactions of general CBP business between the hours of 8...

19 CFR 101.6 - Hours of business.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Hours of business. 101.6 Section 101.6 Customs... GENERAL PROVISIONS § 101.6 Hours of business. Except as specified in paragraphs (a) through (g) of this section, each CBP office shall be open for the transactions of general CBP business between the hours of 8...

29 CFR 778.101 - Maximum nonovertime hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Maximum nonovertime hours. 778.101 Section 778.101 Labor... Requirements Introductory § 778.101 Maximum nonovertime hours. As a general standard, section 7(a) of the Act provides 40 hours as the maximum number that an employee subject to its provisions may work for an employer...

Gadolinium-enhanced cardiovascular magnetic resonance: administered dose in relationship to United States Food and Drug Administration (FDA) guidelines.

PubMed

Nacif, Marcelo S; Arai, Andrew E; Lima, Joao A C; Bluemke, David A

2012-02-29

Myocardial late gadolinium enhancement was originally validated using higher than label-recommended doses of gadolinium chelate. The objective of this study was to evaluate available evidence for various gadolinium dosing regimens used for CMR. The relationship of gadolinium dose warnings (due to nephrogenic systemic fibrosis) announced in 2008 to gadolinium dosing regimens was also examined. We conducted a meta-analysis of peer reviewed publications from January, 2004 to December, 2010. Major subject search headings (MeSh) terms from the National Library of Medicine's PubMed were: contrast media, gadolinium, heart, magnetic resonance imaging; searches were limited to human studies with abstracts published in English. Case reports, review articles, editorials, MRA related papers and all reports that did not indicate gadolinium type or weight-based dose were excluded. For all included references, full text was available to determine the total administered gadolinium dose on a per kg basis. Average and median dose values were weighted by the number of subjects in each study. 399 publications were identified in PubMed; 233 studies matched the inclusion criteria, encompassing 19,934 patients with mean age 54.2 ± 11.4 (range 9.3 to 76 years). 34 trials were related to perfusion testing and 199 to myocardial late gadolinium enhancement. In 2004, the weighted-median and weighted-mean contrast dose were 0.15 and 0.16 ± 0.06 mmol/kg, respectively. Median contrast doses for 2005-2010 were: 0.2 mmol/kg for all years, respectively. Mean contrast doses for the years 2005-2010 were: 0.19 ± 0.03, 0.18 ± 0.04, 0.18 ± 0.10, 0.18 ± 0.03, 0.18 ± 0.04 and 0.18 ± 0.04 mmol/kg, respectively (p for trend, NS). Gadopentetate dimeglumine was the most frequent gadolinium type [114 (48.9%) studies]. No change in mean gadolinium dose was present before, versus after the Food and Drug Administration (FDA) black box warning (p > 0.05). Three multi-center dose ranging trials have been

The future of work hours--the European view.

PubMed

Akerstedt, Torbjörn; Kecklund, Göran

2005-01-01

In Europe the way work hours are handled varies between different countries. However, there are some issues that dominate the discussion in Europe and seem representative for what is happening. One such is the reduction of working hours--which was attempted in several countries but which now seems to be backfiring--probably related to the competition from countries outside Europe. Another area is compressed work hours--the drive towards maximizing the hours per work day in order to increase the number of days off. The health effects are debated--some find clear positive effects. A third area is company oriented flexible work hours, permitting the employer to make moderate changes in work hours when needed. The health impacts have not been evaluated but the loss of individual influence at work is obvious. In some parts of Europe self-determined work hours have been tried with very positive effects. The EU work hour directive is intended to provide uniformity but permits a counterproductive "opting out", creating problems of imbalance.

[Three cases of scombroid poisoning].

PubMed

Harmelin, Y; Hubiche, T; Pharaon, M; Del Giudice, P

2018-01-01

Scombroid poisoning is a poorly known type of food poisoning due to the presence of histamine in spoiled fish of the Scombridae family. We report 3 cases of scombroid poisoning seen at the Fréjus-Saint-Raphaël hospital in the Var region. Within around thirty minutes of eating a meal containing tuna, three patients presented varied symptoms: malaise, itchy rash, headache, and for two of them, nausea. The diagnosis of scombroid poisoning was based on the circumstances in which the clinical signs appeared and on the signs themselves. The patients were given antihistamines and one injection of intravenous corticosteroids, and symptoms regressed rapidly within a few hours. The symptoms of scombroid poisoning appear within a few minutes after eating fish of the Scombridae family and related species. The first symptoms are cutaneous, with flush, pruritus, and erythema of the face and trunk having an urticarial appearance, together with faintness. Gastrointestinal symptoms include nausea, vomiting, abdominal cramps and occasionally diarrhea. Symptoms subside within a few hours. Histamine is present in the flesh of these fish due to decarboxylation of histidine through the action of Gram-negative bacteria whose development is enhanced by heat and sun. Scombroid poisoning is one of the most common types of poisoning caused by eating fish but it is underdiagnosed by dermatologists. The diagnosis is made by measuring histamine levels in the incriminated fish or in the patient's plasma. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Using additional information on working hours to predict coronary heart disease: a cohort study

PubMed Central

Kivimäki, Mika; Batty, G. David; Hamer, Mark; Ferrie, Jane E.; Vahtera, Jussi; Virtanen, Marianna; Marmot, Michael G.; Singh-Manoux, Archana; Shipley, Martin J.

2011-01-01

Background Long hours are associated with increased risk of coronary heart disease. Adding information on long hours to traditional risk factors could potentially help improve risk prediction. Objective To examine whether information on long working hours improves the ability of the Framingham risk model to predict coronary heart disease in a low-risk employed population. Design Prospective cohort study; baseline medical examination (1991-1993) and coronary heart disease follow-up to 2004. Settings Civil service departments in London (the Whitehall II study). Participants 7095 adults (2109 women) aged 39 to 62, working full time, and free of coronary heart disease at baseline. Measurements Working hours and the Framingham risk score were measured at baseline. Coronary death and non-fatal myocardial infarction were ascertained from three sources: medical screenings every 5 years, hospital data and register linkage. Results 192 persons had incident coronary heart disease during a median 12.3 year follow-up. After adjustment for the Framingham score, participants working ≥11 hours per day had a 1.67-fold (95% CI: 1.10-2.55) increased risk of coronary heart disease relative to those working 7-8 hours. The addition of working hours to the Framingham score led to a net reclassification improvement of 4.7% (p=0.034), resulting from a better identification of individuals who later developed coronary heart disease (sensitivity gain). Limitations The findings may not be generalizable to populations with a larger proportion of high-risk individuals. Furthermore, the predictive utility of working hours was not validated in an independent cohort. Conclusion Information on working hours may improve prediction of coronary heart disease risk based on the Framingham risk score in low-risk working populations. Primary Funding Source Medical Research Council, British Heart Foundation, BUPA Foundation, UK; National Heart, Lung and Blood Institute and National Institute on Aging, NIH

How Many Hours of Instruction Are Needed for Students to Become Competent in Engineering Subjects?

ERIC Educational Resources Information Center

Perdigones, Alicia; Benedicto, Susana; Sánchez-Espinosa, Elvira; Gallego, Eutiquio; García, José L.

2014-01-01

The aim of this work was to compare the curricula of three different agricultural engineering courses and to determine the competence of graduating students in three subject areas in order to identify possible shortfalls in the number of hours of instruction (HI) required for full competence to be attained. A total of 132 students sat a voluntary…

Teaching and learning in an 80-hour work week: a novel day-float rotation for medical residents.

PubMed

Wong, Jeffrey G; Holmboe, Eric S; Huot, Stephen J

2004-05-01

The 80-hour workweek limit for residents provides an opportunity for residency directors to creatively innovate their programs. Our novel day-float rotation augmented both the educational structure within the inpatient team setting and the ability for house staff to complete their work within the mandated limits. Descriptive evaluation of the rotation was performed through an end-of-rotation questionnaire. The average length of the ward residents' work week was quantified before and after the rotation's implementation. Educational portfolios and mentored peer-teaching opportunities enriched the rotation. As measured by our evaluation, this new rotation enhanced learning and patient care while reducing work hours for inpatient ward residents.

75 FR 232 - Finding of Failure To Submit Certain State Implementation Plans Required for the 1-Hour Ozone NAAQS

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... Failure To Submit Certain State Implementation Plans Required for the 1-Hour Ozone NAAQS AGENCY...) for three ozone nonattainment areas to satisfy certain requirements of the Clean Air Act (CAA) for the 1-hour ozone National Ambient Air Quality Standards (NAAQS). To accompany this action we are issuing...

Use of Web-based materials to enhance anatomy instruction in the health sciences.

PubMed

Granger, Noelle A; Calleson, Diane C; Henson, O W; Juliano, Eve; Wineski, Lawrence; McDaniel, Martha D; Burgoon, Jennifer M

2006-07-01

Teaching anatomy by dissection is under considerable pressure to evolve and/or even be eliminated, and curricular hours in the dissection laboratory are decreasing. As a possible means of easing this pressure, an online interactive anatomy program has been created to enhance the dissection experience, observational learning, and three-dimensional comprehension of human anatomy. An assessment was made of the utility of the program in preparing students for dissection laboratories and for examinations. The efficacy of the application was evaluated by first-year students and faculty with pre- and post-use surveys in anatomy courses at three medical schools. It was found that students felt better prepared if they utilized the Web site prior to their dissection laboratory, and faculty reported spending less time explaining basic concepts or techniques. It is concluded that a comprehensive online program significantly enhances the quality and efficiency of instruction in human anatomy in the dissection laboratory and could prove to be a useful tool at other institutions.

Effectiveness of the Twelve-Hour Shift.

ERIC Educational Resources Information Center

Brinton, Robert D.

1983-01-01

Although labor unions traditionally have fought for shorter working hours, there have been recent reversals in this trend. The Pulp and Paperboard Division of Temple-Eastex Incorporated converted to a 12-hour shift and found that safety improved, productivity increased, and overtime decreased. (JOW)

The Student Credit Hour: Counting What Counts

ERIC Educational Resources Information Center

Wellman, Jane

2005-01-01

The article discusses the student credit hour (SCH). The author begins with a rethinking of the basic unit of measurement in American higher education--the SCH. The credit hour was developed at the turn of the 20th century as a measure of student time in the classroom: one hour per week in class for one semester equalled one SCH. The credit hour…

Association between sleeping hours, working hours and obesity in Hong Kong Chinese: the 'better health for better Hong Kong' health promotion campaign.

PubMed

Ko, G T C; Chan, J C N; Chan, A W Y; Wong, P T S; Hui, S S C; Tong, S D Y; Ng, S-M; Chow, F; Chan, C L W

2007-02-01

To study the inter-relationships between sleeping hours, working hours and obesity in subjects from a working population. A cross-sectional observation study under the 'Better Health for Better Hong Kong' Campaign, which is a territory-wide health awareness and promotion program. 4793 subjects (2353 (49.1%) men and 2440 (50.9%) women). Their mean age (+/-s.d.) was 42.4+/-8.9 years (range 17-83 years, median 43.0 years). Subjects were randomly selected using computer-generated codes in accordance to the distribution of occupational groups in Hong Kong. The mean daily sleeping time was 7.06+/-1.03 h (women vs men: 7.14+/-1.08 h vs 6.98+/-0.96 h, P<0.001). Increasing body mass index (BMI) was associated with reducing number of sleeping hours and increasing number of working hours reaching significance in the whole group as well as among male subjects. Those with short sleeping hour (6 h or less) and long working hours (>9 h) had the highest BMI and waist in both men and women. Based on multiple regression analysis with age, smoking, alcohol drinking, systolic and diastolic blood pressure, mean daily sleeping hours and working hours as independent variables, BMI was independently associated with age, systolic and diastolic blood pressure in women, whereas waist was associated with age, smoking and blood pressure. In men, blood pressure, sleeping hours and working hours were independently associated with BMI, whereas waist was independently associated with age, smoking, blood pressure, sleeping hours and working hours in men. Obesity is associated with reduced sleeping hours and long working hours in men among Hong Kong Chinese working population. Further studies are needed to investigate the underlying mechanisms of this relationship and its potential implication on prevention and management of obesity.

Enhanced carotid-cardiac baroreflex response and elimination of orthostatic hypotension 24 hours after acute exercise in paraplegics

NASA Technical Reports Server (NTRS)

Engelke, K. A.; Shea, J. D.; Doerr, D. F.; Convertino, V. A.

1992-01-01

To test the hypothesis that an acute bout of maximal exercise can ameliorate orthostatic hypotension consequent to prolonged wheelchair confinement, we evaluated heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure responses during 15 minutes of 70 degrees head-up tilt (HUT) in 10 paraplegic subjects 24 hours after arm crank exercise designed to elicit maximal effort, and during a control (no exercise) conditions. Additionally, the carotid baroreceptor stimulus-cardiac response relationship was determined by measurement of R-R interval during external application of graded pressures to the carotid sinuses. One week separated the treatment conditions. The maximum slope of the carotid-cardiac baroreflex response was increased (p = 0.049) by exercise (6.2 +/- 1.7 msec/mmHg) compared to control (3.3 +/- 0.6). During control HUT, HR increased from 61 +/- 1 to 90 +/- 7 bpm (p = 0.001) while SBP decreased from 118 +/- 5 to 106 +/- 9 mmHg (p = 0.025). During HUT 24 hours after exercise, HR increased from 60 +/- 2 to 90 +/- 4 bpm (p = 0.001), but the reduction in SBP was essentially eliminated (116 +/- 5 to 113 +/- 5 mmHg).

Use and Underlying Reasons for Duty Hour Flexibility in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.

PubMed

Bilimoria, Karl Y; Quinn, Christopher M; Dahlke, Allison R; Kelz, Rachel R; Shea, Judy A; Rajaram, Ravi; Love, Remi; Kreutzer, Lindsey; Biester, Thomas; Yang, Anthony D; Hoyt, David B; Lewis, Frank R

2017-02-01

The Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial randomly assigned surgical residency programs to either standard duty hour policies or flexible policies that eliminated caps on shift lengths and time off between shifts. Our objectives were to assess adherence to duty hour requirements in the Standard Policy arm and examine how often and why duty hour flexibility was used in the Flexible Policy arm. A total of 3,795 residents in the FIRST trial completed a survey in January 2016 (response rate >95%) that asked how often and why they exceeded current standard duty hour limits in both study arms. Flexible Policy interns worked more than 16 hours continuously at least once in a month more frequently than Standard Policy residents (86% vs 37.8%). Flexible Policy residents worked more than 28 hours once in a month more frequently than Standard Policy residents (PGY1: 64% vs 2.9%; PGY2 to 3: 62.4% vs 41.9%; PGY4 to 5: 52.2% vs 36.6%), but this occurred most frequently only 1 to 2 times per month. Although residents reported working more than 80 hours in a week 3 or more times in the most recent month more frequently under Flexible Policy vs Standard Policy (19.9% vs 16.2%), the difference was driven by interns (30.9% vs 19.6%), and there were no significant differences in exceeding 80 hours among PGY2 to 5 residents. The most common reasons reported for extending duty hours were facilitating care transitions (76.6%), stabilizing critically ill patients (70.7%), performing routine responsibilities (67.9%), and operating on patients known to the trainee (62.0%). There were differences in duty hours worked by residents in the Flexible vs Standard Policy arms of the FIRST trial, but it appeared that residents generally used the flexibility for patient care and educational opportunities selectively. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Participation in Activities outside of School Hours in Relation to Problem Behavior and Social Skills in Middle Childhood

ERIC Educational Resources Information Center

Howie, LaJeana D.; Lukacs, Susan L.; Pastor, Patricia N.; Reuben, Cynthia A.; Mendola, Pauline

2010-01-01

Background: Research has shown that participating in activities outside of school hours is associated with lower dropout rates, enhanced school performance, improved social skills, and reduced problem behaviors. However, most prior studies have been limited to small populations of older children (greater than 12 years). This analysis focuses on…

Delinking resident duty hours from patient safety

PubMed Central

2014-01-01

Patient safety is a powerful motivating force for change in modern medicine, and is often cited as a rationale for reducing resident duty hours. However, current data suggest that resident duty hours are not significantly linked to important patient outcomes. We performed a narrative review and identified four potential explanations for these findings. First, we question the relevance of resident fatigue in the creation of harmful errors. Second, we discuss factors, including workload, experience, and individual characteristics, that may be more important determinants of resident fatigue than are duty hours. Third, we describe potential adverse effects that may arise from – and, therefore, counterbalance any potential benefits of – duty hour reductions. Fourth, we explore factors that may mitigate any risks to patient safety associated with using the services of resident trainees. In summary, it may be inappropriate to justify a reduction in working hours on the grounds of a presumed linkage between patient safety and resident duty hours. Better understanding of resident-related factors associated with patient safety will be essential if improvements in important patient safety outcomes are to be realized through resident-focused strategies. PMID:25561349

The Credit Hour and Public Budgeting.

ERIC Educational Resources Information Center

Wellman, Jane V.

2003-01-01

Discusses the ways the credit hour has come to be used by public funding systems in higher education. The literature review shows that the credit hour has become a barrier to innovation and a way to create systemic inequities between institutions or sectors in resource allocation. (SLD)

14 CFR 65.47 - Maximum hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Maximum hours. 65.47 Section 65.47 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRMEN CERTIFICATION: AIRMEN OTHER THAN FLIGHT CREWMEMBERS Air Traffic Control Tower Operators § 65.47 Maximum hours...

Myths and realities of the 80-hour work week.

PubMed

Schenarts, Paul J; Anderson Schenarts, Kimberly D; Rotondo, Michael F

2006-01-01

Myths are so ingrained into cultural traditions that emotion frequently overshadows a rational evaluation of the facts. The reduction in resident work hours has resulted in the formation of several myths. The purpose of this review is to examine the published data on resident work hours to separate out myth from reality. An electronic database was searched for publications related to resident training, work-hours, continuity of care, sleep deprivation, quality of life, patient safety, clinical/operative experience, faculty work hours, and surgical education. Sleep deprivation has been shown to be harmful, and residents played a role in advocating for work-hour limits. Surgical residents have seen a less dramatic improvement in quality of life compared with other disciplines. Work-hour reductions have decreased participation in clinic but have not resulted in a significant decline in clinical or operative exposure. Limiting resident work hours will unlikely result in a decrease health-care cost. Reduction in resident work hours has not resulted in an improvement or deterioration in patient outcome. Reduction of work hours has not increased faculty work hours nor made surgery a more attractive career choice. Despite strongly held opinions, resident work-hour reduction has resulted in little significant change in lifestyle, clinical exposure, patient well-being, faculty work hours, or medical student recruitment.

5 CFR 610.408 - Use of credit hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Flexible and Compressed Work Schedules § 610.408 Use of credit hours. Members of the Senior Executive Service (SES) may not accumulate credit hours under an alternative work schedule. Any credit hours...

[General practitioners' participation in out-of-hours work].

PubMed

Sandvik, Hogne; Zakariassen, Erik; Hunskår, Steinar

2007-10-04

Out-of-hours work is often perceived as burdensome and there is an inherent increased risk of making mistakes. The aim of the study was to examine Regular General Practitioners' (RGPs') experiences with and attitudes to out-of-hours work. A questionnaire was sent to all RGPs in Norway. Participation in out-of-hours work was analysed against characteristics of the physician, list, and municipality. 2,913 RGPs responded (78%). 50% participated fully, 15% partly, and 35% did not participate in out-of-hours work. 28% were formally exempted, and 13% had a regular locum. Women and elderly RGPs participated less, as did RGPs in large and central municipalities. Out-of-hours cooperatives covering several municipalities reduced the amount of work, but did not increase the RGPs' participation rate. List characteristics had little influence on the participation rate. 60% of the RGPs tried to give away most of their duties, 16% wanted more out-of-hours work than their regular duties and 16% of those below 55 years who were still doing out-of-hours work wanted to continue after 55 years. RGPs in small and remote municipalities considered out-of-hours work more challenging, but less remunerating, and more often wanted to move from the municipality. Many RGPs do not participate in out-of-hours work. As Norwegian RGPs constitute an aging cohort, this may become an increasing problem.

Lack of normal MR enhancement of the pituitary gland: findings in three siblings with combined pituitary hormone deficiency.

PubMed

Falcone, S; Sanchez, J; Quencer, R M

1998-02-01

We present the MR appearance of the sella turcica in three sibling dwarfs with combined pituitary hormone deficiency in which MR images revealed a peripheral curvilinear band of enhancement about the pituitary gland in all three patients, a normal-size pituitary gland in two siblings, a mildly enlarged pituitary gland in one sibling, and a thin infundibulum and a normal posterior pituitary bright spot in all three siblings. Possible antecedents include an abnormal vascular supply, pituitary gland replacement by a nonfunctioning adenoma, a proteinaceous cyst, or a hamartoma.

Working hours, occupational stress and depression among physicians.

PubMed

Tomioka, K; Morita, N; Saeki, K; Okamoto, N; Kurumatani, N

2011-05-01

Physicians report high prevalence of depression, work long hours and are exposed to many occupational stresses (OSs). To investigate the cross-sectional association between working hours, OS and depression among physicians. A self-administered questionnaire was mailed to 1902 alumni of a medical school. The questionnaire evaluated working hours in the previous week, OS assessed by the effort-reward imbalance model, social support and depression evaluated by the Center for Epidemiologic Studies Depression scale. The associations between these occupational factors and depression were analyzed using multiple logistic regression. The questionnaire was returned by 795 alumni (response rate, 42%), and 706 respondents (534 men and 172 women) were suitable for analysis. The odds ratio (OR) of depression in the long working hours group (>70 h/week) was 1.8 (95% CI: 1.1-2.8) compared with the short working hours group (<54 h/week), adjusted for basic attributes. The adjusted ORs of depression in the upper effort-reward ratio (ERR) tertile versus the lower ERR tertile were 0.6 (0.2-1.8) in the short working hours group, 8.5 (3.0-24.0) in the middle working hours group and 9.9 (3.8-25.7) in the long working hours group. The adjusted ORs of depression stratified according to working hours and ERR tended to be higher in the groups with a higher ERR, but no association between working hours and depression was found. This study indicates that the management of OS is needed as a countermeasure against depression among physicians.

Linkage Between Hourly Precipitation Events and Atmospheric Temperature Changes over China during the Warm Season

PubMed Central

Miao, Chiyuan; Sun, Qiaohong; Borthwick, Alistair G. L.; Duan, Qingyun

2016-01-01

We investigated changes in the temporospatial features of hourly precipitation during the warm season over mainland China. The frequency and amount of hourly precipitation displayed latitudinal zonation, especially for light and moderate precipitation, which showed successive downward change over time in northeastern and southern China. Changes in the precipitation amount resulted mainly from changes in frequency rather than changes in intensity. We also evaluated the linkage between hourly precipitation and temperature variations and found that hourly precipitation extreme was more sensitive to temperature than other categories of precipitation. A strong dependency of hourly precipitation on temperature occurred at temperatures colder than the median daily temperature; in such cases, regression slopes were greater than the Clausius-Clapeyron (C-C) relation of 7% per degree Celsius. Regression slopes for 31.6%, 59.8%, 96.9%, and 99.1% of all stations were greater than 7% per degree Celsius for the 75th, 90th, 99th, and 99.9th percentiles for precipitation, respectively. The mean regression slopes within the 99.9th percentile of precipitation were three times the C-C rate. Hourly precipitation showed a strong negative relationship with daily maximum temperature and the diurnal temperature range at most stations, whereas the equivalent correlation for daily minimum temperature was weak. PMID:26931350

17 CFR 201.104 - Business hours.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 3 2014-04-01 2014-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

17 CFR 201.104 - Business hours.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 2 2011-04-01 2011-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

17 CFR 201.104 - Business hours.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 2 2012-04-01 2012-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

17 CFR 201.104 - Business hours.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 17 Commodity and Securities Exchanges 2 2013-04-01 2013-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

17 CFR 201.104 - Business hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Business hours. 201.104 Section 201.104 Commodity and Securities Exchanges SECURITIES AND EXCHANGE COMMISSION RULES OF PRACTICE Rules of Practice General Rules § 201.104 Business hours. The Headquarters office of the Commission, at...

Experience With Flexible Hours of Work

ERIC Educational Resources Information Center

Hartley, Jo

1976-01-01

A summary of an 80-page booklet called Hours of Work When Workers Can Choose is presented. The booklet reports a survey and focuses on the benefits of flexible hours of work. It was published by the Business and Professional Women's Foundation and is available from that organization. (EC)

Remaking Surgical Socialization: Work Hour Restrictions, Rites of Passage, and Occupational Identity

PubMed Central

Brooks, Joanna Veazey; Bosk, Charles L.

2012-01-01

We examine how a policy aimed at improving patient safety by limiting residents’ work hours brought with it an unintended and unexamined consequence: altered socialization due to modified rites of passage during residency that endangered the stereotypical “Surgical Personality” and created a potential rift between the occupational identities of surgical residents who train under duty hour regulations and those who trained before they were imposed. Through participant observation occurring between June 2008 and June 2010, in-depth interviews (n=13), and focus groups (n=2), we explore how surgical residents training in four U.S. hospitals think about the threats that the shift from unrestricted to restricted duty hours creates for their claims of competence and professionalism. We identify three types of resident responses: (1) neutralizing statements that deny any significant change to occupational identity has occurred; (2) embracing statements that express the belief that a changed and more balanced occupational identity is needed; and (3) apprehensive statements that expressed fear of an altered occupational identity and an anxiety about readiness for individual practice. PMID:22863331

Three enhancer regions regulate gbx2 gene expression in the isthmic region during zebrafish development.

PubMed

Islam, Md Ekramul; Kikuta, Hiroshi; Inoue, Fumitaka; Kanai, Maiko; Kawakami, Atsushi; Parvin, Mst Shahnaj; Takeda, Hiroyuki; Yamasu, Kyo

2006-12-01

In vertebrate embryos, positioning of the boundary between the midbrain and hindbrain (MHB) and subsequent isthmus formation are dependent upon the interaction between the Otx2 and Gbx genes. In zebrafish, sequential expression of gbx1 and gbx2 in the anterior hindbrain contributes to this process, whereas in mouse embryos, a single Gbx gene (Gbx2) is responsible for MHB development. In the present study, to investigate the regulatory mechanism of gbx2 in the MHB/isthmic region of zebrafish embryos, we cloned the gene and showed that its organization is conserved among different vertebrates. Promoter analyses revealed three enhancers that direct reporter gene expression after the end of epiboly in the anterior-most hindbrain, which is a feature of the zebrafish gbx2 gene. One of the enhancers is located upstream of gbx2 (AMH1), while the other two enhancers are located downstream of gbx2 (AMH2 and AMH3). Detailed analysis of the AMH1 enhancer showed that it directs expression in the rhombomere 1 (r1) region and the dorsal thalamus, as has been shown for gbx2, whereas no expression was induced by the AMH1 enhancer in other embryonic regions in which gbx2 is expressed. The AMH1 enhancer is composed of multiple regulatory subregions that share the same spatial specificity. The most active of the regulatory subregions is a 291-bp region that contains at least two Pax2-binding sites, both of which are necessary for the function of the main component (PB1-A region) of the AMH1 enhancer. In accordance with these results, enhancer activity in the PB1-A region, as well as gbx2 expression in r1, was missing in no isthmus mutant embryos that lacked functional pax2a. In addition, we identified an upstream conserved sequence of 227bp that suppresses the enhancer activity of AMH1. Taken together, these findings suggest that gbx2 expression during the somitogenesis stage in zebrafish is regulated by a complex mechanism involving Pax2 as well as activators and suppressors in the

34 CFR 668.9 - Relationship between clock hours and semester, trimester, or quarter hours in calculating Title...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Relationship between clock hours and semester, trimester, or quarter hours in calculating Title IV, HEA program assistance. 668.9 Section 668.9 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION...

Determination of Semivariogram Models to Krige Hourly and Daily Solar Irradiance in Western Nebraska(.

NASA Astrophysics Data System (ADS)

Merino, G. G.; Jones, D.; Stooksbury, D. E.; Hubbard, K. G.

2001-06-01

In this paper, linear and spherical semivariogram models were determined for use in kriging hourly and daily solar irradiation for every season of the year. The data used to generate the models were from 18 weather stations in western Nebraska. The models generated were tested using cross validation. The performance of the spherical and linear semivariogram models were compared with each other and also with the semivariogram models based on the best fit to the sample semivariogram of a particular day or hour. There were no significant differences in the performance of the three models. This result and the comparable errors produced by the models in kriging indicated that the linear and spherical models could be used to perform kriging at any hour and day of the year without deriving an individual semivariogram model for that day or hour.The seasonal mean absolute errors associated with kriging, within the network, when using the spherical or the linear semivariograms models were between 10% and 13% of the mean irradiation for daily irradiation and between 12% and 20% for hourly irradiation. These errors represent an improvement of 1%-2% when compared with replacing data at a given site with the data of the nearest weather station.

47 CFR 0.403 - Office hours.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Office hours. 0.403 Section 0.403 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMISSION ORGANIZATION General Information General § 0.403 Office hours. The main offices of the Commission are open from 8 a.m. to 5:30 p.m., Monday through...

"Hour of Code": A Case Study

ERIC Educational Resources Information Center

Du, Jie; Wimmer, Hayden; Rada, Roy

2018-01-01

This study investigates the delivery of the "Hour of Code" tutorials to college students. The college students who participated in this study were surveyed about their opinion of the Hour of Code. First, the students' comments were discussed. Next, a content analysis of the offered tutorials highlights their reliance on visual…

Changing the Formula of Residents' Work Hours in Internal Medicine: Moving From “Years in Training” to “Hours in Training”

PubMed Central

Mansi, Ishak A

2011-01-01

Background In a recent report, the Institute of Medicine recommended more restrictions on residents' working hours. Several problems exist with a system that places a weekly limit on resident duty hours: (1) it assumes the presence of a linear relationship between hours of work and patient safety; (2) it fails to consider differences in intensity among programs; and (3) it does not address increases in the scientific content of medicine, and it places the burden of enforcing the duty hour limits on the Accreditation Council for Graduate Medical Education. Proposal An innovative method of calculating credit hours for graduate medical education would shift the focus from “years of residency” to “hours of residency.” For example, internal medicine residents would be requested to spend 8640 hours of total training hours (assuming 60 hours per week for 48 weeks annually) instead of the traditional 3 years. This method of counting training hours is used by other professions, such as the Intern Development Program of the National Council of Architectural Registration Boards. The proposed approach would allow residents and program directors to pace training based on individual capabilities. Standards for resident education should include the average number of patients treated in each setting (inpatient or outpatient). A possible set of “multipliers” based on these parameters, and possibly others such as resident evaluation, is devised to calculate the “final adjusted accredited hours” that count toward graduation. Anticipated Benefits Substituting “years of training” with “hours of training” may resolve many of the concerns with the current residency education model, as well as adapt to the demands of residents' personal lives. It also may allow residents to pace their training according to their capabilities and learning styles, and contribute to reflective learning and better quality education. PMID:22379516

Chance-Constrained Day-Ahead Hourly Scheduling in Distribution System Operation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jiang, Huaiguang; Zhang, Yingchen; Muljadi, Eduard

This paper aims to propose a two-step approach for day-ahead hourly scheduling in a distribution system operation, which contains two operation costs, the operation cost at substation level and feeder level. In the first step, the objective is to minimize the electric power purchase from the day-ahead market with the stochastic optimization. The historical data of day-ahead hourly electric power consumption is used to provide the forecast results with the forecasting error, which is presented by a chance constraint and formulated into a deterministic form by Gaussian mixture model (GMM). In the second step, the objective is to minimize themore » system loss. Considering the nonconvexity of the three-phase balanced AC optimal power flow problem in distribution systems, the second-order cone program (SOCP) is used to relax the problem. Then, a distributed optimization approach is built based on the alternating direction method of multiplier (ADMM). The results shows that the validity and effectiveness method.« less

Effective implementation of work-hour limits and systemic improvements.

PubMed

Landrigan, Christopher P; Czeisler, Charles A; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Lockley, Steven W

2007-11-01

Sleep deprivation, ubiquitous among nurses and physicians, recently has been shown to greatly increase rates of serious medical errors and occupational injuries among health care workers in the United States. The Accreditation Council for Graduate Medical Education's current work-hour limits for physicians-in-training allow work hours well in excess of those proven safe. No regulations limit the work hours of other groups of health care providers in the United States. Consequently, nursing work shifts exceeding 12 hours remain common. Physician-in-training shifts of 30 consecutive hours continue to be endorsed officially, and data demonstrate that even the 30-hour limit is exceeded routinely. By contrast, European health care workers are limited by law to 13 consecutive hours of work and to 48-56 hours of work per week. Except for a few institutions that have eliminated 24-hour shifts, as a whole, the United States lags far behind other industrialized nations in ensuring safe work hours. Preventing health care provider sleep deprivation could be an extremely powerful means of addressing the epidemic of medical errors in the United States. Implementation of evidence-based work-hour limits, scientifically designed work schedules, and infrastructural changes, such as the development of standardized handoff systems, are urgently needed.

20 CFR 801.304 - Business hours.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

20 CFR 801.304 - Business hours.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 4 2012-04-01 2012-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

20 CFR 801.304 - Business hours.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

20 CFR 801.304 - Business hours.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 4 2014-04-01 2014-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

20 CFR 801.304 - Business hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Business hours. 801.304 Section 801.304 Employees' Benefits BENEFITS REVIEW BOARD, DEPARTMENT OF LABOR ESTABLISHMENT AND OPERATION OF THE BOARD Action by the Board § 801.304 Business hours. The office of the Clerk of the Board at Washington, DC...

Ultrasound simulator-assisted teaching of cardiac anatomy to preclinical anatomy students: A pilot randomized trial of a three-hour learning exposure.

PubMed

Canty, David Jeffrey; Hayes, Jenny A; Story, David Andrew; Royse, Colin Forbes

2015-01-01

Ultrasound simulation allows students to virtually explore internal anatomy by producing accurate, moving, color, three-dimensional rendered slices from any angle or approach leaving the organs and their relationships intact without requirement for consumables. The aim was to determine the feasibility and efficacy of self-directed learning of cardiac anatomy with an ultrasound simulator compared to cadavers and plastic models. After a single cardiac anatomy lecture, fifty university anatomy students participated in a three-hour supervised self-directed learning exposure in groups of five, randomized to an ultrasound simulator or human cadaveric specimens and plastic models. Pre- and post-tests were conducted using pictorial and non-pictorial multiple-choice questions (MCQs). Simulator students completed a survey on their experience. Four simulator and seven cadaver group students did not attend after randomization. Simulator use in groups of five students was feasible and feedback from participants was very positive. Baseline test scores were similar (P = 0.9) between groups. After the learning intervention, there was no difference between groups in change in total test score (P = 0.37), whether they were pictorial (P = 0.6) or non-pictorial (P = 0.21). In both groups there was an increase in total test scores (simulator +19.8 ±12.4%% and cadaver: +16.4% ± 10.2, P < 0.0001), pictorial question scores (+22.9 ±18.0%, 19.7 ±19.3%, P < 0.001) and non-pictorial question scores (+16.7 ±18.2%, +13 ±15.4%, P = 0.002). The ultrasound simulator appears equivalent to human cadaveric prosections for learning cardiac anatomy. © 2014 American Association of Anatomists.

40 CFR 51.905 - How do areas transition from the 1-hour NAAQS to the 8-hour NAAQS and what are the anti...

Code of Federal Regulations, 2011 CFR

2011-07-01

... obligation exists. (2) 8-Hour NAAQS Nonattainment/1-Hour NAAQS Maintenance. An area designated nonattainment for the 8-hour NAAQS that is a maintenance area for the 1-hour NAAQS at the time of designation for... deferred for so long as the area continues to maintain the 8-hour NAAQS; and (2) No longer applies once the...

40 CFR 51.905 - How do areas transition from the 1-hour NAAQS to the 8-hour NAAQS and what are the anti...

Code of Federal Regulations, 2010 CFR

2010-07-01

... obligation exists. (2) 8-Hour NAAQS Nonattainment/1-Hour NAAQS Maintenance. An area designated nonattainment for the 8-hour NAAQS that is a maintenance area for the 1-hour NAAQS at the time of designation for... deferred for so long as the area continues to maintain the 8-hour NAAQS; and (2) No longer applies once the...

The work hours of GPs: survey of English GPs.

PubMed

Gravelle, Hugh; Hole, Arne Risa

2007-02-01

There is no current information about the hours worked by English GPs. To compare the reported hours worked by GPs with that of other professions and to explain the variation in GP hours worked and on call. National postal survey of 1871 GPs in February 2004. English general practice. Multiple regression analyses of part-time versus full-time status, hours worked, and hours on call. Full-time male GPs report more hours worked (49.6; 95% CI [confidence interval] = 48.9 to 50.2) than males in other professional occupations (47.9; 95% CI = 47.6 to 48.1) and male managers (49.1; 95% CI = 48.8 to 49.5). Full-time female GPs report fewer hours (43.2; 95% CI = 42.0 to 44.3) than females in other professional occupations (44.7; 95% CI = 44.4 to 45.0) and female managers (44.1; 95% CI = 43.7 to 44.5). The number of hours worked decreased with practice list size, and increased with the number of patients per GP. GPs work longer hours in practices with older patients and with a higher proportion of patients in nursing homes. Fewer hours are worked in practices with higher 'additional needs' payments. Having children under 18 years of age increased the probability that female GPs work part-time but has no effect on the probability of male GPs working part-time. Given full-time/part-time status, having children under 18 years of age reduces the hours of male and female GPs. Male English GPs report longer hours worked than other professional groups and managers. The sex differences between GPs in hours worked are mostly attributable to the differential impact of family circumstances, particularly the number of children they have. Perversely, 'additional needs' payments are higher in practices where GPs work fewer hours.

Stress relaxation properties of four orthodontic aligner materials: A 24-hour in vitro study.

PubMed

Lombardo, Luca; Martines, Elisa; Mazzanti, Valentina; Arreghini, Angela; Mollica, Francesco; Siciliani, Giuseppe

2017-01-01

To investigate the stress release properties of four thermoplastic materials used to make orthodontic aligners when subjected to 24 consecutive hours of deflection. Four types of aligner materials (two single and two double layered) were selected. After initial yield strength testing to characterize the materials, each sample was subjected to a constant load for 24 hours in a moist, temperature-regulated environment, and the stress release over time was measured. The test was performed three times on each type of material. All polymers analyzed released a significant amount of stress during the 24-hour period. Stress release was greater during the first 8 hours, reaching a plateau that generally remained constant. The single-layer materials, F22 Aligner polyurethane (Sweden & Martina, Due Carrare, Padova, Italy) and Duran polyethylene terephthalate glycol-modified (SCHEU, Iserlohn, Germany), exhibited the greatest values for both absolute stress and stress decay speed. The double-layer materials, Erkoloc-Pro (Erkodent, Pfalzgrafenweiler, Germany) and Durasoft (SCHEU), exhibited very constant stress release, but at absolute values up to four times lower than the single-layer samples tested. Orthodontic aligner performance is strongly influenced by the material of their construction. Stress release, which may exceed 50% of the initial stress value in the early hours of wear, may cause significant changes in the behavior of the polymers at 24 hours from the application of orthodontic loads, which may influence programmed tooth movement.

Resident duty hour modification affects perceptions in medical education, general wellness, and ability to provide patient care.

PubMed

Moeller, Andrew; Webber, Jordan; Epstein, Ian

2016-07-13

Resident duty hours have recently been under criticism, with concerns for resident and patient well-being. Historically, call shifts have been long, and some residency training programs have now restricted shift lengths. Data and opinions about the effects of such restrictions are conflicting. The Internal Medicine Residency Program at Dalhousie University recently moved from a traditional call structure to a day float/night float system. This study evaluated how this change in duty hours affected resident perceptions in several key domains. Senior residents from an internal medicine training program in Canada responded to an anonymous online survey immediately before and 6 months after the implementation of duty hour reform. The survey contained questions relating to three major domains: resident wellness, ability to deliver quality health care, and medical education experience. Mean pre- and post-intervention scores were compared using the t-test for paired samples. Twenty-three of 27 (85 %) senior residents completed both pre- and post-reform surveys. Residents perceived significant changes in many domains with duty hour reform. These included improved general wellness, less exposure to personal harm, fewer feelings of isolation, less potential for error, improvement in clinical skills expertise, increased work efficiency, more successful teaching, increased proficiency in medical skills, more successful learning, and fewer rotation disruptions. Senior residents in a Canadian internal medicine training program perceived significant benefits in medical education experience, ability to deliver healthcare, and resident wellness after implementation of duty hour reform.

Do difficulties in accessing in-hours primary care predict higher use of out-of-hours GP services? Evidence from an English National Patient Survey.

PubMed

Zhou, Yin; Abel, Gary; Warren, Fiona; Roland, Martin; Campbell, John; Lyratzopoulos, Georgios

2015-05-01

It is believed that some patients are more likely to use out-of-hours primary care services because of difficulties in accessing in-hours care, but substantial evidence about any such association is missing. We analysed data from 567,049 respondents to the 2011/2012 English General Practice Patient Survey who reported at least one in-hours primary care consultation in the preceding 6 months. Of those respondents, 7% also reported using out-of-hours primary care. We used logistic regression to explore associations between use of out-of-hours primary care and five measures of in-hours access (ease of getting through on the telephone, ability to see a preferred general practitioner, ability to get an urgent or routine appointment and convenience of opening hours). We illustrated the potential for reduction in use of out-of-hours primary care in a model where access to in-hours care was made optimal. Worse in-hours access was associated with greater use of out-of-hours primary care for each access factor. In multivariable analysis adjusting for access and patient characteristic variables, worse access was independently associated with increased out-of-hours use for all measures except ease of telephone access. Assuming these associations were causal, we estimated that an 11% relative reduction in use of out-of-hours primary care services in England could be achievable if access to in-hours care were optimal. This secondary quantitative analysis provides evidence for an association between difficulty in accessing in-hours care and use of out-of-hours primary care services. The findings can motivate the development of interventions to improve in-hour access. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

New ways of working in theatres. Three session working days.

PubMed

Collins, Gill

2006-01-01

Innovative ideas will be required to meet government targets for the health service in the future. Increasing the number of hours available to surgical teams from two to three sessions could be one solution. Efficient and effective utilisation of a huge capital resource would appear to be further justification for increased hours, although the Audit Commission suggests that improving existing utilisation rather than extending hours should be the priority. However if operating sessions could be increased from two to three there is a potential to reduce waiting lists.

Resident perceptions of the impact of duty hour restrictions on resident-attending interactions: an exploratory study.

PubMed

Gerjevic, Kristen A; Rosenbaum, Marcy E; Suneja, Manish

2017-07-18

The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations. Focus group interviews were conducted with residents exploring their perceptions of how duty hour regulations impact their interactions with attending physicians. Qualitative analysis identified key themes in residents' experiences interacting with faculty in regard to duty hour regulations. Forty residents from five departments in two hospital systems participated. Discussion of these interactions highlighted that attending physicians demonstrate behaviors that explicitly or implicitly either lend their support and understanding of residents' need to comply with these regulations or imply a lack of support and understanding. Three major themes that contributed to the ease or difficulty in addressing duty hour regulations included attending physicians' explicit communication of expectations, implicit non-verbal and verbal cues and the program's organizational culture. Resident physicians' perception of attending physicians' explicit and implicit communication and residency programs organization culture has an impact on residents' experience with duty hour restrictions. Residency faculty and programs could benefit from explicitly addressing and supporting the challenges that residents perceive in complying with duty hour restrictions.

Effects of an extension of the equilibration period up to 96 hours on the characteristics of cryopreserved bull semen.

PubMed

Fleisch, A; Malama, E; Witschi, U; Leiding, C; Siuda, M; Janett, F; Bollwein, H

2017-02-01

This study was designed to investigate the effects of an equilibration period up to 96 hours and three extenders (AndroMed, OPTIXcell, and Triladyl) on the quality of cryopreserved bull semen and to evaluate, whether an extension of the equilibration time to 72 hours does affect fertility in the field. One ejaculate of 17 bulls was collected and divided into three equal aliquots and diluted, respectively, with the three extenders. Each aliquot was again divided into five parts and equilibrated for 4, 24, 48, 72, and 96 hours before freezing in an automatic freezer. Sperm motility, plasma membrane and acrosome integrity (PMAI), and DNA fragmentation index (% DFI) were measured during equilibration. In addition to the parameters measured during equilibration, the percentage of viable sperm cells with high mitochondrial membrane potential (HMMP) was measured immediately after thawing, and after 3 hours of incubation at 37 °C. Sperm motility was assessed using CASA, and PMAI, HMMP, and % DFI were measured using flow cytometry. Equilibration time did affect all parameters before freezing (P < 0.01), and also the extender affected all parameters except HMMP (P < 0.05). After thawing, all parameters except HMMP immediately after thawing were influenced by the equilibration period (P < 0.001), whereas all parameters except % DFI immediately after thawing were influenced by the extender (P < 0.001). The changes of semen characteristics during 3 hours of incubation were also dependent on the equilibration time and the extender used in all parameters (P < 0.01). In the field study, semen of nine bulls was collected thrice weekly, processed using Triladyl egg yolk extender, and frozen in 0.25 mL straws with 15 × 10 6 spermatozoa per straw. In total, the nonreturn rates on Day 90 after insemination (NRR90) of 263,816 inseminations in two periods were evaluated. Whereas semen collected on Mondays and Wednesdays was equilibrated for 24 hours in both periods

Maternal work hours and adolescents' school outcomes among low-income families in four urban counties.

PubMed

Gennetian, Lisaa A; Lopoo, Leonard M; London, Andrew S

2008-02-01

We examine how changes in maternal work hours affect adolescent children's school participation and performance outcomes using data from interviews in 1998 and 2001 with approximately 1700 women who, in May 1995, were welfare-reliant, single mothers of adolescents living in neighborhoods of concentrated poverty in Cuyahoga (Cleveland), Los Angeles, Miami-Dade, and Philadelphia counties. Analyses control for a broad array of mothers' characteristics, including their psychological and physical health, experiences with domestic violence and substance abuse, as well as unobserved time-invariant characteristics. In fixed-effects models, we find unfavorable effects of increased maternal work hours on three of six outcomes: skipping school, performing above average, and parental contact about behavior problems. Adolescent-aged sons seem to be particularly sensitive to changes in mothers' hours of work.

Analysis of 24-hour versus 48-hour traffic counts for HPMS sampling.

DOT National Transportation Integrated Search

2014-04-01

The Illinois Department of Transportation (IDOT) has requested a waiver from the Federal Highway Administration (FHWA) to : allow IDOT to implement a 24-hour traffic-count program on the non-state HPMS routes, as opposed to the current Highway : Perf...

A new approach for evaluating flexible working hours.

PubMed

Giebel, Ole; Janssen, Daniela; Schomann, Carsten; Nachreiner, Friedhelm

2004-01-01

Recent studies on flexible working hours show at least some of these working time arrangements seem to be associated with impairing effects of health and well-being. According to available evidence, variability of working hours seems to play an important role. The question, however, is how this variability can be assessed and used to explain or predict impairments. Based on earlier methods used to assess shift-work effects, a time series analysis approach was applied to the matter of flexible working hours. Data on the working hours of 4 week's length of 137 respondents derived from a survey on flexible work hours involving 15 companies of different production and service sectors in Germany were converted to time series and analyzed by spectral analysis. A cluster analysis of the resulting power spectra yielded 5 clusters of flexible work hours. Analyzing these clusters for differences in reported impairments showed that workers who showed suppression of circadian and weekly rhythms experienced severest impairments, especially in circadian controlled functions like sleep and digestion. The results thus indicate that analyzing the periodicity of flexible working hours seems to be a promising approach for predicting impairments which should be investigated further in the future.

BOREAS ECMWF 6-Hour Analysis and Forecast Data

NASA Technical Reports Server (NTRS)

Viterbo, Pedro; Hall, Forrest G. (Editor); Newcommer, Jeffrey A. (Editor); Betts, Alan; Strub, Richard

2000-01-01

In cooperation with BOREAS atmospheric research efforts, the ECMWF agreed to provide BOREAS with a customized subset of its 6-hourly forecast data. This data set contains parameters from three ECMWF data products in GRIB format: Surface and Diagnostic Fields, Supplemental Fields, and Extension Data. Sample software and information are provided to assist in reading the data files. Temporally, the atmospheric parameters are available for the four main synoptic hours of 00, 06, 12, and 18 UTC from 1994 to 1996. Spatially, the data are stored in a 0.5- by 0.5-degree latitude/longitude grid. To cover the entire BOREAS study area, the grid extends from 48 to 62 degrees latitude and -92 to -114 degrees longitude. The data are stored in binary data representation known as FM 92 GRIB. Due to the complexity of the content and format of this data set, users are advised to read Sections 6, 7, 8, and 14 before using data. Based on agreements between BOREAS and ECMWF, users may legally obtain and use these data only by having a set of the BOREAS CD-ROMs that contain the data. Possession or use of these data under any other circumstance is prohibited. See Sections 11.3 and 20.4 for details.

Three-Dimensional Hierarchical Plasmonic Nano-Architecture Enhanced Surface-Enhanced Raman Scattering Immuno-Sensor for Cancer Biomarker Detection in Blood Plasma

PubMed Central

Li, Ming; Cushing, Scott K.; Zhang, Jianming; Suri, Savan; Evans, Rebecca; Petros, William P.; Gibson, Laura F.; Ma, Dongling; Liu, Yuxin; Wu, Nianqiang

2013-01-01

A three-dimensional (3D) hierarchical plasmonic nano-architecture has been designed for a sensitive surface-enhanced Raman scattering (SERS) immuno-sensor for protein biomarker detection. The capture antibody molecules are immobilized on a plasmonic gold triangle nano-array pattern. On the other hand, the detection antibody molecules are linked to the gold nano-star@Raman-reporter@silica sandwich nanoparticles. When protein biomarkers are present, the sandwich nanoparticles are captured over the gold triangle nano-array, forming a confined 3D plasmonic field, leading to the enhanced electromagnetic field in intensity and in 3D space. As a result, the Raman reporter molecules are exposed to a high density of “hot spots”, which amplifies the Raman signal remarkably, improving the sensitivity of the SERS immuno-sensor. This SERS immuno-sensor exhibits a wide linear range (0.1 pg/mL to 10 ng/mL), and a low limit of detection (7 fg/mL) toward human immunoglobulin G (IgG) protein in the buffer solution. This biosensor has been successfully used for detection of the vascular endothelial growth factor (VEGF) in the human blood plasma from clinical breast cancer patient samples. PMID:23659430

Three-dimensional nanoporous MoS2 framework decorated with Au nanoparticles for surface-enhanced Raman scattering

NASA Astrophysics Data System (ADS)

Sheng, Yingqiang; Jiang, Shouzhen; Yang, Cheng; Liu, Mei; Liu, Aihua; Zhang, Chao; Li, Zhen; Huo, Yanyan; Wang, Minghong; Man, Baoyuan

2017-08-01

The three-dimensional (3D) MoS2 decorated with Au nanoparticles (Au NPs) hybrids (3D MoS2-Au NPs) for surface-enhanced Raman scattering (SERS) sensing was demonstrated in this paper. SEM, Raman spectroscopy, TEM, SAED, EDX and XRD were performed to characterize 3D MoS2-Au NPs hybrids. Rhodamine 6G (R6G), fluorescein and gallic acid molecules were used as the probe for the SERS detection of the 3D MoS2-Au NPs hybrids. In addition, we modeled the enhancement of the electric field of MoS2-Au NPs hybrids using Finite-difference time-domain (FDTD) analysis, which can further give assistance to the mechanism understanding of the SERS activity.

Comfort response of three silicone hydrogel daily disposable contact lenses.

PubMed

Varikooty, Jalaiah; Keir, Nancy; Richter, Doris; Jones, Lyndon W; Woods, Craig; Fonn, Desmond

2013-09-01

To evaluate subjective ocular comfort across the day with three silicone hydrogel daily disposables (SHDDs) in a group of adapted lens wearers. Masked subjects (asymptomatic or symptomatic of end-of-day (EOD) dryness with habitual lenses) wore three SHDDs: DAILIES TOTAL1 (DT1), Clariti 1day (C1D), or 1-DAY ACUVUE TRUEYE (AVTE), each for 3 days. On day 2, wearing time (WT) and comfort ratings after insertion, at 4, 8, and 12 hours, and at EOD were recorded. Because not all subjects wore lenses for 12 hours, comfort was analyzed across the day (up to 8 hours, 8 to 12 hours), and a new variable ("cumulative comfort" [CC]) was calculated for EOD. One hundred four subjects completed the study (51 asymptomatic, 53 symptomatic). The two groups had different WTs (mean WT, 14.0 and 12.7 hours, respectively; p < 0.001). Ocular comfort was rated higher in the asymptomatic group throughout the day (p < 0.001). One hundred four subjects wore all three SHDDs for at least 8 hours, whereas 74 (45 asymptomatic, 29 symptomatic) subjects wore them for 12 hours or longer. Comfort ratings were higher with DT1 (least square means [LSM] = 91.0) than with C1D (LSM = 86.5; p < 0.001) and AVTE (LSM = 87.7; p = 0.011) for the first 8 hours and lower with C1D compared with DT1 (p = 0.012) from 8 to 12 hours. Mean EOD (± SD) comfort with the C1D lens was 72 ± 21, lower than both DT1 (mean, 79 ± 17; p = 0.001) and AVTE (mean, 78 ± 21; p = 0.010). Mean CC was higher in the asymptomatic group (mean, 1261 ± 59) compared with that in the symptomatic group (mean, 1009 ± 58; p < 0.001) and higher for DT1 (mean, 1184 ± 258) than C1D (mean, 1094 ± 318; p = 0.002) and AVTE (mean, 1122 ± 297; p = 0.046). All three SHDDs had average WTs of 12 hours or longer for 1 day. Comfort during the first 12 hours was highest with DT1 (similar to AVTE between 8 and 12 hours) and lowest with C1D. End-of-day comfort was lowest with C1D, and CC was highest for DT1. Cumulative comfort may be a valuable new

Fluidized-bed combustion 1000-hour test program. Volume IV. Engineering details and post-test inspections

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roberts, A. G.; Barker, S. N.; Phillips, R. N.

1981-09-01

Volume IV of the report on the 1000 hour programme consists of three appendices giving details of the enginmering/construction aspects of the plant and reports from Stal-Laval Turbin A.B. Appendix N has been entered individually. (LTN)

The impact of small changes in bar closing hours on violence. The Norwegian experience from 18 cities

PubMed Central

Rossow, Ingeborg; Norström, Thor

2012-01-01

Aims To estimate the effect on violence of small changes in closing hours for on-premise alcohol sales, and to assess whether a possible effect is symmetrical. Design, setting, and participants A quasi-experimental design drawing on data from 18 Norwegian cities that have changed (extended or restricted) the closing hours for on-premise alcohol sales. All changes were ≤ 2 hours. Measurements Closing hours were measured in terms of the latest permitted hour of on-premise trading, ranging from 1 a.m. to 3 a.m. The outcome measure comprised police-reported assaults that occurred in the city centre between 10 p.m. and 5 a.m. at weekends. Assaults outside the city centre during the same time window should not be affected by changes in closing hours but function as a proxy for potential confounders, and was thus included as a control variable. The data spanned the period Q1 2000–Q3 2010, yielding 774 observations. Findings Outcomes from main analyses suggested that each 1-hour extension of closing hours was associated with a statistically significant increase of 4.8 assaults (95% CI 2.60, 6.99) per 100 000 inhabitants per quarter (i.e. an increase of about 16%). Findings indicate that the effect is symmetrical. These findings were consistent across three different modelling techniques. Conclusion In Norway, each additional 1-hour extension to the opening times of premises selling alcohol is associated with a 16% increase in violent crime. PMID:21906198

Advantages of T2 Weighted Three Dimensional and T1 Weighted Three Dimensional Contrast Medium Enhanced Magnetic Resonance Urography in Examination of the Child Population.

PubMed

Sehic, Adnan; Julardzija, Fuad; Vegar-Zubovic, Sandra; Sefic-Pasic, Irmina

2017-03-01

The aim of this study is to prove the advantages of combined use of T2 weighted three dimensional (T2 W 3D) and T1 weighted three dimensional contrast medium enhanced (T1 W 3D CE) magnetic resonance (MR) urography in displaying urinary tract in child population. Total of 120 patients were included in the study, 71 (59%) male patients and 49 (41%) female patients. The study was conducted on the Radiology clinic, University of Sarajevo Clinical Center, during the period from February to November 2016. Patients were examined on the 1.5T and 3T MRI, with standard protocol which includes T2 W 3D and T1 W 3D contrast medium enhanced MR urography. In the post procesing quantitative measurement of signal intensity and evaluation of the display quality in the area of renal pelvis, middle of ureter and the mouth of the ureter were done. Measurement was concluded on Syngo software B13. Analyzing the acquired data and statistically processing them we got results which have shown higher signal intensity of measured structures on T1 W 3D contrast medium enhanced MR urography on the level p<0.01 and p<0.05 compared to T2 W 3D MR urography in patients that had normal dynamics of contrast medium secretion. However, in kidneys with decreased function, T2 W 3D MR urography provided higher signal intensity and better display compared to T1 W 3D contrast medium enhanced MR urography on the level p<0.05 and p<0.01. T2 W3D MR urography is useful in imaging nonfunctional kidney as well as in patients prone to allergic reactions, where as T1 W3D CE MR urography is at an advantage over T2 W 3D MR urography in imaging the kidney functionality, kidney dynamics measurement, it provides higher MRI signal intensity required for clear 3D reconstructions.

Fentanyl, but not haloperidol, entrains persisting circadian activity episodes when administered at 24- and 31-hour intervals

PubMed Central

Leffel, Joseph K.; Kosobud, Ann E; Timberlake, William

2009-01-01

Administration of several drugs of abuse on a 24-hour schedule has been shown to entrain both pre-drug (anticipatory) and post-drug (evoked) circadian activity episodes that persist for several days when the drug is withheld. The present tested the entrainment effects of fentanyl, an opioid agonist with a noted abuse liability, and haloperidol, an antipsychotic dopamine antagonist without apparent abuse liability. Adult female Sprague-Dawley rats housed under constant light in cages with attached running wheels received repeated low, medium, or high doses of either fentanyl or haloperidol on a 24-hour administration schedule followed by a 31-hour schedule (Experiment 1) or solely on a 31-hour schedule (Experiment 2). The results showed that all three doses of fentanyl entrained both pre-drug and post-drug episodes of wheel running when administered every 24░hours, and the combined pre- and post-fentanyl activity episodes persist for at least 3 days when the drug is withheld during test days. On the 31-hour schedule, fentanyl produced an ``ensuing" activity episode approximately 24░hours post-administration, but failed to produce an anticipatory episode 29–31░hours post-administration. In contrast, haloperidol injections failed to produce both pre-drug episodes on the 24-hour schedule and circadian ensuing episodes on the 31-hour schedule, and post-haloperidol suppression of activity appeared to mask the freerunning activity rhythm. Taken together, these results provide additional evidence that drugs of abuse share a common ability to entrain circadian activity episodes. PMID:19595707

Report of 1,000 Hour Catalyst Longevity Evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daniel M. Ginosar

2009-06-01

This report presents the results of a 1,000 hour, high-pressure, catalyst longevity test for the decomposition of concentrated sulfuric acid. The reaction is used for both the sulfur-iodine (S-I) cycle and hybrid sulfur cycle. By the time of the delivery date of April 17, 2009, for project milestone no. 2NIN07TC050114, the 1% Pt/TiO2 catalyst had been in the reaction environment for 658 hours. During the first 480 hours of testing, the catalyst activity provided stable, near-equilibrium yields of 46.8% SO2 and 22.8% O2. However, product yields declined at sample exposure times >480 hours. At 658 hours of operation, catalyst activitymore » (based on oxygen yield) declined to 57% relative to the stable period of catalyst activity. Thus, as of April 17, this catalyst did not provide the desired stability level of <10% degradation per 1,000 hours. The experiment was terminated on April 27, after 792 hours, when a fitting failed and the catalyst was displaced from the reactor such that the sample could not be recovered. Oxygen conversion at the end of the experiment was 12.5% and declining, suggesting that at that point, catalyst activity had decreased to 54% of the initial level.« less

29 CFR 4.178 - Computation of hours worked.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Compliance with Compensation Standards § 4.178 Computation of hours worked. Since employees subject to the... such hours are adequately segregated, as indicated in § 4.179, compensation in accordance with the Act will be required for all hours of work in any workweek in which the employee performs any work in...

5 CFR 551.521 - Fractional hours of work.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Fractional hours of work. 551.521 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Overtime Pay Provisions Fractional Hours of Work § 551.521 Fractional hours of work. (a) An employee shall be compensated for every minute of regular overtime work. (b...

5 CFR 551.521 - Fractional hours of work.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Fractional hours of work. 551.521 Section... ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Overtime Pay Provisions Fractional Hours of Work § 551.521 Fractional hours of work. (a) An employee shall be compensated for every minute of regular overtime work. (b...

29 CFR 778.100 - The maximum-hours provisions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false The maximum-hours provisions. 778.100 Section 778.100 Labor... Requirements Introductory § 778.100 The maximum-hours provisions. Section 7(a) of the Act deals with maximum... specifically exempt from its overtime pay requirements. It prescribes the maximum weekly hours of work...

The Research of Utilization Hours of Coal-Fired Power Generation Units Based on Electric Energy Balance

NASA Astrophysics Data System (ADS)

Liu, Junhui; Yang, Jianlian; Wang, Jiangbo; Yang, Meng; Tian, Chunzheng; He, Xinhui

2018-01-01

With grid-connected scale of clean energy such as wind power and photovoltaic power expanding rapidly and cross-province transmission scale being bigger, utilization hours of coal-fired power generation units become lower and lower in the context of the current slowdown in electricity demand. This paper analyzes the influencing factors from the three aspects of demand, supply and supply and demand balance, and the mathematical model has been constructed based on the electric energy balance. The utilization hours of coal-fired power generation units have been solved considering the relationship among proportion of various types of power installed capacity, the output rate and utilization hours. By carrying out empirical research in Henan Province, the utilization hours of coal-fired units of Henan Province in 2020 has been achieved. The example validates the practicability and the rationality of the model, which can provide a basis for the decision-making for coal-fired power generation enterprises.

Multicenter Evaluation of a 0-Hour/1-Hour Algorithm in the Diagnosis of Myocardial Infarction With High-Sensitivity Cardiac Troponin T.

PubMed

Mueller, Christian; Giannitsis, Evangelos; Christ, Michael; Ordóñez-Llanos, Jorge; deFilippi, Christopher; McCord, James; Body, Richard; Panteghini, Mauro; Jernberg, Tomas; Plebani, Mario; Verschuren, Franck; French, John; Christenson, Robert; Weiser, Silvia; Bendig, Garnet; Dilba, Peter; Lindahl, Bertil

2016-07-01

We aim to prospectively validate the diagnostic accuracy of the recently developed 0-h/1-h algorithm, using high-sensitivity cardiac troponin T (hs-cTnT) for the early rule-out and rule-in of acute myocardial infarction. We enrolled patients presenting with suspected acute myocardial infarction and recent (<6 hours) onset of symptoms to the emergency department in a global multicenter diagnostic study. Hs-cTnT (Roche Diagnostics) and sensitive cardiac troponin I (Siemens Healthcare) were measured at presentation and after 1 hour, 2 hours, and 4 to 14 hours in a central laboratory. Patient triage according to the predefined hs-cTnT 0-hour/1-hour algorithm (hs-cTnT below 12 ng/L and Δ1 hour below 3 ng/L to rule out; hs-cTnT at least 52 ng/L or Δ1 hour at least 5 ng/L to rule in; remaining patients to the "observational zone") was compared against a centrally adjudicated final diagnosis by 2 independent cardiologists (reference standard). The final diagnosis was based on all available information, including coronary angiography and echocardiography results, follow-up data, and serial measurements of sensitive cardiac troponin I, whereas adjudicators remained blinded to hs-cTnT. Among 1,282 patients enrolled, acute myocardial infarction was the final diagnosis for 213 (16.6%) patients. Applying the hs-cTnT 0-hour/1-hour algorithm, 813 (63.4%) patients were classified as rule out, 184 (14.4%) were classified as rule in, and 285 (22.2%) were triaged to the observational zone. This resulted in a negative predictive value and sensitivity for acute myocardial infarction of 99.1% (95% confidence interval [CI] 98.2% to 99.7%) and 96.7% (95% CI 93.4% to 98.7%) in the rule-out zone (7 patients with false-negative results), a positive predictive value and specificity for acute myocardial infarction of 77.2% (95% CI 70.4% to 83.0%) and 96.1% (95% CI 94.7% to 97.2%) in the rule-in zone, and a prevalence of acute myocardial infarction of 22.5% in the observational zone. The hs

40 CFR 51.905 - How do areas transition from the 1-hour NAAQS to the 1997 8-hour NAAQS and what are the anti...

Code of Federal Regulations, 2014 CFR

2014-07-01

... obligation exists. (2) 8-Hour NAAQS Nonattainment/1-Hour NAAQS Maintenance. An area designated nonattainment for the 8-hour NAAQS that is a maintenance area for the 1-hour NAAQS at the time of designation for... deferred for so long as the area continues to maintain the 8-hour NAAQS; and (2) No longer applies once the...

40 CFR 51.905 - How do areas transition from the 1-hour NAAQS to the 1997 8-hour NAAQS and what are the anti...

Code of Federal Regulations, 2012 CFR

2012-07-01

... obligation exists. (2) 8-Hour NAAQS Nonattainment/1-Hour NAAQS Maintenance. An area designated nonattainment for the 8-hour NAAQS that is a maintenance area for the 1-hour NAAQS at the time of designation for... deferred for so long as the area continues to maintain the 8-hour NAAQS; and (2) No longer applies once the...

40 CFR 51.905 - How do areas transition from the 1-hour NAAQS to the 1997 8-hour NAAQS and what are the anti...

Code of Federal Regulations, 2013 CFR

2013-07-01

... obligation exists. (2) 8-Hour NAAQS Nonattainment/1-Hour NAAQS Maintenance. An area designated nonattainment for the 8-hour NAAQS that is a maintenance area for the 1-hour NAAQS at the time of designation for... deferred for so long as the area continues to maintain the 8-hour NAAQS; and (2) No longer applies once the...

Effect of a Protected Sleep Period on Hours Slept During Extended Overnight In-hospital Duty Hours Among Medical Interns

PubMed Central

Volpp, Kevin G.; Shea, Judy A.; Small, Dylan S.; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian; Novak, Cristina; Bellini, Lisa M.; Dine, C. Jessica; Mollicone, Daniel J.; Dinges, David F.

2013-01-01

Context A 2009 Institute of Medicine report recommended protected sleep periods for medicine trainees on extended overnight shifts, a position reinforced by new Accreditation Council for Graduate Medical Education requirements. Objective To evaluate the feasibility and consequences of protected sleep periods during extended duty. Design, Setting, and Participants Randomized controlled trial conducted at the Philadelphia VA Medical Center medical service and Oncology Unit of the Hospital of the University of Pennsylvania (2009–2010). Of the 106 interns and senior medical students who consented, 3 were not scheduled on any study rotations. Among the others, 44 worked at the VA center, 16 at the university hospital, and 43 at both. Intervention Twelve 4-week blocks were randomly assigned to either a standard intern schedule (extended duty overnight shifts of up to 30 hours; equivalent to 1200 overnight intern shifts at each site), or a protected sleep period (protected time from 12:30 AM to 5:30 AM with handover of work cell phone; equivalent to 1200 overnight intern shifts at each site). Participants were asked to wear wrist actigraphs and complete sleep diaries. Main Outcome Measures Primary outcome was hours slept during the protected period on extended duty overnight shifts. Secondary outcome measures included hours slept during a 24-hour period (noon to noon) by day of call cycle and Karolinska sleepiness scale. Results For 98.3% of on-call nights, cell phones were signed out as designed. At the VA center, participants with protected sleep had a mean 2.86 hours (95% CI, 2.57–3.10 hours) of sleep vs 1.98 hours (95% CI, 1.68–2.28 hours) among those who did not have protected hours of sleep (P < .001). At the university hospital, participants with protected sleep had a mean 3.04 hours (95% CI, 2.77–3.45 hours) of sleep vs 2.04 hours (95% CI, 1.79–2.24) among those who did not have protected sleep (P <.001). Participants with protected sleep were

Autophagy occurs within an hour of adenosine triphosphate treatment after nerve cell damage: the neuroprotective effects of adenosine triphosphate against apoptosis

PubMed Central

Lu, Na; Wang, Baoying; Deng, Xiaohui; Zhao, Honggang; Wang, Yong; Li, Dongliang

2014-01-01

After hypoxia, ischemia, or inflammatory injuries to the central nervous system, the damaged cells release a large amount of adenosine triphosphate, which may cause secondary neuronal death. Autophagy is a form of cell death that also has neuroprotective effects. Cell Counting Kit assay, monodansylcadaverine staining, flow cytometry, western blotting, and real-time PCR were used to determine the effects of exogenous adenosine triphosphate treatment at different concentrations (2, 4, 6, 8, 10 mmol/L) over time (1, 2, 3, and 6 hours) on the apoptosis and autophagy of SH-SY5Y cells. High concentrations of extracellular adenosine triphosphate induced autophagy and apoptosis of SH-SY5Y cells. The enhanced autophagy first appeared, and peaked at 1 hour after treatment with adenosine triphosphate. Cell apoptosis peaked at 3 hours, and persisted through 6 hours. With prolonged exposure to the adenosine triphosphate treatment, the fraction of apoptotic cells increased. These data suggest that the SH-SY5Y neural cells initiated autophagy against apoptosis within an hour of adenosine triphosphate treatment to protect themselves against injury. PMID:25368646

Long working hours and physical activity.

PubMed

Angrave, David; Charlwood, Andy; Wooden, Mark

2015-08-01

It is widely believed that persons employed in jobs demanding long working hours are at greater risk of physical inactivity than other workers, primarily because they have less leisure time available to undertake physical activity. The aim of this study was to test this hypothesis using prospective data obtained from a nationally representative sample of employed persons. Longitudinal data from the Household, Income and Labour Dynamics in Australia Survey (93,367 observations from 17,893 individuals) were used to estimate conditional fixed effects logistic regression models of the likelihood of moderate or vigorous physical exercise for at least 30 min, at least four times a week. No significant associations between long working hours and the incidence of healthy levels of physical activity were uncovered once other exogenous influences on activity levels were controlled for. The odds of men or women who usually work 60 or more hours per week exercising at healthy levels were 6% and 11% less, respectively, than those of comparable persons working a more standard 35-40 h/week; however, neither estimate was significantly different from 0 at 95% CI. The findings suggest that there is no trade-off between long working hours and physical activity in Australia. It is argued that these findings are broadly consistent with previous research studies from Anglo-Saxon countries (where long working hours are pervasive) that employed large nationally representative samples. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

12 CFR 7.3000 - Bank hours and closings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Bank hours and closings. 7.3000 Section 7.3000 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY BANK ACTIVITIES AND OPERATIONS Bank Operations § 7.3000 Bank hours and closings. (a) Bank hours. A national bank's board of directors...

12 CFR 7.3000 - Bank hours and closings.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 1 2011-01-01 2011-01-01 false Bank hours and closings. 7.3000 Section 7.3000 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY BANK ACTIVITIES AND OPERATIONS Bank Operations § 7.3000 Bank hours and closings. (a) Bank hours. A national bank's board of directors...

Flexible working hours and well-being in Finland.

PubMed

Kandolin, I; Härmä, M; Toivanen, M

2001-12-01

Flexibility of working hours became more prevalent in the 1990s in Finland. According to a representative survey on Finnish wage and salary earners (n = 1790) at the beginning of 2000, a great majority of male (76%) and female (65%) employees regularly worked overtime and/or had irregular working hours every month. These employees were flexible in meeting the needs of their companies/employers. Individual flexibility of working hours was far less common, only one third of male and female employees were able to regulate their working hours. A better balance between company-controlled and individual flexibility would, however, improve the well-being of employees. Employees working overtime without being allowed to regulate their working hours felt more symptoms of distress and had more conflicts in combining workplace and family roles than those who could individually determine their working hours flexibly. An investment in individually determined flexibility, for example by means of participatory planning, would improve the well-being of employees, and thus also improve the productivity of the organization.

29 CFR 2530.200b-2 - Hour of service.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regular work schedule of 40 hours per week. The employee's hourly rate of compensation is, therefore, $4... is scheduled to work 371/2 hours per week (although from time to time working overtime). B must... calculated on the basis of units of time (weeks). C has no regular work schedule but works at least 50 hours...

Regulating danger on the highways: hours of service regulations.

PubMed

Mansfield, Daniel; Kryger, Meir

2015-12-01

Current hours of service regulations governing commercial truck drivers in place in the United States, Canada, Australia, and the European Union are summarized and compared to facilitate the assessment of the effectiveness of such provisions in preventing fatigue and drowsiness among truck drivers. Current hours of service provisions governing commercial truck drivers were derived from governmental sources. The commercial truck driver hours of service provisions in the United States, Canada, and the European Union permit drivers to work 14 hours and those of Australia permit drivers to work 12 hours a day on a regular basis. The regulations do not state what a driver may do with time off. They are consistent with a driver being able to drive after 24 hours without sleep. They do not take into account circadian rhythm by linking driving or rest to time of day. Current hours of service regulations governing commercial truck drivers leave gaps--permitting drivers to work long hours on a regular basis, permitting driving after no sleep for 24 hours, and failing to take into account the importance of circadian rhythm, endangering the public safety and the truck drivers themselves. Copyright © 2015 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers

PubMed Central

Waongenngarm, Pooriput; Rajaratnam, Bala S.; Janwantanakul, Prawit

2015-01-01

Background Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values (t(9) = −11.97 to −2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury. PMID:27014491

Effect of the 80-hour workweek on resident burnout.

PubMed

Gelfand, Dmitri V; Podnos, Yale D; Carmichael, Joseph C; Saltzman, Darin J; Wilson, Samuel E; Williams, Russell A

2004-09-01

With the introduction of the newly mandated restrictions on resident work hours, we expected improvement in subjective feelings of personal accomplishment and lessened emotional exhaustion and depersonalization. Residents and faculty members completed an anonymous online Maslach Burnout Inventory Human Services Survey (3rd ed; Consulting Psychologist Press Inc, Palo Alto, Calif) and work-hour registry before and after implementation of new restrictions. Urban, university-based department of surgery. All house staff (n = 37) and faculty (n = 27). Introduction of new Institutional Standards for Resident Duty Hours 2003. Main Outcome Measure Resident work hours and levels of emotional exhaustion, perceived degree of depersonalization, and personal accomplishment. Resident work hours per week decreased from 100.7 to 82.6 (P < .05) with introduction of the new schedule. Home call and formal educational activity time within working hours (eg, clinical conferences) significantly (P < .05) decreased from 11.5 and 4.8 hours to 4.6 and 2.5 hours per week, respectively. Operating room hours, clinic time, and duration of rounds did not show a significant change. Changes in parameters of resident and faculty emotional exhaustion, depersonalization, and personal accomplishment did not show statistical significance (P > .05). Despite successful reductions in resident work hours, measures of burnout were not significantly affected. However, important clinical activities such as time spent in the operating room, clinic, and making rounds were maintained. Formal in-hospital education time was reduced.

Migration plans and hours of work in Malaysia.

PubMed

Gillin, E D; Sumner, D A

1985-01-01

"This article describes characteristics of prospective migrants in the Malaysian Family Life Survey and investigates how planning to move affects hours of work. [The authors] use ideas about intertemporal substitution...to discuss the response to temporary and permanent wage expectations on the part of potential migrants. [An] econometric section presents reduced-form estimates for wage rates and planned migration equations and two-stage least squares estimates for hours of work. Men currently planning a move were found to work fewer hours. Those originally planning only a temporary stay at their current location work more hours." excerpt

Five-year Experience With Arterial Switch Operation in the First Hours of Life.

PubMed

Chasovskyi, Kyrylo; Mykychak, Yaroslav; Rudenko, Nadiia; Vorobyova, Hanna; Yemets, Illya

2017-01-01

We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications. Overall 30-day survival was 98% (2 [2%] group I vs 5 [2%] group II, P = 1.000). Fifty (13.3%) major complications were observed: 14 (15%) in group I and 36 (15%) in group II (P = 0.635). Although peLOS and morbidity index did not differ significantly between groups, postoperative VT (42 hours [24, 67] vs 27 hours [22, 47], P = 0.008) and total hospital stay were significantly longer in group II (18 days [10, 19] vs 14 days [12, 18]). A median volume of 80 mL (60-100 mL) of autologous umbilical cord blood was collected (80 mL, group 1 vs 60 mL, group II; P = 0.090). Homologous blood cell transfusion was avoided in 70 patients (78%) in group I and in 13 patients (6%) in group II (P < 0.001). Arterial switch operation during the initial 24 hours of life has similar outcomes in view of morbidity and mortality to the conventional approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Forecasting of hourly load by pattern recognition in a small area power system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dehdashti-Shahrokh, A.

1982-01-01

An intuitive, logical, simple and efficient method of forecasting hourly load in a small area power system is presented. A pattern recognition approach is used in developing the forecasting model. Pattern recognition techniques are powerful tools in the field of artificial intelligence (cybernetics) and simulate the way the human brain operates to make decisions. Pattern recognition is generally used in analysis of processes where the total physical nature behind the process variation is unkown but specific kinds of measurements explain their behavior. In this research basic multivariate analyses, in conjunction with pattern recognition techniques, are used to develop a linearmore » deterministic model to forecast hourly load. This method assumes that load patterns in the same geographical area are direct results of climatological changes (weather sensitive load), and have occurred in the past as a result of similar climatic conditions. The algorithm described in here searches for the best possible pattern from a seasonal library of load and weather data in forecasting hourly load. To accommodate the unpredictability of weather and the resulting load, the basic twenty-four load pattern was divided into eight three-hour intervals. This division was made to make the model adaptive to sudden climatic changes. The proposed method offers flexible lead times of one to twenty-four hours. The results of actual data testing had indicated that this proposed method is computationally efficient, highly adaptive, with acceptable data storage size and accuracy that is comparable to many other existing methods.« less

Fatigue in Residency Education: Understanding the Influence of Work Hours Regulations in Europe.

PubMed

Taylor, Taryn S; Teunissen, Pim W; Dornan, Tim; Lingard, Lorelei

2017-12-01

Although one proposed solution to the problem of fatigued medical trainees is the implementation of work hours regulations, concerns about the effectiveness of these regulations are growing. Canada remains one of the few Western jurisdictions without legislated regulation. Recent research suggests that fatigue is a complex social construct, rather than simply a lack of sleep; thus, the authors explored how regulations and fatigue are understood in countries with established work hours frameworks to better inform other jurisdictions looking to address trainee fatigue. Using constructivist grounded theory methodology, the authors conducted individual, semistructured interviews in 2015-2016 with 13 postgraduate medical trainees from four European countries with established work hours regulations. Data collection and analysis proceeded iteratively, and the authors used a constant comparative approach to analysis. Trainees reported that they were commonly fatigued and that they violated the work hours restrictions for various reasons, including educational pursuits. Although they understood the regulations were legislated specifically to ensure safe patient care and optimize trainee well-being, they also described implicit meanings (e.g., monitoring for trainee efficiency) and unintended consequences (e.g., losing a sense of vocation). Work hours regulations carry multiple, conflicting meanings for trainees that are captured by three predominant rhetorics: the rhetoric of patient safety, of well-being, and of efficiency. Tensions within each of those rhetorics reveal that managing fatigue within clinical training environments is complex. These findings suggest that straightforward solutions are unlikely to solve the problem of fatigue, assure patient safety, and improve trainee well-being.

Work-hour restrictions as an ethical dilemma for residents.

PubMed

Carpenter, Robert O; Austin, Mary T; Tarpley, John L; Griffin, Marie R; Lomis, Kimberly D

2006-04-01

We propose that the standardized work-hour limitations have created an ethical dilemma for residents. A survey tool was designed to assess factors that influence the number of hours residents work and report. The program directors of pediatrics, internal medicine, and general surgery at our institution supported their residents' participation. A voluntary, anonymous survey of these residents was performed. One hundred seventy of 265 eligible residents were surveyed. Eighty-one percent of residents surveyed responded. Eighty percent of respondents reported exceeding work-hour restrictions at least once within the past 6 months. The factor of greatest influence measured was concern for patient care (80%). Forty-nine percent of respondents admitted underreporting their work hours. The Accreditation Council for Graduate Medical Education work-hour restrictions have created an ethical dilemma for residents. Our data show that a significant number of residents feel compelled to exceed work-hour regulations and report those hours falsely.

NASA 50 amp hour nickel cadmium battery waste heat determination

NASA Technical Reports Server (NTRS)

Mueller, V. C.

1980-01-01

A process for determining the waste heat generated in a 50-ampere-hour, nickel cadmium battery as a function of the discharge rate is described and results are discussed. The technique involved is essentially calibration of the battery as a heat transfer rate calorimeter. The tests are run at three different levels of battery activity, one at 40-watts of waste heat generated, one at 60, and one at 100. Battery inefficiency ranges from 14 to 18 percent at discharge rates of 284 to 588 watts, respectively and top-of-cell temperatures of 20 C.

Developing a policy game intervention to enhance collaboration in public health policymaking in three European countries.

PubMed

Spitters, H P E M; van Oers, J A M; Sandu, P; Lau, C J; Quanjel, M; Dulf, D; Chereches, R; van de Goor, L A M

2017-12-19

One of the key elements to enhance the uptake of evidence in public health policies is stimulating cross-sector collaboration. An intervention stimulating collaboration is a policy game. The aim of this study was to describe the design and methods of the development process of the policy game ‘In2Action’ within a real-life setting of public health policymaking networks in the Netherlands, Denmark and Romania. The development of the policy game intervention consisted of three phases, pre intervention, designing the game intervention and tailoring the intervention. In2Action was developed as a role-play game of one day, with main focus to develop in collaboration a cross-sector implementation plan based on the approved strategic local public health policy. This study introduced an innovative intervention for public health policymaking. It described the design and development of the generic frame of the In2Action game focusing on enhancing collaboration in local public health policymaking networks. By keeping the game generic, it became suitable for each of the three country cases with only minor changes. The generic frame of the game is expected to be generalizable for other European countries to stimulate interaction and collaboration in the policy process.

Association between Enhanced Access Services in Pediatric Primary Care and Utilization of Emergency Departments: A National Parent Survey

PubMed Central

Zickafoose, Joseph S.; DeCamp, Lisa R.; Prosser, Lisa A.

2013-01-01

Objectives To measure the prevalence of enhanced access services in pediatric primary care and to assess whether enhanced access services are associated with lower emergency department (ED) utilization. Study design Internet-based survey of a national sample of parents (n=820, response rate 41%). We estimated the prevalence of reported enhanced access services and ED use in the prior 12 months. We then used multivariate negative binomial regression to assess associations between enhanced access services and ED use. Results The majority of parents reported access to advice by telephone during office hours (80%), same-day sick visits (79%), and advice by telephone outside office hours (54%). Fewer than one-half of parents reported access to their child’s primary care office on weekends (47%), after 5:00 pm on any night (23%), or by email (13%). Substantial proportions of parents reported that they did not know if these services were available (7-56%, depending on service). Office hours after 5:00 pm on ≥5 nights a week was the only service significantly associated with ED utilization in multivariate analysis (adjusted incidence rate ratio: 0.51 [95% CI 0.28-0.92]). Conclusions The majority of parents report enhanced access to their child’s primary care office during office hours, but many parents do not have access or do not know if they have access outside of regular office hours. Extended office hours may be the most effective practice change to reduce emergency department use. Primary care practices should prioritize the most effective enhanced access services and communicate existing services to families. PMID:23759421

The impact of small changes in bar closing hours on violence. The Norwegian experience from 18 cities.

PubMed

Rossow, Ingeborg; Norström, Thor

2012-03-01

To estimate the effect on violence of small changes in closing hours for on-premise alcohol sales, and to assess whether a possible effect is symmetrical. A quasi-experimental design drawing on data from 18 Norwegian cities that have changed (extended or restricted) the closing hours for on-premise alcohol sales. All changes were ≤ 2 hours. Closing hours were measured in terms of the latest permitted hour of on-premise trading, ranging from 1 a.m. to 3 a.m. The outcome measure comprised police-reported assaults that occurred in the city centre between 10 p.m. and 5 a.m. at weekends. Assaults outside the city centre during the same time window should not be affected by changes in closing hours but function as a proxy for potential confounders, and was thus included as a control variable. The data spanned the period Q1 2000-Q3 2010, yielding 774 observations. Outcomes from main analyses suggested that each 1-hour extension of closing hours was associated with a statistically significant increase of 4.8 assaults (95% CI 2.60, 6.99) per 100,000 inhabitants per quarter (i.e. an increase of about 16%). Findings indicate that the effect is symmetrical. These findings were consistent across three different modelling techniques. In Norway, each additional 1-hour extension to the opening times of premises selling alcohol is associated with a 16% increase in violent crime. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

PubMed

Conway, Sadie H; Pompeii, Lisa A; Gimeno Ruiz de Porras, David; Follis, Jack L; Roberts, Robert E

2017-07-15

Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

21 CFR 1316.45 - Filings; address; hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Filings; address; hours. 1316.45 Section 1316.45 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Administrative Hearings § 1316.45 Filings; address; hours. Documents required or...

Night Owl: Maryland's After-Hours Reference Service.

ERIC Educational Resources Information Center

Duke, Deborah C.

1994-01-01

Discusses "Night Owl," a Maryland public library's after hours telephone reference service. Issues include project start-up, user profiles, types of questions, volume, after hours reference accessibility, security, costs, service limits, publicity, staffing, and employee turnover. Similar services in other states are cited. (Contains six…

5 CFR 550.183 - Substantial hours requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement. (a...

5 CFR 550.183 - Substantial hours requirement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement. (a...

5 CFR 550.183 - Substantial hours requirement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement. (a...

5 CFR 550.183 - Substantial hours requirement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement. (a...

Self-reporting of internal medicine house staff work hours.

PubMed

Saunders, David L; Kehoe, Kimberly C; Rinehart, Vivian H; Berg, Benjamin W

2005-01-01

The 80-hour workweek became a reality for residency programs nationwide on July 1, 2003. In this review of administrative data, we examine the self-reporting of work hours by a cohort of Internal Medicine residents. Data was collected from 27 residents in training at Tripler Army Medical Center over a 4 month period from September 1 to December 31 2002. House staff reported their hours on a daily basis by responding to an email message, as well as on a monthly basis utilizing the Army's UCAPERs (Uniform Chart of Account Personnel System) mandatory monthly workload tracking system. Data from the two separate reporting systems was compared for accuracy, completeness and internal consistency. Compliance with daily reporting was variable (67-97% with overall compliance rate of 86%) but lower when compared with the mandatory military monthly reporting system (95-100%). There were large differences in reporting of average weekly work hours among individual residents when monthly reporting was compared to daily reporting of data with higher averages with monthly data reporting. Weekly totals averaged nearly 12 hours higher when reported monthly compared to reporting on a daily basis (p < 0.0001). A total of 18 residents reported that they worked more than 80 hours per week during one month using monthly data, while only 7 reported that they averaged more than 80 hours with the daily reporting data. When average weekly hours reported on a daily basis were compared with the total number of inpatient days worked over the four month period using a simple regression model, there was a significant relationship with average hours increasing with increasing number of inpatient days worked (adjusted R square = 0. 19, p = 0.01). Little internal consistency was found in the comparison of daily versus monthly work hour reporting, indicating that self-reporting may not provide accurate data. Complying with the 80-hour workweek is crucial for residency programs to maintain

Changes in Doctors' Working Hours: A Longitudinal Analysis.

PubMed

Joyce, Catherine M; Wang, Wei C; Cheng, Terence C

2015-10-01

The study examined changes in doctors' working hours and satisfaction with working hours over five time points and explored the influence of personal characteristics on these outcomes. Latent growth curve modeling was applied to Medicine in Australia: Balancing Employment and Life data, collected from 2008 to 2012. Findings showed that working hours significantly declined over time, with a greater decrease among males, older doctors, and doctors with fewer children. Satisfaction increased faster over time among specialists, doctors with poorer health, those whose partners did not work full-time, and those with older children. The more hours the doctors worked initially, the lower satisfaction reported, and the greater the increase in satisfaction. Findings are consistent with a culture change in the medical profession, whereby long working hours are no longer seen as synonymous with professionalism. This is important to take into account in projecting future workforce supply. © The Author(s) 2015.

Duty hour reform in a shifting medical landscape.

PubMed

Jena, Anupam B; Prasad, Vinay

2013-09-01

The circumstances that led to the death of Libby Zion in 1984 prompted national discussions about the impact of resident fatigue on patient outcomes. Nearly 30 years later, national duty hour reforms largely motivated by patient safety concerns have demonstrated a negligible impact of duty hour reductions on patient mortality. We suggest that the lack of an impact of duty hour reforms on patient mortality is due to a different medical landscape today than existed in 1984. Improvements in quality of care made possible by computerized order entry, automated medication checks, inpatient pharmacists, and increased resident supervision have, among other systemic changes, diminished the adverse impact that resident fatigue is able to have on patient outcomes. Given this new medical landscape, advocacy towards current and future duty hour reforms may be best justified by evidence of the impact of duty hour reform on resident wellbeing, education, and burnout.

[Three-dimensional vertically aligned CNTs coated by Ag nanoparticles for surface-enhanced Raman scattering].

PubMed

Zhang, Xiao-Lei; Zhang, Jie; Fan, Tuo; Ren, Wen-Jie; Lai, Chun-Hong

2014-09-01

In order to make surface-enhanced Raman scattering (SERS) substrates contained more "hot spots" in a three-dimensional (3D) focal volume, and can be adsorbed more probe molecules and metal nanoparticles, to obtain stronger Raman spectral signal, a new structure based on vertically aligned carbon nanotubes (CNTs) coated by Ag nanoparticles for surface Raman enhancement is presented. The vertically aligned CNTs are synthesized by chemical vapor deposition (CVD). A silver film is first deposited on the vertically aligned CNTs by magnetron sputtering. The samples are then annealed at different temperature to cause the different size silver nanoparticles to coat on the surface and sidewalls of vertically aligned CNTs. The result of scanning electron microscopy(SEM) shows that Ag nanoparticles are attached onto the sidewalls and tips of the vertically aligned CNTs, as the annealing temperature is different , pitch size, morphology and space between the silver nanoparticles is vary. Rhodamine 6G is served as the probe analyte. Raman spectrum measurement indicates that: the higher the concentration of R6G, the stronger the Raman intensity, but R6G concentration increase with the enhanced Raman intensity varies nonlinearly; when annealing temperature is 450 °C, the average size of silver nanoparticles is about 100 to 120 nm, while annealing temperature is 400 °C, the average size is about 70 nm, and the Raman intensity of 450 °C is superior to the annealing temperature that of 400 °C and 350 °C.

29 CFR 778.406 - Nonovertime hours as well as overtime hours must be irregular if section 7(f) is to apply.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... Midland Finance Co. (N.D. Ga.), 16 WH Cases 141; Trager v. J. E. Plastics Mfg. Co. (S.D.N.Y.), 13 WH Cases... 29 Labor 3 2014-07-01 2014-07-01 false Nonovertime hours as well as overtime hours must be... must be irregular if section 7(f) is to apply. Any employment in which the employee's hours fluctuate...

29 CFR 778.406 - Nonovertime hours as well as overtime hours must be irregular if section 7(f) is to apply.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... Midland Finance Co. (N.D. Ga.), 16 WH Cases 141; Trager v. J. E. Plastics Mfg. Co. (S.D.N.Y.), 13 WH Cases... 29 Labor 3 2010-07-01 2010-07-01 false Nonovertime hours as well as overtime hours must be... must be irregular if section 7(f) is to apply. Any employment in which the employee's hours fluctuate...

29 CFR 778.406 - Nonovertime hours as well as overtime hours must be irregular if section 7(f) is to apply.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... Midland Finance Co. (N.D. Ga.), 16 WH Cases 141; Trager v. J. E. Plastics Mfg. Co. (S.D.N.Y.), 13 WH Cases... 29 Labor 3 2011-07-01 2011-07-01 false Nonovertime hours as well as overtime hours must be... must be irregular if section 7(f) is to apply. Any employment in which the employee's hours fluctuate...

29 CFR 778.406 - Nonovertime hours as well as overtime hours must be irregular if section 7(f) is to apply.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... Midland Finance Co. (N.D. Ga.), 16 WH Cases 141; Trager v. J. E. Plastics Mfg. Co. (S.D.N.Y.), 13 WH Cases... 29 Labor 3 2012-07-01 2012-07-01 false Nonovertime hours as well as overtime hours must be... must be irregular if section 7(f) is to apply. Any employment in which the employee's hours fluctuate...

29 CFR 778.406 - Nonovertime hours as well as overtime hours must be irregular if section 7(f) is to apply.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... Midland Finance Co. (N.D. Ga.), 16 WH Cases 141; Trager v. J. E. Plastics Mfg. Co. (S.D.N.Y.), 13 WH Cases... 29 Labor 3 2013-07-01 2013-07-01 false Nonovertime hours as well as overtime hours must be... must be irregular if section 7(f) is to apply. Any employment in which the employee's hours fluctuate...

Flexibility of working hours in the 24-hour society.

PubMed

Costa, G

2006-01-01

The 24-hour Society undergoes an ineluctable process towards a social organisation where time constraints are no more restricting human life. The borders between working and social times are no more fixed and rigidly determined, and the value of working time changes according to the different economic and social effects you may consider. Shift and night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of health and social well-being? Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building up a more sustainable society. Flexible working times now appear to be one of the best ways to cope with the demands of the modern life, but there are different points of view about labour and temporal 'flexibility" between employers and employees. For the former it means a prompt adaptation to market demands and technological innovations; for the latter it is a way to improve working and social life, by decreasing work constraints and increasing control and autonomy. Although it can be easily speculated that individual-based 'flexibility" should improve health and well-being, and especially satisfaction, whereas company-based flexibility" might interfere negatively, the effective consequences on health and well-being have still to be analysed properly.

Ruling out acute myocardial infarction. A prospective multicenter validation of a 12-hour strategy for patients at low risk.

PubMed

Lee, T H; Juarez, G; Cook, E F; Weisberg, M C; Rouan, G W; Brand, D A; Goldman, L

1991-05-02

Although previous investigations have suggested that 24 hours is required to exclude acute myocardial infarction in patients who are admitted to a coronary care unit for the evaluation of acute chest pain, we hypothesized that a 12-hour period might be adequate for patients with a low probability of infarction at the time of admission. Using a Bayesian model, we developed a strategy to identify candidates for a shorter period of observation from an analysis of a derivation set of 976 patients with acute chest pain who were admitted to three teaching and four community hospitals. In the derivation set, patients whose clinical characteristics in the emergency room predicted a low (less than or equal to 7 percent) probability of myocardial infarction had only a 0.4 percent risk of infarction if they had neither abnormal levels of cardiac enzymes nor recurrent ischemic pain during the first 12 hours of hospitalization. In an independent testing set of 2684 patients from the seven hospitals, 957 admitted patients (36 percent) were classified as candidates for this 12-hour period of observation according to a previously published multivariate algorithm. Few of these patients were actually transferred from a monitored setting at 12 hours. Of the 771 candidates for a 12-hour period of observation who did not have enzyme abnormalities or recurrent pain during the first 12 hours, 4 (0.5 percent) were subsequently found to have acute myocardial infarction, and only 3 (0.4 percent) died after primary cardiac arrests, all of which occurred three to five days after admission. Rates of other major cardiovascular complications were low in the patients who might have been transferred from the coronary care unit after 12 hours with this strategy. In patients with a higher initial risk of infarction, the standard strategy of 24-hour observation identified all but 11 of 739 acute myocardial infarctions (1 percent). Emergency room clinical data can be used to identify a large subgroup

19 CFR 360.107 - Hours of operation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.107 Hours of operation. The automatic licensing system will generally be accessible...

19 CFR 360.107 - Hours of operation.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.107 Hours of operation. The automatic licensing system will generally be accessible...

19 CFR 360.107 - Hours of operation.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.107 Hours of operation. The automatic licensing system will generally be accessible...

19 CFR 360.107 - Hours of operation.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.107 Hours of operation. The automatic licensing system will generally be accessible...

19 CFR 360.107 - Hours of operation.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Hours of operation. 360.107 Section 360.107 Customs Duties INTERNATIONAL TRADE ADMINISTRATION, DEPARTMENT OF COMMERCE STEEL IMPORT MONITORING AND ANALYSIS SYSTEM § 360.107 Hours of operation. The automatic licensing system will generally be accessible...

17 CFR 171.3 - Business address; hours.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Business address; hours. 171.3 Section 171.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... MEMBER RESPONSIBILITY ACTIONS General Provisions § 171.3 Business address; hours. The principal office of...

17 CFR 12.3 - Business address; hours.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Business address; hours. 12.3 Section 12.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The...

17 CFR 12.3 - Business address; hours.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Business address; hours. 12.3 Section 12.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The...

17 CFR 171.3 - Business address; hours.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 17 Commodity and Securities Exchanges 1 2012-04-01 2012-04-01 false Business address; hours. 171.3 Section 171.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... MEMBER RESPONSIBILITY ACTIONS General Provisions § 171.3 Business address; hours. The principal office of...

17 CFR 12.3 - Business address; hours.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 17 Commodity and Securities Exchanges 1 2014-04-01 2014-04-01 false Business address; hours. 12.3 Section 12.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The...

17 CFR 12.3 - Business address; hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 12.3 Section 12.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The...

17 CFR 171.3 - Business address; hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 171.3 Section 171.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... MEMBER RESPONSIBILITY ACTIONS General Provisions § 171.3 Business address; hours. The principal office of...

Long work hours and obesity in Korean adult workers.

PubMed

Jang, Tae-Won; Kim, Hyoung-Ryoul; Lee, Hye-Eun; Myong, Jun-Pyo; Koo, Jung-Wan

2014-01-01

The present study was designed to identify the association between work hours and obesity in Korean adult manual and nonmanual workers, and to determine whether there is a gender difference in this association. The study was conducted using Korean National Health and Nutrition Examination Survey data collected between 2007 and 2010. Individuals aged below 25 or over 64 years, pregnant women, part-time workers, soldiers, housewives and students were excluded. The total number of individuals included in the analysis was 8,889 (5,241 male and 3,648 female subjects). The outcome variable was obesity, defined as body mass index ≥25 kg/m(2). Variables considered in the model were age, education, income, marital status, alcohol drinking, smoking, daily energy intake, physical activity, sleep hours per day, the type of job, work hours, and work schedule. Work hours were categorized as <40, 40-48 (reference), 49-60, and >60 hours per week. In the multiple SURVEYLOGISTIC regression analyses, the adjusted odds ratio of obesity for long work hours (>60 hours per week) in male manual workers was 1.647 (95% confidence interval 1.262-2.151). Long work hours did not significantly increase the odds ratio for obesity in male nonmanual workers and female manual and nonmanual workers. More than 60 work hours per week increased the risk of obesity in Korean male manual workers. This result might be helpful in preventing obesity in Korean adult workers, especially male manual workers.

Agreement between twenty-four hour salt ingestion and sodium excretion in a controlled environment

PubMed Central

Lerchl, Kathrin; Rakova, Natalia; Dahlmann, Anke; Rauh, Manfred; Goller, Ulrike; Basner, Mathias; Dinges, David F.; Beck, Luis; Agureev, Alexander; Larina, Irina; Baranov, Victor; Morukov, Boris; Eckardt, Kai-Uwe; Vassilieva, Galina; Wabel, Peter; Vienken, Jörg; Kirsch, Karl; Johannes, Bernd; Krannich, Alexander; Luft, Friedrich C.; Titze, Jens

2015-01-01

Accurately collected 24-hour urine collections are presumed to be valid for estimating salt intake in individuals. We performed two independent ultra-long-term salt balance studies lasting 105 (4 men) and 205 (6 men) days in 10 men simulating a flight to Mars. We controlled dietary intake of all constituents for months at salt intakes of 12, 9, and 6 grams per day and collected all urine. The subjects’ daily menus consisted of 27,279 individual servings, out of which 83.0% were completely consumed, 16.5% completely rejected, and 0.5% incompletely consumed. Urinary recovery of dietary salt was 92% of recorded intake, indicating long-term steady state sodium balance in both studies. Even at fixed salt intake, 24-hour sodium excretion (UNaV) showed infradian rhythmicity. We defined a ±25 mmol deviation from the average difference between recorded sodium intake and UNaV as the prediction interval to accurately classify a 3-gram difference in salt intake. Due to the biological variability in UNaV, only every-other daily urine sample correctly classified a 3-gram difference in salt intake (49%). By increasing the observations to three consecutive 24-hour collections and sodium intakes, classification accuracy improved to 75%. Collecting seven 24-hour urines and sodium intake samples improved classification accuracy to 92%. We conclude that single 24-hour urine collections at intakes ranging from 6–12 grams salt per day were not suitable to detect a 3-gram difference in individual salt intake. Repeated measurements of 24-hour UNaV improve precision. This knowledge could be relevant to patient care and the conduct of intervention trials. PMID:26259596

7 CFR 1520.2 - Location and hours.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Location and hours. 1520.2 Section 1520.2 Agriculture Regulations of the Department of Agriculture (Continued) FOREIGN AGRICULTURAL SERVICE, DEPARTMENT OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.2 Location and hours. Members of the public...

24-Hour Academic Libraries: Adjusting to Change

ERIC Educational Resources Information Center

Bowman, Adam C.

2013-01-01

The purpose of this study was to explore the adaptive measures that academic libraries perform when implementing and operating a 24-hour schedule. Five in-depth interviews were conducted with current managerial-level librarians at 24-hour academic libraries. The exploratory interviews revealed similar measures for security, budgeting, employee…

Hourly associations between heat and ambulance calls.

PubMed

Guo, Yuming

2017-01-01

The response speed of ambulance calls is very crucial to rescue patients suffering immediately life threatening conditions. The serious health outcomes might be caused by exposing to extreme heat only several hours before. However, limited evidence is available on this topic. This study aims to examine the hourly association between heat and ambulance calls, to improve the ambulance services and to better protect health. Hourly data on ambulance calls for non-accidental causes, temperature and air pollutants (PM 10 , NO 2 , and O 3 ) were collected from Brisbane, Australia, during 2001 and 2007. A time-stratified case-crossover design was used to examine the associations between hourly ambulance calls and temperature during warm season (Nov, Dec, Jan, Feb, and Mar), while adjusting for potential confounders. Stratified analyses were performed for sex and age groups. Ambulance calls peaked at 10am for all groups, except those aged <15 years at 19pm, while temperature was hottest at 13pm. The hourly heat-ambulance calls relationships were non-linear for all groups, with thresholds between 27 °C and 31 °C. The associations appeared immediately, and lasted for about 24 h. There were no significant modification effect by sex and age. The findings suggest that hot hourly temperatures (>27 °C) increase the demands of ambulance. This information is helpful to increase the efficiency of ambulance service then save lives, for example, preparing more ambulance before appearance of extremely hot temperature in combination with weather forecast. Also, people should better arrange their time for outdoor activities to avoid exposing to extreme hot temperatures. Copyright © 2016 Elsevier Ltd. All rights reserved.

An Enhanced Three-Level Voltage Switching State Scheme for Direct Torque Controlled Open End Winding Induction Motor

NASA Astrophysics Data System (ADS)

Kunisetti, V. Praveen Kumar; Thippiripati, Vinay Kumar

2018-01-01

Open End Winding Induction Motors (OEWIM) are popular for electric vehicles, ship propulsion applications due to less DC link voltage. Electric vehicles, ship propulsions require ripple free torque. In this article, an enhanced three-level voltage switching state scheme for direct torque controlled OEWIM drive is implemented to reduce torque and flux ripples. The limitations of conventional Direct Torque Control (DTC) are: possible problems during low speeds and starting, it operates with variable switching frequency due to hysteresis controllers and produces higher torque and flux ripple. The proposed DTC scheme can abate the problems of conventional DTC with an enhanced voltage switching state scheme. The three-level inversion was obtained by operating inverters with equal DC-link voltages and it produces 18 voltage space vectors. These 18 vectors are divided into low and high frequencies of operation based on rotor speed. The hardware results prove the validity of proposed DTC scheme during steady-state and transients. From simulation and experimental results, proposed DTC scheme gives less torque and flux ripples on comparison to two-level DTC. The proposed DTC is implemented using dSPACE DS-1104 control board interface with MATLAB/SIMULINK-RTI model.

An Enhanced Three-Level Voltage Switching State Scheme for Direct Torque Controlled Open End Winding Induction Motor

NASA Astrophysics Data System (ADS)

Kunisetti, V. Praveen Kumar; Thippiripati, Vinay Kumar

2018-06-01

Open End Winding Induction Motors (OEWIM) are popular for electric vehicles, ship propulsion applications due to less DC link voltage. Electric vehicles, ship propulsions require ripple free torque. In this article, an enhanced three-level voltage switching state scheme for direct torque controlled OEWIM drive is implemented to reduce torque and flux ripples. The limitations of conventional Direct Torque Control (DTC) are: possible problems during low speeds and starting, it operates with variable switching frequency due to hysteresis controllers and produces higher torque and flux ripple. The proposed DTC scheme can abate the problems of conventional DTC with an enhanced voltage switching state scheme. The three-level inversion was obtained by operating inverters with equal DC-link voltages and it produces 18 voltage space vectors. These 18 vectors are divided into low and high frequencies of operation based on rotor speed. The hardware results prove the validity of proposed DTC scheme during steady-state and transients. From simulation and experimental results, proposed DTC scheme gives less torque and flux ripples on comparison to two-level DTC. The proposed DTC is implemented using dSPACE DS-1104 control board interface with MATLAB/SIMULINK-RTI model.

[Does abbreviation of preoperative fasting to two hours with carbohydrates increase the anesthetic risk?].

PubMed

Oliveira, Kátia Gomes Bezerra de; Balsan, Maiumy; Oliveira, Sérgio de Souza; Aguilar-Nascimento, José Eduardo

2009-01-01

The objective of the present study was to evaluate the incidence of possible anesthetic complications related with the abbreviation of preoperative fasting to two hours with a solution of 12.5% dextrinomaltose within the ACERTO (from the Portuguese for Acceleration of Total Postoperative Recovery) project. All patients undergoing different types of digestive tract and abdominal wall surgeries within a new protocol of perioperative conducts, established by the ACERTO project, between August 2005 and December 2007 were evaluated. All patients received oral nutritional supplementation (12.5% dextrinomaltose) six and two hours before the procedure. Data were collected prospectively without the knowledge of the professionals in the department. The length of preoperative fasting and anesthetic complications related with the short fasting time (pulmonary aspiration) were recorded. Three hundred and seventy five patients, 174 male (46.4%) and 201 female (53.6%), ages 18 to 90 years, were evaluated. The mean preoperative fasting time was four hours, ranging from two to 20 hours. Pulmonary aspiration was not observed during the procedures. The length of fasting was longer (p < 0.01) when combined anesthesia (blockade + general) was used. Adopting the multidisciplinary preoperative measures of the ACERTO project was not associated with any preoperative fasting-associated complications. Dextrinomaltose is a useful and safe nutritional supplement for the patient.

Perceptions of the benefits and challenges of the role of advanced practice nurses in nurse-led out-of-hours care in Hong Kong: a questionnaire study.

PubMed

Christiansen, Angela; Vernon, Veronica; Jinks, Annette

2013-04-01

The aim of the study was to identify the factors that nurses perceive may facilitate or hinder the development of advanced practice nurse roles in Hong Kong. Advanced practice nurses are increasingly prominent in nurse-led out-of-hours care in Hong Kong in response to changes to junior doctors' hours of work. Three five-day workshops for Hong Kong-based advanced practice nurses were offered in partnership with UK clinicians. The aim of the workshops was to share UK experiences of implementation of the 'Hospital at Night' model of care delivery. The questionnaire study undertaken was not part of the workshop programme. However, the workshops gave the authors a unique opportunity to access relatively large numbers of Hong Kong-based advanced practice nurses. The workshops were attended by experienced nurses who had been or were about to be appointed as advanced practice nurses. All nurses who attended one of the three workshops (n=120) agreed to participate in the study. Responses to two open questions posed in the questionnaire were the subject of a content analysis. A prominent finding of the study was that respondents viewed the benefits of introducing advanced practice nurse roles in Hong Kong as outweighing any challenges. One of the main features of the perceived benefits relates to improving the quality and safety of patient care. The greatest challenges associated with the role related to acceptance of the role by other healthcare professionals, and difficulties associated with the general public's traditional attitudes to healthcare provision in Hong Kong. Education of the public concerning the implementation of such roles is of crucial importance. Findings from this study enhance understanding of the factors that hinder or facilitate advanced practice roles in out-of-hours care in Hong Kong. © 2012 Blackwell Publishing Ltd.

Gender, Parenthood, and Work Hours of Physicians.

ERIC Educational Resources Information Center

Grant, Linda; And Others

1990-01-01

Data from 204 young physicians (147 men, 57 women) revealed that parenthood significantly reduced women's, but not men's, practice hours. No significant gender differences existed for nonparents. Gaps between ideal and actual practice hours were smaller for mothers than for other groups, suggesting that mothers were more satisfied than other…

Hourly pattern of allergenic alder and birch pollen concentrations in the air: Spatial differentiation and the effect of meteorological conditions

NASA Astrophysics Data System (ADS)

Borycka, K.; Kasprzyk, I.

2018-06-01

In temperate climate widespread alder and birch are an important source of strong aeroallergens. The diurnal pattern of airborne pollen concentrations depends on the rhythm of pollen release from anthers as well as weather conditions, convection air currents, long-distance transport, pollen trap location and local vegetation. The aim of the study was to present a diurnal pattern of Alnus (alder) and Betula (birch) pollen concentrations in the air in a horizontal and vertical gradient and examine the weather parameters that had the greatest impact on the pattern. The study was conducted in Rzeszów City, southeast Poland over three years. Pollen grains were collected using a Hirst volumetric spore trap at three sampling points: two at 12 m the agl, and one at 1.5 m agl. Data were analysed using circular statistics and a nonlinear function. For alder, three models of hourly patterns were elaborated and the most common presented early morning minimum and early afternoon maximum. For birch, the most common model has one peak at night and a marked decrease in concentrations in early morning, although a second model has peak during early afternoon. A model with 3 peaks is much less common. These models are characteristic for warm temperate climate regions, where alders and birches are common. The diurnal patterns did not depend on the localization of traps or proximity of the pollen source, although these factors influenced the hourly concentrations, with higher values observed at roof level. Significant relationships between the hourly pollen counts and meteorological parameters were observed only for alder. Three incidents of increasing birch pollen concentrations were observed during the first two hours of precipitation and linked to a convection effect. Unstable weather conditions caused by air convection might strongly modify the circadian pattern and cause the nightly peaks concentrations. The general results are that people suffering from allergies may be exposed

The Association between Long Working Hours and Self-Rated Health.

PubMed

Song, Jun-Taek; Lee, Goeun; Kwon, Jongho; Park, Jung-Woo; Choi, Hyunrim; Lim, Sinye

2014-01-20

This study was conducted to determine the number of hours worked per week by full-time wage workers by using the data of the Korean Labor and Income Panel Study (KLIPS), which represents the domestic urban area household, and to determine the association between weekly working hours and the level of self-rated health. We used data from the 11th KLIPS conducted in 2008. The subjects of this study were 3,699 full-time wage workers between the ages of 25 and 64 years. The association between weekly working hours and self-rated health was analyzed considering socio-demographic characteristics, work environment, and health-related behaviors. Among the workers, 29.7% worked less than 40 hours per week; 39.7%, more than 40 to 52 hours; 19.7%, more than 52 to 60 hours; and 10.9%, more than 60 hours per week. After controlling for socio-demographic variables, work environment-related variables, and health-related behavior variables, the odds ratio (OR) for poor self-rated health for the group working more than 40 hours and up to 52 hours was calculated to be 1.06 (95% confidence interval (CI), 0.89-1.27) when the group working less than 40 hours per week was considered the reference. The OR for the group working more than 60 hours was 1.42 (95% CI, 1.10-1.83) and that for the group working more than 52 hours and up to 60 hours was 1.07 (95% CI, 0.86-1.33). After stratification by gender and tenure, the OR of the female workers group and that of the group with a tenure of more than 1 year were found to be significantly higher than those of the other groups. This study showed that workers working more than 60 hours per week have a significantly higher risk of poor self-rated health than workers working less than 40 hours per week. This effect was more obvious for the female workers group and the group with a tenure of more than 1 year. In the future, longitudinal studies may be needed to determine the association between long working hours and various health effects in Korean

The Association between Long Working Hours and Self-Rated Health

PubMed Central

2014-01-01

Objectives This study was conducted to determine the number of hours worked per week by full-time wage workers by using the data of the Korean Labor and Income Panel Study (KLIPS), which represents the domestic urban area household, and to determine the association between weekly working hours and the level of self-rated health. Methods We used data from the 11th KLIPS conducted in 2008. The subjects of this study were 3,699 full-time wage workers between the ages of 25 and 64 years. The association between weekly working hours and self-rated health was analyzed considering socio-demographic characteristics, work environment, and health-related behaviors. Results Among the workers, 29.7% worked less than 40 hours per week; 39.7%, more than 40 to 52 hours; 19.7%, more than 52 to 60 hours; and 10.9%, more than 60 hours per week. After controlling for socio-demographic variables, work environment-related variables, and health-related behavior variables, the odds ratio (OR) for poor self-rated health for the group working more than 40 hours and up to 52 hours was calculated to be 1.06 (95% confidence interval (CI), 0.89-1.27) when the group working less than 40 hours per week was considered the reference. The OR for the group working more than 60 hours was 1.42 (95% CI, 1.10-1.83) and that for the group working more than 52 hours and up to 60 hours was 1.07 (95% CI, 0.86-1.33). After stratification by gender and tenure, the OR of the female workers group and that of the group with a tenure of more than 1 year were found to be significantly higher than those of the other groups. Conclusions This study showed that workers working more than 60 hours per week have a significantly higher risk of poor self-rated health than workers working less than 40 hours per week. This effect was more obvious for the female workers group and the group with a tenure of more than 1 year. In the future, longitudinal studies may be needed to determine the association between long working

Clinical outcome of acute nonvariceal upper gastrointestinal bleeding after hours: the role of urgent endoscopy.

PubMed

Ahn, Dong-Won; Park, Young Soo; Lee, Sang Hyub; Shin, Cheol Min; Hwang, Jin-Hyeok; Kim, Jin-Wook; Jeong, Sook-Hyang; Kim, Nayoung; Lee, Dong Ho

2016-05-01

This study was performed to investigate the clinical role of urgent esophagogastroduodenoscopy (EGD) for acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) performed by experienced endoscopists after hours. A retrospective analysis was performed for consecutively collected data of patients with ANVUGIB between January 2009 and December 2010. A total of 158 patients visited the emergency unit for ANVUGIB after hours. Among them, 60 underwent urgent EGD (within 8 hours) and 98 underwent early EGD (8 to 24 hours) by experienced endoscopists. The frequencies of hemodynamic instability, fresh blood aspirate on the nasogastric tube, and high-risk endoscopic findings were significantly higher in the urgent EGD group. Primary hemostasis was achieved in all except two patients. There were nine cases of recurrent bleeding, and 30-day mortality occurred in three patients. There were no significant differences between the two groups in primary hemostasis, recurrent bleeding, and 30-day mortality. In a multiple linear regression analysis, urgent EGD significantly reduced the hospital stay compared with early EGD. In patients with a high clinical Rockall score (more than 3), urgent EGD tended to decrease the hospital stay, although this was not statistically significant (7.7 days vs. 12.0 days, p > 0.05). Urgent EGD after hours by experienced endoscopists had an excellent endoscopic success rate. However, clinical outcomes were not significantly different between the urgent and early EGD groups.

Compatibility and activity of enoxaparin sodium in 0.9% sodium chloride injection for 48 hours.

PubMed

Mewborn, A L; Kessler, J M; Joyner, K A

1996-01-15

The stability of enoxaparin sodium in 0.9% sodium chloride injection in polyvinyl chloride (PVC) containers was studied. Triplicate solutions of 120 mg (1.2 mL) of enoxaparin (as the sodium salt) and 98.8 mL of 0.9% sodium chloride injection were prepared in 250-mL PVC containers and stored at room temperature (20-22 degrees C). Samples were taken immediately after preparation and at 0.25, 0.5, 0.75, 1, 4, 12, 16, 24, and 48 hours. Inspections for color change and precipitation were performed with a clarity inspection station and a magnifying glass. Samples of the three admixtures were evaluated in duplicate for pharmacologic activity by an automated coagulation heparin assay. Throughout the 48-hour study period, the enoxaparin admixtures were free of color change, evolution of gas, and precipitates. The pharmacologic activity of enoxaparin in the PVC containers remained > 94% of the initial measured activity for 48 hours. Enoxaparin 1.2 mg/mL (as the sodium salt) in 0.9% sodium chloride injection in PVC containers was stable for up to 48 hours at 20-22 degrees C.

Impact of extended duty hours on medical trainees

PubMed Central

Weiss, Pnina; Kryger, Meir; Knauert, Melissa

2018-01-01

Many studies on resident physicians have demonstrated that extended work hours are associated with a negative impact on well-being, education, and patient care. However, the relationship between the work schedule and the degree of impairment remains unclear. In recent years, because of concerns for patient safety, national minimum standards for duty hours have been instituted (2003) and revised (2011). These changes were based on studies of the effects of sleep deprivation on human performance and specifically on the effect of extended shifts on resident performance. These requirements necessitated significant restructuring of resident schedules. Concerns were raised that these changes have impaired continuity of care, resident education and supervision, and patient safety. We review the studies on the effect of extended work hours on resident well-being, education, and patient care as well as those assessing the effect of work hour restrictions. Although many studies support the adverse effects of extended shifts, there are some conflicting results due to factors such as heterogeneity of protocols, schedules, subjects, and environments. Assessment of the effect of work hour restrictions has been even more difficult. Recent data demonstrating that work hour limitations have not been associated with improvement in patient outcomes or resident education and well-being have been interpreted as support for lifting restrictions in some specialties. However, these studies have significant limitations and should be interpreted with caution. Until future research clarifies duty hours that optimize patient outcomes, resident education, and well-being, it is recommended that current regulations be followed. PMID:29073389

Nursing work hours: individual needs versus working conditions.

PubMed

Silva, Amanda Aparecida; Rotenberg, Lúcia; Fischer, Frida Marina

2011-12-01

To assess factors associated with professional and total hours of work (work + home) among nursing staff. Cross-sectional study conducted in a university hospital in the city of São Paulo, southeastern Brazil, between 2004 and 2005. A total of 696 workers (nurses, nurse technicians and aids), mostly women (87.8%) working day and/or night shifts, participated in the study. A self-administered questionnaire was used to collected information on demographic characteristics, and working and life conditions. Translated and adapted into Portuguese versions of the Job Stress Scale, Effort-reward imbalance, Short-Form-Health-related quality of life and the Work Ability Index were also administered. Logistic regression models were used for data analysis. Sole breadwinner, working night shifts and effort-reward imbalance were the variables associated with both professional (OR = 3.38, OR = 10.43, OR = 2.07, respectively) and total hours of work (OR = 1.57, OR = 3.37, OR = 2.75, respectively). There was no significant association between the variables related to hours of work and low Work Ability Index. Inadequate rest at home was statistically associated with professional (OR = 2.47) and total hours of work (OR = 1.48). Inadequate leisure time was significantly associated with professional hours of work (OR = 1.58) and barely associated with total hours of work (OR = 1.43). The sole breadwinner, working night shifts and effort-reward imbalance are variables that need to be further investigated in studies on work hours among nursing staff. These studies should explore workers' income and the relationship between effort and reward, taking into consideration gender issues.

Power enhancement of heat engines via correlated thermalization in a three-level "working fluid".

PubMed

Gelbwaser-Klimovsky, David; Niedenzu, Wolfgang; Brumer, Paul; Kurizki, Gershon

2015-09-23

We explore means of maximizing the power output of a heat engine based on a periodically-driven quantum system that is constantly coupled to hot and cold baths. It is shown that the maximal power output of such a heat engine whose "working fluid" is a degenerate V-type three-level system is that generated by two independent two-level systems. Hence, level degeneracy is a thermodynamic resource that may effectively double the power output. The efficiency, however, is not affected. We find that coherence is not an essential asset in such multilevel-based heat engines. The existence of two thermalization pathways sharing a common ground state suffices for power enhancement.

Hourly temporal distribution of wind

NASA Astrophysics Data System (ADS)

Deligiannis, Ilias; Dimitriadis, Panayiotis; Koutsoyiannis, Demetris

2016-04-01

The wind process is essential for hydrometeorology and additionally, is one of the basic renewable energy resources. Most stochastic forecast models are limited up to daily scales disregarding the hourly scale which is significant for renewable energy management. Here, we analyze hourly wind timeseries giving emphasis on the temporal distribution of wind within the day. We finally present a periodic model based on statistical as well as hydrometeorological reasoning that shows good agreement with data. Acknowledgement: This research is conducted within the frame of the undergraduate course "Stochastic Methods in Water Resources" of the National Technical University of Athens (NTUA). The School of Civil Engineering of NTUA provided moral support for the participation of the students in the Assembly.

39 CFR 954.4 - Office business hours.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Office business hours. 954.4 Section 954.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.4 Office business hours. The offices of the...

39 CFR 959.3 - Office, business hours.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Office, business hours. 959.3 Section 959.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.3 Office, business hours. The offices of the officials mentioned in these rules are...

39 CFR 952.4 - Office business hours.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Office business hours. 952.4 Section 952.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.4 Office business hours. The offices of the officials identified in these...

39 CFR 959.3 - Office, business hours.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Office, business hours. 959.3 Section 959.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.3 Office, business hours. The offices of the officials mentioned in these rules are...

39 CFR 952.4 - Office business hours.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Office business hours. 952.4 Section 952.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.4 Office business hours. The offices of the officials identified in these...

39 CFR 954.4 - Office business hours.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Office business hours. 954.4 Section 954.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.4 Office business hours. The offices of the...

39 CFR 954.4 - Office business hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 954.4 Section 954.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.4 Office business hours. The offices of the...

39 CFR 959.3 - Office, business hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Office, business hours. 959.3 Section 959.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.3 Office, business hours. The offices of the officials mentioned in these rules are...

39 CFR 952.4 - Office business hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 952.4 Section 952.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.4 Office business hours. The offices of the officials mentioned in these...

Alternative diagnostic criteria for idiopathic hypersomnia: A 32-hour protocol.

PubMed

Evangelista, Elisa; Lopez, Régis; Barateau, Lucie; Chenini, Sofiene; Bosco, Adriana; Jaussent, Isabelle; Dauvilliers, Yves

2018-02-01

To assess the diagnostic value of extended sleep duration on a controlled 32-hour bed rest protocol in idiopathic hypersomnia (IH). One hundred sixteen patients with high suspicion of IH (37 clear-cut IH according to multiple sleep latency test criteria and 79 probable IH), 32 with hypersomnolence associated with a comorbid disorder (non-IH), and 21 controls underwent polysomnography, modified sleep latency tests, and a 32-hour bed rest protocol. Receiver operating characteristic curves were used to find optimal total sleep time (TST) cutoff values on various periods that discriminate patients from controls. TST was longer in patients with clear-cut IH than other groups (probable IH, non-IH, and controls) and in patients with probable IH than non-IH and controls. The TST cutoff best discriminating clear-cut IH and controls was 19 hours for the 32-hour recording (sensitivity = 91.9%, specificity = 85.7%) and 12 hours (100%, 85.7%) for the first 24 hours. The 19-hour cutoff displayed a specificity and sensitivity of 91.9% and 81.2% between IH and non-IH patients. Patients with IH above the 19-hour cutoff were overweight, had more sleep inertia, and had higher TST on all periods compared to patients below 19 hours, whereas no differences were found for the 12-hour cutoff. An inverse correlation was found between the mean sleep latency and TST during 32-hour recording in IH patients. In standardized and controlled stringent conditions, the optimal cutoff best discriminating patients from controls was 19 hours over 32 hours, allowing a clear-cut phenotypical characterization of major interest for research purposes. Sleepier patients on the multiple sleep latency test were also the more severe in terms of extended sleep. Ann Neurol 2018;83:235-247. © 2018 American Neurological Association.

Perspectives on the working hours of Australian junior doctors

PubMed Central

2014-01-01

The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work–life balance. It is notable that reductions in junior doctors’ working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices. PMID:25560522

Perspectives on the working hours of Australian junior doctors.

PubMed

Glasgow, Nicholas J; Bonning, Michael; Mitchell, Rob

2014-01-01

The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work-life balance. It is notable that reductions in junior doctors' working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.

Overview of the Enhanced Natural Gestures Instructional Approach and Illustration of Its Use with Three Students with Angelman Syndrome

ERIC Educational Resources Information Center

Calculator, Stephen; Diaz-Caneja Sela, Patricia

2015-01-01

Background: This investigation details procedures used to teach enhanced natural gestures (ENGs) and illustrates its use with three students with Angelman syndrome (AS). Materials and Methods: Themes were extracted, using a process of content analysis, to organize individuals' feedback pertaining to previous versions of the instructional…

The eighty-hour workweek: surgical attendings' perspectives.

PubMed

Griner, Devan; Menon, Rema P; Kotwall, Cyrus A; Clancy, Thomas V; Hope, William W

2010-01-01

The year 2008 was a sentinel year in resident education; this was the first graduating general surgery class trained entirely under the 80-hour workweek. The purpose of this study was to evaluate attending surgeon perceptions of surgical resident attitudes and performance before and after duty-hour restrictions. An electronic survey was sent to all surgical teaching institutions in North Carolina. Both surgeon and hospital characteristics were documented. The survey consisted of questions designed to assess residents' attitudes/performance before and after the implementation of the work-hour restriction. In all, 77 surveys were returned (33% response rate). The survey demonstrated that 92% of educators who responded to the survey recognized a difference between the restricted residents (RRs) and the nonrestricted residents (NRRs), and most respondents (67%) attributed this to both the work-hour restrictions and the work ethic of current residents. Most attending surgeons reported no difference between the RRs and the NRRs in most categories; however, they identified a negative change in the areas of work ethic, technical skills development, decision-making/critical-thinking skills, and patient ownership among the RR group. Most surgeons expressed less trust (55%) with patient care and less confidence (68%) in residents' ability to operate independently in the RR group. Eighty-nine percent indicated that additional decreases in work hours would continue to hamper the mission of timely and comprehensive resident education. The perception of surgical educators was that RRs are clearly different from the NRRs and that the primary difference is in work ethic and duty-hour restrictions. Although similar in most attributes, RRs are perceived as having a lower baseline work ethic and a less developed technical skill set, decision-making ability, and sense of patient ownership. Subsequent study is needed to evaluate these concerns. Copyright 2010 Association of Program

Effects on employees of controlling working hours and working schedules.

PubMed

Kubo, T; Takahashi, M; Togo, F; Liu, X; Shimazu, A; Tanaka, K; Takaya, M

2013-03-01

High levels of control over working time and low variability in working hours have been associated with improved health-related outcomes. The potential mechanisms for this association remain unclear. To examine how work-time control and variability of working times are associated with fatigue recovery, sleep quality, work-life balance, and 'near misses' at work. Manufacturing sector employees completed a questionnaire that assessed work-time control, work-time variability, fatigue recovery, sleep quality, work-life balance and the frequency of near misses in the past 6 months. Mixed model analysis of covariance and multiple logistic regression analysis tested the main effects of work-time control and variability and their interaction, while adjusting for age, sex, work schedules, and overtime work in the past month. Subscales of work-time control were also investigated (control over daily working hours and over days off). One thousand three hundred and seventy-two completed questionnaires were returned, a response rate of 69%. A significantly higher quality of sleep and better work-life balance were found in the 'high control with low variability' reference group than in the other groups. Significantly better recovery of fatigue was also observed in the group having control over days off with low variability. While near misses were more frequent in the group with high control over daily working hours coupled with high variability compared with the reference group this was not significant. High work-time control and low variability were associated with favourable outcomes of health and work-life balance. This combined effect was not observed for the safety outcome addressed here.

Sex, Kids and the Family Hour: A Three-Part Study of Sexual Content on Television. A Special Report from Children Now and the Kaiser Family Foundation.

ERIC Educational Resources Information Center

Kaiser Foundation, Oakland, CA.

This series of studies focused on the content of television programming about sexual activity and sexual relationships, examining what messages are communicated in the so-called "family hour," the first hour of prime time broadcast television (8-9 p.m. in most areas of the country). First, a content analysis documented the nature of…

29 CFR 778.318 - Productive and nonproductive hours of work.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Special Problems Effect of Failure to Count Or Pay for Certain Working Hours § 778.318 Productive and... Act; such nonproductive working hours must be counted and paid for. (b) Compensation payable for... which such nonproductive hours are properly counted as working time but no special hourly rate is...

46 CFR 386.1 - Hours of admission to property.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Academy property shall be closed to the public during other than normal working hours, as well as during... not apply where the Superintendent has approved the after normal working hours use of buildings or athletic facilities for authorized activities. During normal working hours, property shall be closed to the...

°Enhancing High Temperature Anode Performance with 2° Anchoring Phases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Walker, Robert A.; Sofie, Stephen W.; Amendola, Roberta

2015-10-01

Project accomplishments included developing and optimizing strength testing of aluminum titanate (ALT)-doped Ni-YSZ materials and identified the dopant levels that optimized mechanical strength and enhanced electrochemical performance. We also optimized our ability to fabricate electrolyte supported button cells with anodes consisting of powders provided by Fuel Cell Energy. In several instances, those anodes were infiltrated with ALT and tested with hydrogen for 30 hours at 800°C at an applied potential of 0.4 V. Our research activities were focused in three areas: 1) mechanical strength testing on as prepared and reducced nickel-YSZ structures that were either free of a dopant ormore » prepared by mechanically mixing in ALT at various weight percents (up to 10 wt%); 2) 24-hour electrochemical testing of electroylte supported cells having anodes made from Ni/YSZ and Ni/YSZ/ALT anodes with specific attention focused on modeling degradation rates; and 3) operando EIS and optical testing of both in-house fabricated devices as well as membrane electrode assemblies that were acquired from commercial vendors.« less

Health and psychosocial effects of flexible working hours.

PubMed

Janssen, Daniela; Nachreiner, Friedhelm

2004-12-01

To examine whether any impairments in health and social lives can be found under different kinds of flexible working hours, and whether such effects are related to specific characteristics of these working hours. Two studies -- a company based survey (N=660) and an internet survey (N=528) -- have been conducted. The first one was a questionnaire study (paper and pencil) on employees working under some 'typical' kinds of different flexible working time arrangements in different companies and different occupational fields (health care, manufacturing, retail, administration, call centres). The second study was an internet-based survey, using an adaptation of the questionnaire from the first study. The results of both studies consistently show that high variability of working hours is associated with increased impairments in health and well-being and this is especially true if this variability is company controlled. These effects are less pronounced if variability is self-controlled; however, autonomy does not compensate the effects of variability. Recommendations for an appropriate design of flexible working hours should be developed in order to minimize any impairing effects on health and psychosocial well-being; these recommendations should include -- besides allowing for discretion in controlling one's (flexible) working hours -- that variability in flexible working hours should be kept low (or at least moderate), even if this variability is self-controlled.

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $274 per hour. [77 FR 35826, June 15, 2012] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $257 per hour. [74 FR 27660, June 10, 2009] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $272 per hour. [78 FR 39481, July 1, 2013] Schedule of Fees ...

10 CFR 170.20 - Average cost per professional staff-hour.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Average cost per professional staff-hour. 170.20 Section... Provisions § 170.20 Average cost per professional staff-hour. Fees for permits, licenses, amendments... professional staff-hour rate of $259 per hour. [75 FR 34235, June 16, 2010] Schedule of Fees ...

Impacts of extended working hours in logging

Treesearch

Dana Mitchell; Tom Gallagher

2008-01-01

Last year at the 2007 AIM in Minneapolis, MN, the authors presented the human factors impacts to consider when implementing extended working hours in the logging industry. In a continuation of this project, we have researched existing literature to identify possible actions that logging business owners can take to reduce the impact of extended working hours on their...

46 CFR 9.9 - Two hours between broken periods.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Two hours between broken periods. 9.9 Section 9.9 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC EXTRA COMPENSATION FOR OVERTIME SERVICES § 9.9 Two hours between broken periods. Where 2 hours or more intervene...

Effect of Body Mass Index on Postoperative Transfusions and 24-Hour Chest-Tube Output

PubMed Central

Nolan, Heather R.; Ramaiah, Chandrashekhar

2011-01-01

An increasing obese population in the United States focuses attention on the effect of obesity on surgical outcomes. Our objective was to see if obesity, determined by body mass index (BMI), contributed to bleeding in coronary artery bypass graft (CABG) surgery as measured by intraoperative and postoperative packed red blood cell transfusion frequency and amount and 24-hour chest-tube output. A retrospective chart review examined 150 subjects undergoing single-surgeon off-pump or on-pump CABG surgery between September 2006 and April 2009. BMI groups included normal-weight (BMI <25), overweight (BMI 25 to 29), and obese (BMI ≥30). Analyses used a chi-square test to determine variances in number of transfusions, and ANOVA for transfusion amount and 24-hour chest-tube amount. The percentage of subjects receiving intraoperative transfusions varied significantly by BMI group (p = 0.022). The percentage of subjects receiving transfusions in the 72-hour postoperative period showed a decreasing linear trend based on BMI group (p = 0.054). The percentage of subjects receiving transfusions in the combined intraoperative or 72-hour postoperative period showed a decreasing linear trend based on BMI group (p = 0.054). The transfusion amount during the 72-hour postoperative period varied significantly between BMI groups (p = 0.021), and the test for a linear decrease across groups was significant (p = 0.020). Twenty-four hour chest-tube output showed variation across all three BMI categories (p = 0.018) with chest-tube output decreasing with increasing obesity in a linear fashion (p = 0.006). Transfusion rate and amount indicate total blood loss is decreased in the obese, and chest-tube output findings give a direct measurable indicator of blood loss from the surgical site indicating increasing BMI is linearly correlated with decreasing postoperative bleeding. PMID:22654469

The Associations Between Long Working Hours, Physical Inactivity, and Burnout.

PubMed

Hu, Nien-Chih; Chen, Jong-Dar; Cheng, Tsun-Jen

2016-05-01

To examine the correlations between long working hours, physical activity, and burnout. A cross-sectional survey was administered to 1560 full-time employees, who underwent periodic health examinations in the year 2013. The subjects were divided into upper, middle, and lower tertiles according to the Copenhagen Burnout Inventory (CBI) score. The comparison of the high- and low-burnout groups revealed that long working hours were significantly correlated with burnout in a dose-dependent manner. Long working hours were more significantly associated with burnout among individuals younger than 50 years, females, and physically inactive employees. Long working hours are correlated with burnout when working over 40 hours per week and is even stronger when working over 60 hours per week. Limiting working hours to 40 weekly may be beneficial for the prevention of burnout. Physical activity helps reduce the risk of burnout.

Long working hours and sickness absence-a fixed effects design.

PubMed

Bernstrøm, Vilde Hoff

2018-05-02

While long working hours seem to lead to impaired health, several studies have also shown that long working hours are related to lower levels of sickness absence. Previous studies on the relationship between long working hours and sickness absence have compared those who work long hours to those who do not, looking only at between-individual correlations. Those results might therefore reflect relatively stable differences between employees who typically work long hours and employees who typically do not. The aim of the present study is to examine within-individual correlations between long working hours and sickness absence. Records from the Human Resources department in a large Norwegian hospital from 2012 to 2015 provided objective data on both working hours and sickness absence. Two analyses were performed: a prospective cohort analysis to replicate the results from previous between-individual analyses and a second analysis of within-individual correlations using a fixed effect design. In line with existing research, both between-individual and within-individual analyses showed a negative relationship between long working hours (> 48 h/week) and short-term sickness absence (1-8 days) and no significant difference in incidence of long-term sickness absence (> 8 days). The results indicate that the negative relationship between long working hours and sickness absence is not due only to relatively stable individual differences between those who typically work long hours and those who do not. The results from both analyses therefore still contrast with previous research showing a negative relationship between long working hours and other health indicators.

29 CFR 778.318 - Productive and nonproductive hours of work.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Productive and nonproductive hours of work. 778.318 Section... nonproductive hours of work. (a) Failure to pay for nonproductive time worked. Some agreements provide for payment only for the hours spent in productive work; the work hours spent in waiting time, time spent in...

Life of a Six-Hour Hurricane

NASA Technical Reports Server (NTRS)

Shelton, Kay L.; Molinari, John

2009-01-01

Hurricane Claudette developed from a weak vortex in 6 h as deep convection shifted from downshear into the vortex center, despite ambient vertical wind shear exceeding 10 m/s. Six hours later it weakened to a tropical storm, and 12 h after the hurricane stage a circulation center could not be found at 850 hPa by aircraft reconnaissance. At hurricane strength the vortex contained classic structure seen in intensifying hurricanes, with the exception of 7-12 C dewpoint depressions in the lower troposphere upshear of the center. These extended from the 100-km radius to immediately adjacent to the eyewall, where equivalent potential temperature gradients reached 6 K/km. The dry air was not present prior to intensification, suggesting that it was associated with vertical shear-induced subsidence upshear of the developing storm. It is argued that weakening of the vortex was driven by cooling associated with the mixing of dry air into the core, and subsequent evaporation and cold downdrafts. Evidence suggests that this mixing might have been enhanced by eyewall instabilities after the period of rapid deepening. The existence of a fragile, small, but genuinely hurricane-strength vortex at the surface for 6 h presents difficult problems for forecasters. Such a "temporary hurricane" in strongly sheared flow might require a different warning protocol than longer-lasting hurricane vortices in weaker shear.

Patient Outcomes when Housestaff Exceed 80 Hours per Week.

PubMed

Ouyang, David; Chen, Jonathan H; Krishnan, Gomathi; Hom, Jason; Witteles, Ronald; Chi, Jeffrey

2016-09-01

It has been posited that high workload and long work hours for trainees could affect the quality and efficiency of patient care. Duty hour restrictions seek to balance patient care and resident education by limiting resident work hours. Through a retrospective cohort study, we investigated whether patient care on an inpatient general medicine service at a large academic medical center is impacted when housestaff work more than 80 hours per week. We identified all admissions to a housestaff-run general medicine service between June 25, 2013 and June 29, 2014. Each hospitalization was classified by whether the patient was admitted by housestaff who have worked more than 80 hours per week during their hospitalization. Housestaff computer activity and duty hours were calculated by institutional electronic heath record audit, as well as length of stay and a composite of in-hospital mortality, intensive care unit (ICU) transfer rate, and 30-day readmission rate. We identified 4767 hospitalizations by 3450 unique patients; of which 40.9% of hospitalizations were managed by housestaff who worked more than 80 hours that week during their hospitalization. There was a significantly higher rate of the composite outcome (19.2% vs 16.7%, P = .031) for patients admitted by housestaff working more than 80 hours per week during their hospitalization. We found a statistically significant higher length of stay (5.12 vs 4.66 days, P = .048) and rate of ICU transfer (3.53% vs 2.38%, P = .029). There was no statistically significant difference in 30-day readmission rate (13.7% vs 12.8%, P = .395) or in-hospital mortality rate (3.18% vs 2.42%, P = .115). There was no correlation with team census on admission and patient outcomes. Patients taken care of by housestaff working more than 80 hours per week had increased length of stay and number of ICU transfers. There was no association between resident work-hours and patient in-hospital mortality or 30-day readmission rate. Copyright �

Patient Outcomes When Housestaff Exceed Eighty Hours per Week

PubMed Central

Ouyang, David; Chen, Jonathan H.; Krishnan, Gomathi; Hom, Jason; Witteles, Ronald; Chi, Jeffrey

2016-01-01

Purpose It has been posited that high workload and long work hours for trainees could affect the quality and efficiency of patient care. Duty hour restrictions seek to balance patient care and resident education by limiting resident work hours. Through a retrospective cohort study, we investigate whether patient care on an inpatient general medicine service at a large academic medical center is impacted when housestaff work greater than eighty hours per week Methods We identified all admissions to a housestaff-run general medicine service between June 25, 2013 and June 29, 2014. Each hospitalization was classified by whether or not the patient was admitted by housestaff who have worked more than eighty hours a week during their hospitalization. Housestaff computer activity and duty hours were calculated by institutional electronic heath record audit, as well as length of stay and a composite of in-hospital mortality, ICU transfer rate, and 30-day readmission rate. Results We identified 4,767 hospitalizations by 3,450 unique patients; of which 40.9% of hospitalizations were managed by housestaff who worked more than eighty hours that week during their hospitalization. There was a significantly higher rate of the composite outcome (19.2% vs. 16.7%, p = 0.031) for patients admitted by housestaff working more than eighty hours a week during their hospitalization. We found a statistically significant higher length of stay (5.12 vs. 4.66 days, p = 0.048) and rate of ICU transfer (3.18% vs. 2.38%, p = 0.029). There was no statistically significant difference in 30-day readmission rate (13.7% vs. 12.8%, p = 0.395), or in-hospital mortality rate (3.18% vs. 2.42%, p = 0.115).There was no correlation with team census on admission and patient outcomes. Conclusions Patients taken care of by housestaff working more than eighty hours a week had increased length of stay and number of ICU transfers. There was no association between resident work-hours and patient in

Working hours and health behaviour among nurses at public hospitals.

PubMed

Fernandes, Juliana da Costa; Portela, Luciana Fernandes; Rotenberg, Lúcia; Griep, Rosane Harter

2013-01-01

To analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. This is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). Men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

29 CFR 778.324 - Effect on hourly rate employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... pay, the average hourly rate is thereby increased as in § 778.322. If the reduction in work schedule... Problems Reduction in Workweek Schedule with No Change in Pay § 778.324 Effect on hourly rate employees. A similar situation is presented where employees have been hired at an hourly rate of pay and have...

29 CFR 778.324 - Effect on hourly rate employees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... pay, the average hourly rate is thereby increased as in § 778.322. If the reduction in work schedule... Problems Reduction in Workweek Schedule with No Change in Pay § 778.324 Effect on hourly rate employees. A similar situation is presented where employees have been hired at an hourly rate of pay and have...

Comparison of Outcomes of ST-Elevation Myocardial Infarction Treated by Percutaneous Coronary Intervention During Off-Hours Versus On-Hours.

PubMed

Enezate, Tariq H; Omran, Jad; Al-Dadah, Ashraf S; Alpert, Martin; Mahmud, Ehtisham; Patel, Mitul; Aronow, Herbert D; Bhatt, Deepak L

2017-11-15

Previous studies have reported worse outcomes and longer door-to-balloon times (DBTs) in patients presenting with ST-elevation myocardial infarction (STEMI) after normal working hours, during weekends, and on holidays (off-hours) compared with normal business hours (on-hours). Recent studies, however, have reported similar outcomes regardless of presentation time. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January 1990 through December 2016. Only studies comparing STEMI outcomes during off-hours versus on-hours with percutaneous coronary intervention were included. A random-effects meta-analysis model was used to pool outcomes across the studies. Clinical end points included short- (<30 days of presentation), intermediate- (at 1 to 2 years), and long-term (at 3 to 4 years) stent thrombosis, mortality, recurrent myocardial infarction (MI), and major adverse cardiovascular events (MACEs). A total of 86,776 patients (62 years and 74.5% male) were identified from 39 studies. There was no significant difference between both groups with regard to mean DBT (odds ratio [OR] 0.74, 95% confidence interval [CI] -2.73 to 4.22, p = 0.67) or median DBT (p = 0.19). There was no significant difference between the 2 groups for short-term end points including mortality (OR 1.11, 95% CI 0.99 to 1.25, p = 0.08), MI (OR 1.25, 95% CI 0.90 to 1.74, p = 0.18), MACE (OR 1.06, 95% CI 0.93 to 1.20, p = 0.40), or stent thrombosis (OR 1.23, 95% CI 0.83 to 1.82, p = 0.31). Similarly, intermediate-term end points were not statistically different for mortality (OR 0.97, 95% CI 0.89 to 1.05, p = 0.46), MI (OR 0.86, 95% CI 0.73 to 1.02, p = 0.08), or MACE (OR 1.00, 95% CI 0.92 to 1.08, p = 0.98). Long-term end points did not differ statistically between groups for mortality (OR 0.95, 95% CI 0.83 to 1.09, p = 0.46), MI (OR 1.19, 95% CI 0.77 to 1.84, p = 0.44), or MACE (OR 0.98, 95% CI 0.89 to 1.08, p = 0

Variance in direct exposure measures of typing force and wrist kinematics across hours and days among office computer workers.

PubMed

Asundi, Krishna; Johnson, Peter W; Dennerlein, Jack T

2012-01-01

To determine the number of direct measurements needed to obtain a representative estimate of typing force and wrist kinematics, continuous measures of keyboard reaction force and wrist joint angle were collected at the workstation of 22 office workers while they completed their own work over three days, six hours per day. Typing force and wrist kinematics during keyboard, mouse and idle activities were calculated for each hour of measurement along with variance in measurements between subjects and between day and hour within subjects. Variance in measurements between subjects was significantly greater than variance in measurements between days and hours within subjects. Therefore, we concluded a single, one-hour period of continuous measures is sufficient to identify differences in typing force and wrist kinematics between subjects. Within subjects, day and hour of measurement had a significant effect on some measures and thus should be accounted for when comparing measures within a subject. The dose response relationship between exposure to computer related biomechanical risk factors and musculoskeletal disorders is poorly understood due to the difficulty and cost of direct measures. This study demonstrates a single hour of direct continuous measures is sufficient to identify differences in wrist kinematics and typing force between individuals.

Heat Transfer Enhancement By Three-Dimensional Surface Roughness Technique In Nuclear Fuel Rod Bundles

NASA Astrophysics Data System (ADS)

Najeeb, Umair

This thesis experimentally investigates the enhancement of single-phase heat transfer, frictional loss and pressure drop characteristics in a Single Heater Element Loop Tester (SHELT). The heater element simulates a single fuel rod for Pressurized Nuclear reactor. In this experimental investigation, the effect of the outer surface roughness of a simulated nuclear rod bundle was studied. The outer surface of a simulated fuel rod was created with a three-dimensional (Diamond-shaped blocks) surface roughness. The angle of corrugation for each diamond was 45 degrees. The length of each side of a diamond block is 1 mm. The depth of each diamond block was 0.3 mm. The pitch of the pattern was 1.614 mm. The simulated fuel rod had an outside diameter of 9.5 mm and wall thickness of 1.5 mm and was placed in a test-section made of 38.1 mm inner diameter, wall thickness 6.35 mm aluminum pipe. The Simulated fuel rod was made of Nickel 200 and Inconel 625 materials. The fuel rod was connected to 10 KW DC power supply. The Inconel 625 material of the rod with an electrical resistance of 32.3 kO was used to generate heat inside the test-section. The heat energy dissipated from the Inconel tube due to the flow of electrical current flows into the working fluid across the rod at constant heat flux conditions. The DI water was employed as working fluid for this experimental investigation. The temperature and pressure readings for both smooth and rough regions of the fuel rod were recorded and compared later to find enhancement in heat transfer coefficient and increment in the pressure drops. Tests were conducted for Reynold's Numbers ranging from 10e4 to 10e5. Enhancement in heat transfer coefficient at all Re was recorded. The maximum heat transfer co-efficient enhancement recorded was 86% at Re = 4.18e5. It was also observed that the pressure drop and friction factor increased by 14.7% due to the increased surface roughness.

Modeling Hourly Resident Productivity in the Emergency Department.

PubMed

Joseph, Joshua W; Henning, Daniel J; Strouse, Connie S; Chiu, David T; Nathanson, Larry A; Sanchez, Leon D

2017-08-01

Resident productivity, defined as new patients per hour, carries important implications for emergency department operations. In high-volume academic centers, essential staffing decisions can be made on the assumption that residents see patients at a static rate. However, it is unclear whether this model mirrors reality; previous studies have not rigorously examined whether productivity changes over time. We examine residents' productivity across shifts to determine whether it remained consistent. This was a retrospective cohort study conducted in an urban academic hospital with a 3-year emergency medicine training program in which residents acquire patients ad libitum throughout their shift. Time stamps of all patient encounters were automatically logged. A linear mixed model was constructed to predict productivity per shift hour. A total of 14,364 8- and 9-hour shifts were worked by 75 residents between July 1, 2010, and June 20, 2015. This comprised 6,127 (42.7%) postgraduate year (PGY) 1 shifts, 7,236 (50.4%) PGY-2 shifts, and 998 (6.9%) PGY-3 nonsupervisory shifts (Table 1). Overall, residents treated a mean of 10.1 patients per shift (SD 3.2), with most patients at Emergency Severity Index level 3 or more acute (93.8%). In the initial hour, residents treated a mean of 2.14 patients (SD 1.2), and every subsequent hour was associated with a significant decrease, with the largest in the second, third, and final hours. Emergency medicine resident productivity during a single shift follows a reliable pattern that decreases significantly hourly, a pattern preserved across PGY years and types of shifts. This suggests that resident productivity is a dynamic process, which should be considered in staffing decisions and studied further. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Minimum Wage and Maximum Hours Standards Under the Fair Labor Standards Act. Economic Effects Studies.

ERIC Educational Resources Information Center

Wage and Labor Standards Administration (DOL), Washington, DC.

This report describes the 1966 amendments to the Fair Labor Standards Act and summarizes the findings of three 1969 studies of the economic effects of these amendments. The studies found that economic growth continued through the third phase of the amendments, beginning February 1, 1969, despite increased wage and hours restrictions for recently…

Three approaches for estimating recovery factors in carbon dioxide enhanced oil recovery

USGS Publications Warehouse

Verma, Mahendra K.

2017-07-17

PrefaceThe Energy Independence and Security Act of 2007 authorized the U.S. Geological Survey (USGS) to conduct a national assessment of geologic storage resources for carbon dioxide (CO2) and requested the USGS to estimate the “potential volumes of oil and gas recoverable by injection and sequestration of industrial carbon dioxide in potential sequestration formations” (42 U.S.C. 17271(b)(4)). Geologic CO2 sequestration associated with enhanced oil recovery (EOR) using CO2 in existing hydrocarbon reservoirs has the potential to increase the U.S. hydrocarbon recoverable resource. The objective of this report is to provide detailed information on three approaches that can be used to calculate the incremental recovery factors for CO2-EOR. Therefore, the contents of this report could form an integral part of an assessment methodology that can be used to assess the sedimentary basins of the United States for the hydrocarbon recovery potential using CO2-EOR methods in conventional oil reservoirs.

12-hour shifts: an ethical dilemma for the nurse executive.

PubMed

Lorenz, Susan G

2008-06-01

Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.

Three day oral course of Augmentin to treat chancroid.

PubMed Central

Ndinya-Achola, J O; Nsanze, H; Karasira, P; Fransen, L; D'Costa, L J; Piot, P; Ronald, A R

1986-01-01

Amoxycillin and clavulanic acid (Augmentin; Beecham Research Laboratories) was used to treat patients with bacteriologically proved chancroid in three different dose regimens. A single dose of Augmentin (amoxycillin 3 g, clavulanic acid 350 mg) was found to be ineffective. A similar dose repeated after 24 hours was equally ineffective, but a dose (amoxycillin 500 mg, clavulanic acid 250 mg) given every 8 hours for three days was found to be effective. The drug was well tolerated and no side effects were noted in any of the patients treated. PMID:3733082

Measurement error corrected sodium and potassium intake estimation using 24-hour urinary excretion.

PubMed

Huang, Ying; Van Horn, Linda; Tinker, Lesley F; Neuhouser, Marian L; Carbone, Laura; Mossavar-Rahmani, Yasmin; Thomas, Fridtjof; Prentice, Ross L

2014-02-01

Epidemiological studies of the association of sodium and potassium intake with cardiovascular disease risk have almost exclusively relied on self-reported dietary data. Here, 24-hour urinary excretion assessments are used to correct the dietary self-report data for measurement error under the assumption that 24-hour urine recovery provides a biomarker that differs from usual intake according to a classical measurement model. Under this assumption, dietary self-reports underestimate sodium by 0% to 15%, overestimate potassium by 8% to 15%, and underestimate sodium/potassium ratio by ≈20% using food frequency questionnaires, 4-day food records, or three 24-hour dietary recalls in Women's Health Initiative studies. Calibration equations are developed by linear regression of log-transformed 24-hour urine assessments on corresponding log-transformed self-report assessments and several study subject characteristics. For each self-report method, the calibration equations turned out to depend on race and age and strongly on body mass index. After adjustment for temporal variation, calibration equations using food records or recalls explained 45% to 50% of the variation in (log-transformed) 24-hour urine assessments for sodium, 60% to 70% of the variation for potassium, and 55% to 60% of the variation for sodium/potassium ratio. These equations may be suitable for use in epidemiological disease association studies among postmenopausal women. The corresponding signals from food frequency questionnaire data were weak, but calibration equations for the ratios of sodium and potassium/total energy explained ≈35%, 50%, and 45% of log-biomarker variation for sodium, potassium, and their ratio, respectively, after the adjustment for temporal biomarker variation and may be suitable for cautious use in epidemiological studies. Clinical Trial Registration- URL: www.clinicaltrials.gov. Unique identifier: NCT00000611.

On the origin of the 1-hour pulsations in the Saturn's magnetosphere

NASA Astrophysics Data System (ADS)

Rusaitis, L.; Walker, R. J.; Khurana, K. K.; Kivelson, M.

2016-12-01

The quasi-periodic pulsations of approximately 1-hour periodicity in the magnetic field and particle fluxes have been regularly detected in the outer Saturnian magnetosphere by the Cassini spacecraft since the orbital insertion in 2004 [Palmaerts, 2016; Roussos, 2016]. In this study we focus on the Cassini's magnetometer (MAG) and the Cassini Plasma Spectrometer (CAPS) data from the July 1st, 2004 to June 4th, 2012 (when the CAPS instrument was turned off). Throughout this 8-year period we find over 130 pulsation events in the MAG data, ranging in periodicity from 40 to 90 minutes, and having a typical amplitude of 0.5-1nT in the transverse (φ ) direction. The pulsations typically last 4-6 hours before decaying, and occur both in the dawn and dusk sectors during the crossings of the outer magnetosphere. We study the pulsations in the azimuthal magnetic field as signatures for the periodic enhancements detected in the CAPS data in the plasma temperature and densities. Additionally, we investigate a high temporal resolution 3-D MHD simulation of Saturn's magnetosphere to look for the signatures of these pulsations at the equivalent positions, and use the simulation results to suggest their physical origin and the triggering mechanism by varying the solar wind parameters.

Lessons from pediatrics residency program directors' experiences with work hour limitations in New York State.

PubMed

Samuels, Ronald C; Chi, Grace W; Rauch, Daniel A; Palfrey, Judith S; Shelov, Steven P

2005-05-01

To evaluate the impact of residency work hour limitations on pediatrics residency programs in New York State, and to learn lessons that can be used nationally with the implementation of the Accreditation Council of Graduate Medical Education's similar rules. A three-page questionnaire was mailed to all pediatrics residency program directors in New York. The questionnaire assessed methods used to accommodate the work hour limitations and perceptions of the limitations' effects. Twenty-one program directors responded (68%). Only large programs used night floats and night teams to meet work hour requirements. Programs of all sizes and in all settings used cross coverage and sent residents home immediately post call. About half of the programs hired additional nonresident staff, usually nurse practitioners, physician assistants, and/or attendings. The most frequently reported effects were decreases in the amount of time residents spent in inpatient settings, patient continuity in inpatient settings, flexibility of residents' scheduling, and increased logistical work needed to maintain continuity clinic. A summary of advice to other program directors was "be creative" and "be flexible." New York's pediatrics residency programs used a variety of mechanisms to meet work hour restrictions. Smaller programs had fewer methods available to them to meet such restrictions. Although the logistical work needed to maintain continuity clinic increased greatly, continuity and outpatient settings themselves were not greatly affected by work hour limitations. Inpatient settings were more affected and experienced much more in the way of change.

Trends in the work hours of physicians in the United States.

PubMed

Staiger, Douglas O; Auerbach, David I; Buerhaus, Peter I

2010-02-24

Recent trends in hours worked by physicians may affect workforce needs but have not been thoroughly analyzed. To estimate trends in hours worked by US physicians and assess for association with physician fees. A retrospective analysis of trends in hours worked among US physicians using nationally representative workforce information from the US Census Bureau Current Population Survey between 1976 and 2008 (N = 116,733). Trends were estimated among all US physicians and by residency status, sex, age, and work setting. Trends in hours were compared with national trends in physician fees, and estimated separately for physicians located in metropolitan areas with high and low fees in 2001. Self-reported hours worked in the week before the survey. After remaining stable through the early 1990s, mean hours worked per week decreased by 7.2% between 1996 and 2008 among all physicians (from 54.9 hours per week in 1996-1998 to 51.0 hours per week in 2006-2008; 95% confidence interval [CI], 5.3%-9.0%; P < .001). Excluding resident physicians, whose hours decreased by 9.8% (95% CI, 5.8%-13.7%; P < .001) in the last decade due to duty hour limits imposed in 2003, nonresident physician hours decreased by 5.7% (95% CI, 3.8%-7.7%; P < .001). The decrease in hours was largest for nonresident physicians younger than 45 years (7.4%; 95% CI, 4.7%-10.2%; P < .001) and working outside of the hospital (6.4%; 95% CI, 4.1%-8.7%; P < .001), and the decrease was smallest for those aged 45 years or older (3.7%; 95% CI, 1.0%-6.5%; P = .008) and working in the hospital (4.0%; 95% CI, 0.4%-7.6%; P = .03). After adjusting for inflation, mean physician fees decreased nationwide by 25% between 1995 and 2006, coincident with the decrease in physician hours. In 2001, mean physician hours were less than 49 hours per week in metropolitan areas with the lowest physician fees, whereas physician hours remained more than 52 hours per week elsewhere (P < .001 for difference). A steady decrease in hours

Hours to Graduation: A National Survey of Credit Hours Required for Baccalaureate Degrees.