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.

Can a Simplified 12-Hour Nighttime Urine Collection Predict Urinary Stone Risk?

PubMed

Hinck, Bryan D; Ganesan, Vishnuvardhan; Tarplin, Sarah; Asplin, John; Granja, Ignacio; Calle, Juan; Sivalingam, Sri; Monga, Manoj

2017-10-01

To determine if there is correlation between nighttime 12-hour and traditional 24-hour urine collection in regard to chemistry values and the supersaturations of calcium oxalate, calcium phosphate, and uric acid for the metabolic evaluation of nephrolithiasis. Ninety-five patients were prospectively enrolled from 2013 to 2015. Patients >18 years of age who presented to a tertiary stone clinic and who would normally be counseled for 24-hour urine collection were eligible for the study. Participants completed 24-hour urine collections twice, with each divided into 2 separate 12-hour collections. Day-time collection began after the first morning void and continued for 12 hours. The night collection proceeded for the next 12 hours through the first morning void. Forty-nine 24-hour samples from 35 patients met inclusion criteria and were included in the analysis. Overall, there was strong correlation between the night 12-hour and the 24-hour urine collections with R 2 ranging from 0.76 for pH to 0.96 for Citrate. In our analysis of variability, the nighttime 12-hour collection differed from the 24-hour collection by 30% in 1-9 patients (2.0%-18.4%) based on individual chemistry value. Diagnosis of underlying metabolic abnormalities was concordant in 92% of patients. A 12-hour nighttime collection has strong correlation with 24-hour urine collection. As such, simplifying the metabolic evaluation to a 12-hour overnight collection may be feasible-improving compliance and decreasing patient burden. Copyright © 2017 Elsevier Inc. All rights reserved.

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 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 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...

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...

Working hours and depressive symptomatology among full-time employees: Results from the fourth Korean National Health and Nutrition Examination Survey (2007-2009).

PubMed

Kim, Inah; Kim, Hyunjoo; Lim, Sinye; Lee, Mira; Bahk, Jinwook; June, Kyung Ja; Kim, Soyeon; Chang, Won Joon

2013-09-01

This study aimed to examine the distribution of working hours and the association between working hours and depressive symptomatology using representative data from a national, population-based survey. Data came from the fourth Korean National Health and Nutrition Examination Survey (2007-2009), which employed a systematic, stratified cluster-sampling method. We used logistic regression procedures to estimate the importance of weekly working hours as a predictor of depressive symptomatology. The prevalence of depressive symptomatology was 10.2%. The work week, which averaged 48.3 hours for the sample as a whole, was longer for men (49.8 hours) than women (45.3 hours), and 12.1% of respondents were engaged in shift work. In logistic regression analyses, compared to those working < 52 hours per week, the odds ratios (OR) of working hours as a predictor of depressive symptomatology were 1.19 [95% confidence interval (95% CI) 0.77-1.85] for those working 52-59 hours per week and 1.62 (95% CI 1.20-2.18) for those working ≥ 60 hours per week, after adjustment for demographic characteristics, health behaviors, socioeconomic status, employment status, and work schedules. It showed a positive dose-response relationship between working hours and depressive symptomatology (P = 0.0059). Working hours in Korea are long. There is an association between working hours and depressive symptomatology, and there seems be a trend in working hours and depressive symptomatology.

ACTION OF VITAMIN E ON EXPERIMENTAL SEVERE ACUTE LIVER FAILURE.

PubMed

Miguel, Fabiano Moraes; Schemitt, Elizângela Gonçalves; Colares, Josieli Raskopf; Hartmann, Renata Minuzzo; Morgan-Martins, Maria Isabel; Marroni, Norma Possa

2017-01-01

Severe Acute Liver Failure (ALF) is a life-threatening clinical syndrome characterized by hepatocyte necrosis, loss of hepatic architecture, and impairment of liver functions. One of the main causes of ALF is hepatotoxicity from chemical agents, which damage hepatocytes and result in increase of reactive oxygen species. The vitamin E isoform is the one with the strongest biological antioxidant activity. To evaluate the antioxidant effect of vitamin E in this ALF model. We used 56 rats (mean weight of 300 g) divided into eight groups, four groups assessed at 24 hours and 4 assessed at 48 hours after induction: control group (CO); Vitamin E (Vit. E); Thioacetamide (TAA) and Thioacetamide + Vitamina E (TAA+Vit.E). Rats were submitted to injections of thioacetamide (400 mg/kg i.p.) at baseline and 8 hours later. Vitamin E (100 mg/kg ip) was administered 30 minutes after the second dose of thioacetamide. The 48-hour group rats received two additional doses of vitamin E (24h and 36h). At 24h or 48 hours after the administration of the first dose of TAA, rats were weighed and anesthetized and their blood sampled for evaluation of liver integrity through enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Liver tissue was sampled for assessment of lipid peroxidation (LPO) by the technique TBARS, antioxidant enzymes SOD, CAT, GPx and GST activity, levels of the NO 2 /NO 3 and histology by H&E in two times. The results were expressed as mean ± standard deviation and statistically analyzed by ANOVA followed by Student-Newman-Keuls, with P <0.05 considered as significant. After treatment with vitamin E, we observed a reduction in liver enzymes AST (U/L) (101.32±19.45 in 24 hours and 97.85±29.65 in 48 hours) related to the TAA group (469.56± 0.69 in 24 hours and 598.23±55.45 in 48 hours) and ALT (U/L) (76.59±8.56 in 24 hours and 68.47±6.49 in 48 hours) compared to the TAA group (312.21±10.23 in 24 hours and 359.15±17.58 in 48 hours). There was a reduction of LPO (nmol/mg Prot) in the TAA+Vit.E group (0.77±0.07 in 24 hours and 0.95±0.08 in 48 hours) compared to the TAA group (1.50±0.07 in 24 hours e 1.65±0.16 in 48 hours). SOD decreased in the TAA+Vit.E group (49.48±9.47 in 24 hours and 62.45±18, 47 in 48 hours), related to the TAA group (98.46±15.48 in 24 hours and 154.13±21.46 in 48 hours), as well as GST (nmol/min/mg Prot) in the TAA+Vit.E group (350.57±36.93 in 24 hours and 453.29±13.84 in 48 hours) compared to the TAA group (561.57±64.56 in 24 hours and 673.43±38.13 in 48 hours). There was an increase in CAT (pmol/min/mg Prot) in the TAA+Vit.E group (3.40±0.44 in 24 hours and 3.0±0.35 in 48 hours) compared to the TAA group (1.65±0.21 in 24 hours and 1.86±0.42 in 48 hours). The GPx (nmol/min/mg Prot) increased in 24 hours in the TAA+Vit.E group (1.01±0.16) compared to the TAA group (0.41±0.04) and decreased in 48 hours (1.19±0.17) compared to the TAA group (1.76±0.21). There was a reduction in NO2/NO3 (mmol/L) levels in the TAA+Vit.E group (31.47±4.26 in 24 hours and 38.93±5.20 in 48 hours) compared to the TAA group (49.37±5.12 in 24 hours and 53.53±5.97 in 48 hours). The histopathological evaluation showed a decrease in liver injury (necrosis and inflammation) in both studied times. These results suggest that vitamin E was able to protect the liver from lesions caused by thioacetamide.

Influence of artificial accelerated aging on dimensional stability of acrylic resins submitted to different storage protocols.

PubMed

Garcia, Lucas da Fonseca Roberti; Roselino, Lourenço de Moraes Rego; Mundim, Fabrício Mariano; Pires-de-Souza, Fernanda de Carvalho Panzeri; Consani, Simonides

2010-08-01

The aim of this study was to evaluate the influence of artificial accelerated aging on dimensional stability of two types of acrylic resins (thermally and chemically activated) submitted to different protocols of storage. One hundred specimens were made using a Teflon matrix (1.5 cm x 0.5 mm) with four imprint marks, following the lost-wax casting method. The specimens were divided into ten groups, according to the type of acrylic resin, aging procedure, and storage protocol (30 days). GI: acrylic resins thermally activated, aging, storage in artificial saliva for 16 hours, distilled water for 8 hours; GII: thermal, aging, artificial saliva for 16 hours, dry for 8 hours; GIII: thermal, no aging, artificial saliva for 16 hours, distilled water for 8 hours, GIV: thermal, no aging, artificial saliva for 16 hours, dry for 8 hours; GV: acrylic resins chemically activated, aging, artificial saliva for 16 hours, distilled water for 8 hours; GVI: chemical, aging, artificial saliva for 16 hours, dry for 8 hours; GVII: chemical, no aging, artificial saliva for 16 hours, distilled water for 8 hours; GVIII: chemical, no aging, artificial saliva for 16 hours, dry for 8 hours GIX: thermal, dry for 24 hours; and GX: chemical, dry for 24 hours. All specimens were photographed before and after treatment, and the images were evaluated by software (UTHSCSA - Image Tool) that made distance measurements between the marks in the specimens (mm), calculating the dimensional stability. Data were submitted to statistical analysis (two-way ANOVA, Tukey test, p= 0.05). Statistical analysis showed that the specimens submitted to storage in water presented the largest distance between both axes (major and minor), statistically different (p < 0.05) from control groups. All acrylic resins presented dimensional changes, and the artificial accelerated aging and storage period influenced these alterations.

Work hours, sleep sufficiency, and prevalence of depression among full-time employees: a community-based cross-sectional study.

PubMed

Nakata, Akinori

2011-05-01

Depression due to long work hours and sleep deprivation is a major occupational health concern. The extent to which work hours and sleep are associated with depression was investigated in employees of small- and medium-scale businesses in the Japanese city of Yashio, Saitama, and in the Ohta ward of Tokyo, a suburb of Tokyo, controlling for various potential confounders. In this cross-sectional study, a total of 2,643 full-time employees (1,928 men and 715 women), aged 18-79 years (mean = 45 years), in 296 small- and medium-scale businesses were surveyed from August 2002 to December 2002 using a self-administered questionnaire evaluating work hours, sleep status, and covariates including sociodemographic and socioeconomic factors, health behaviors, biological factors, medication usage, and occupational factors. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. Prevalence of depression by work hours, sleep status, and covariates was analyzed by χ² test. Risk of depression by work hours, sleep status, and both combined was estimated by multivariate logistic regression analysis. Participants working > 10 hours per day, sleeping < 6 hours per day, and reporting insufficient sleep were, respectively, 37%, 43%, and 97% more likely to be depressed than those working 6 to 8 hours per day, sleeping 6 to < 8 hours per day, and reporting sufficient sleep (P < .05). Participants working > 10 hours per day or > 8 to 10 hours per day with < 6 hours per day of sleep showed a 41%-169% higher prevalence of depression versus those working 6 to 8 hours per day with 6+ hours per day of sleep (P < .05). Participants reporting insufficient sleep in 3 work-hour categories (6 to 8, > 8 to 10, and > 10 hours per day) showed a 62%-179% increase in the prevalence of depression versus those working 6 to 8 hours per day and reporting sufficient sleep (P < .05). No significant effects on depression were found for subjects in any work-hour category with 6+ hours of sleep or with subjective sufficient sleep. Depression associated with long work hours is primarily a result of sleep deprivation. Greater attention should be paid to management of sleep deprivation to prevent workplace depression. © Copyright 2011 Physicians Postgraduate Press, Inc.

Inventory of File SN.2012091412.grib.f18.grib2

Science.gov Websites

of Wind [m/s] 004 surface TMP 18 hour fcst Temperature [K] 005.1 50 mb UGRD 18 hour fcst U-Component 18 hour fcst Temperature [K] 026 100 mb TMP 18 hour fcst Temperature [K] 027 150 mb TMP 18 hour fcst Temperature [K] 028 200 mb TMP 18 hour fcst Temperature [K] 029 250 mb TMP 18 hour fcst Temperature [K] 030

78 FR 72791 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... operators Inspection, test, and 10 work-hours x $0 $850 260 $221,000. corrective actions $85 per hour... (new action).... 185 work-hours $28,771........ $44,496........ 569 $25,318,224. x $85 per hour = $15,725. Revise maintenance program 1 work-hour x $0 $85 569 $48,365. (new action). $85 per hour = $85...

78 FR 24745 - Agency Information Collection Activities: Announcement of Board Approval Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... Securities Dealer. Agency form number: FR MSD-4; FR MSD-5. OMB control number: 7100-0100; 7100-0101... are municipal securities dealers. Estimated annual reporting hours: FR MSD-4, 20 hours; FR MSD-5, 13 hours. Estimated average hours per response: FR MSD-4, 1 hour; FR MSD-5, 0.25 hours. Number of...

50 CFR 21.60 - Conservation order for light geese.

Code of Federal Regulations, 2013 CFR

2013-10-01

... hours for light geese to end one-half hour after sunset, and imposes no daily bag limits for light geese... section may be used only between the hours of one-half hour before sunrise to one-half hour after sunset... persons who pursued light geese during the period one-half hour after sunset; (vi) The total number of...

50 CFR 21.60 - Conservation order for light geese.

Code of Federal Regulations, 2011 CFR

2011-10-01

... hours for light geese to end one-half hour after sunset, and imposes no daily bag limits for light geese... section may be used only between the hours of one-half hour before sunrise to one-half hour after sunset... persons who pursued light geese during the period one-half hour after sunset; (vi) The total number of...

50 CFR 21.60 - Conservation order for light geese.

Code of Federal Regulations, 2012 CFR

2012-10-01

... hours for light geese to end one-half hour after sunset, and imposes no daily bag limits for light geese... section may be used only between the hours of one-half hour before sunrise to one-half hour after sunset... persons who pursued light geese during the period one-half hour after sunset; (vi) The total number of...

50 CFR 21.60 - Conservation order for light geese.

Code of Federal Regulations, 2010 CFR

2010-10-01

... hours for light geese to end one-half hour after sunset, and imposes no daily bag limits for light geese... section may be used only between the hours of one-half hour before sunrise to one-half hour after sunset... persons who pursued light geese during the period one-half hour after sunset; (vi) The total number of...

50 CFR 21.60 - Conservation order for light geese.

Code of Federal Regulations, 2014 CFR

2014-10-01

... hours for light geese to end one-half hour after sunset, and imposes no daily bag limits for light geese... section may be used only between the hours of one-half hour before sunrise to one-half hour after sunset... persons who pursued light geese during the period one-half hour after sunset; (vi) The total number of...

Does graded return-to-work improve sick-listed workers' chance of returning to regular working hours?

PubMed

Høgelund, Jan; Holm, Anders; McIntosh, James

2010-01-01

Using Danish register and survey data, we examine the effect of a national graded return-to-work program on the probability of sick-listed workers returning to regular working hours. During program participation, the sick-listed worker works fewer hours and receives the normal hourly wage for the hours worked and sickness benefit for the hours off work. When the worker's health improves, working hours are increased until the sick-listed worker is able to work regular hours. Taking account of unobserved differences between program participants and non-participants, we find that participation in the program significantly increases the probability of returning to regular working hours. Copyright 2009 Elsevier B.V. All rights reserved.

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 government should consider these data prior to initiating unfunded work-hour mandates, as further reductions in resident work hours may make resident education financially unsustainable. © 2011 by the Journal of Bone and Joint Surgery, Incorporated

Induction of labor using prostaglandin E2 (PGE2) vaginal gel in triacetin base. An efficacy study comparing two dosage regimens.

PubMed

Seeras, R C; Olatunbosun, O A; Pierson, R A; Turnell, R W

1995-01-01

To compare two dosage regimens for the administration of vaginal prostaglandin gel in triacetin base for induction of labor. Seventy subjects planned for elective induction of labor at term were randomized to treatment with PGE2 vaginal gel every 6 or 12 hours. The 6-hourly group received an initial dose of 1 mg, followed by 2 mg at 6 hour intervals for a maximum of two additional doses if not in active labor. The 12-hourly group had an initial dose of 2 mg followed by two additional doses at 12 hour intervals if not in active labor. Successful induction rate was higher in the 12-hourly as compared to 6-hourly gel regimen (100% vs. 91%, P > 0.05). Twelve hours after the initial dose, delivery occurred in 34% delivery had occurred in 57% and 37% respectively (P < 0.01). We found no difference in the induction-active labor interval (P > 0.05), and the induction-delivery interval (P > 0.05) between the two groups. Active labor followed a single dose of gel in 66% of the 12-hourly group compared to 40% of the 6-hourly group (P < 0.01). Syntocinon augmentation was needed in 6% of subjects in the 12-hourly group as compared to 26% in the 6-hourly group (P < 0.01). The cesarean section rate was similar in both groups. Uterine hyperstimulation occurred less frequently in the 12-hourly group (P < 0.05). The perinatal outcome was similar in both groups. The 12-hourly regimen was more effective than the 6-hourly regimen in initiating labor. The majority of the subjects in the 12 hourly group achieved labor following a single dose of gel. Induction delivery interval, however, was similar in both groups.

Formation of solar cells based on Ba{sub 0.5}Sr{sub 0.5}TiO{sub 3} (BST) ferroelectric thick film

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

Irzaman,, E-mail: irzaman@yahoo.com; Syafutra, H., E-mail: irzaman@yahoo.com; Arif, A., E-mail: irzaman@yahoo.com

2014-02-24

Growth of Ba{sub 0.5}Sr{sub 0.5}TiO{sub 3} (BST) 1 M thick films are conducted with variation of annealing hold time of 8 hours, 15 hours, 22 hours, and 29 hours at a constant temperature of 850 °C on p-type Si (100) substrate using sol-gel method then followed by spin coating process at 3000 rpm for 30 seconds. The BST thick film electrical conductivity is obtained to be 10{sup −5} to 10{sup −4} S/cm indicate that the BST thick film is classified as semiconductor material. The semiconductor energy band gap value of BST thick film based on annealing hold time of 8more » hours, 15 hours, 22 hours, and 29 hours are 2.58 eV, 3.15 eV, 3.2 eV and 2.62 eV, respectively. The I-V photovoltaic characterization shows that the BST thick film is potentially solar cell device, and in accordance to annealing hold time of 8 hours, 15 hours, 22 hours and 29 hours have respective solar cell energy conversion efficiencies of 0.343%, 0.399%, 0.469% and 0.374%, respectively. Optical spectroscopy shows that BST thick film solar cells with annealing hold time of 8 hours, 15 hours, and 22 hours absorb effectively light energy at wavelength of ≥ 700 nm. BST film samples with annealing hold time of 29 hours absorb effectively light energy at wavelength of ≤ 700 nm. The BST thick film refraction index is between 1.1 to 1.8 at light wavelength between ±370 to 870 nm.« less

Hereditary Angioedema Attacks Resolve Faster and Are Shorter after Early Icatibant Treatment

PubMed Central

Maurer, Marcus; Kaplan, Allen; Investigators, on behalf of I. O. S.

2013-01-01

Background Attacks of hereditary angioedema (HAE) are unpredictable and, if affecting the upper airway, can be lethal. Icatibant is used for physician- or patient self-administered symptomatic treatment of HAE attacks in adults. Its mode of action includes disruption of the bradykinin pathway via blockade of the bradykinin B2 receptor. Early treatment is believed to shorten attack duration and prevent severe outcomes; however, evidence to support these benefits is lacking. Objective To examine the impact of timing of icatibant administration on the duration and resolution of HAE type I and II attacks. Methods The Icatibant Outcome Survey is an international, prospective, observational study for patients treated with icatibant. Data on timings and outcomes of icatibant treatment for HAE attacks were collected between July 2009–February 2012. A mixed-model of repeated measures was performed for 426 attacks in 136 HAE type I and II patients. Results Attack duration was significantly shorter in patients treated <1 hour of attack onset compared with those treated ≥1 hour (6.1 hours versus 16.8 hours [p<0.001]). Similar significant effects were observed for <2 hours versus ≥2 hours (7.2 hours versus 20.2 hours [p<0.001]) and <5 hours versus ≥5 hours (8.0 hours versus 23.5 hours [p<0.001]). Treatment within 1 hour of attack onset also significantly reduced time to attack resolution (5.8 hours versus 8.8 hours [p<0.05]). Self-administrators were more likely to treat early and experience shorter attacks than those treated by a healthcare professional. Conclusion Early blockade of the bradykinin B2 receptor with icatibant, particularly within the first hour of attack onset, significantly reduced attack duration and time to attack resolution. PMID:23390491

Dodecafluoropentane Emulsion Decreases Infarct Volume in a Rabbit Ischemic Stroke Model

PubMed Central

Culp, William C.; Woods, Sean D.; Skinner, Robert D.; Brown, Aliza T.; Lowery, John D.; Johnson, Jennifer L. H.; Unger, Evan C.; Hennings, Leah J.; Borrelli, Michael J.; Roberson, Paula K.

2011-01-01

Purpose To assess the efficacy of dodecafluoropentane emulsion (DDFPe), a nano droplet emulsion with significant oxygen transport potential, in decreasing infarct volume using an insoluble emboli rabbit stroke model. Methods New Zealand White rabbits (n=64; 5.1±0.50 kg) received angiography and embolic spheres in the internal carotid artery occluding branches. Rabbits were randomly assigned to groups in 4-hour and 7-hour studies. Four-hour groups included: control (n=7, embolized without treatment) or DDFPe treatment 30-min before stroke (n=7), or at stroke onset (n=8), 30-min after stroke (n=5), 1-hour after stroke (n=7), 2-hours after stroke (n=5), or 3-hours after stroke (n=6). Seven-hour groups included control (n=6), DDFPe at 1-hour after stroke (n=8), and DDFPe at 6-hours after stroke (n=5). DDFPe dose was 2% w/v (weight/volume) intravenous injection, 0.6 mL/kg, and repeated every 90 minutes as time allowed. Following euthanasia infarct volume was determined using vital stains on brain sections. Results At 4-hours, median percent infarct volume decreased for all DDFPe treatment times (pre-treatment=0.30%, p=0.004; onset=0.20%, p=0.004; 30-min=0.35%, p=0.009, 1-hour=0.30%, p=0.01, 2-hours=0.40%, p=0.009, 3-hours=0.25%, p=0.003) compared with controls (3.20%). At 7-hours, median percent infarct volume decreased with treatment at 1-hour (0.25%, p=0.007) but not for 6-hours (1.4%, p=0.49) compared with controls (2.2%). Conclusions Intravenous DDFPe in an animal model decreases infarct volumes and protects brain tissue from ischemia justifying further investigation. PMID:22079515

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.

Shift Schedules and Intern Work Hours, Patient Numbers, Conference Attendance, and Sleep at a Single Pediatric Residency Program.

PubMed

Kocolas, Irene; Day, Kristen; King, Marta; Stevenson, Adam; Sheng, Xiaoming; Hobson, Wendy; Bruse, Jaime; Bale, James

2017-03-01

The effects of 2011 Accreditation Council on Graduate Medical Education (ACGME) duty hour standards on intern work hours, patient load, conference attendance, and sleep have not been fully determined. We prospectively compared intern work hours, patient numbers, conference attendance, sleep duration, pattern, and quality in a 2011 ACGME duty hour-compliant shift schedule with a 2003 ACGME duty hour-compliant call schedule at a single pediatric residency program. Interns were assigned to shift or call schedules during 4 alternate months in the winter of 2010-2011. Work hours, patient numbers, conference attendance, sleep duration, pattern, and quality were tracked. Interns worked significantly fewer hours per week on day (73.2 hours) or night (71.6 hours) shifts than during q4 call (79.6 hours; P < .01). During high census months, shift schedule interns cared for significantly more patients/day (8.1/day shift vs 6.2/call; P < .001) and attended significantly fewer conferences than call schedule interns. Night shift interns slept more hours per 24-hour period than call schedule interns (7.2 ± 0.5 vs 6.3 ± 0.9 hours; P < .05) and had more consistent sleep patterns. A shift schedule resulted in reduced intern work hours and improved sleep duration and pattern. Although intern didactic conference attendance declined significantly during high census months, opportunities for experiential learning remained robust with unchanged or increased intern patient numbers. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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.

29 CFR 778.202 - Premium pay for hours in excess of a daily or weekly standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... normal or regular working hours. Similarly, where the employee's normal or regular daily or weekly working hours are greater or less than 8 hours and 40 hours respectively and his contract provides for the... excess of his normal or regular daily working hours), his employer may exclude the premium portion of the...

78 FR 20227 - Airworthiness Directives; Cessna Aircraft Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-04

...,592 1,847 Replacement of LH and RH brackets 6 work-hours x $85 per hour = $510. 4,101 4,611 Authority.... operators Inspection of the affected inboard 1 work-hour x $85 per hour Not Applicable $85 643 airplanes x... Labor cost Parts cost product Replacement of left-hand (LH) brackets..... 3 work-hours x $85 per hour...

Auto Body Welding 2 (Course Outline), Automotive Body Repair and Refinishing 1: 9033.04.

ERIC Educational Resources Information Center

Dade County Public Schools, Miami, FL.

The 90-hour course is a foundation quinmester course in welding for the auto body repairman. The outline consists of seven blocks of instruction (orientation, 6 hours; auto body oxyacetylene welding, 10 hours; electric arc welding equipment, 6 hours; auto body electric arc welding, 8 hours; position welding, 40 hours; electric spot welders, 16…

75 FR 19973 - Agency Information Collection Activities: Announcement of Board Approval Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Municipal Securities Dealer. Agency form number: FR MSD-4 and FR MSD-5. OMB control number: 7100-0100 and... activities as municipal securities dealers. Estimated annual reporting hours: FR MSD-4, 48 hours; and FR MSD-5, 36 hours. Estimated average hours per response: FR MSD-4, 1 hour; and FR MSD- 5, 0.25 hours...

49 CFR Appendix A to Part 355 - Guidelines for the Regulatory Review

Code of Federal Regulations, 2010 CFR

2010-10-01

... working at the required performance level, and other key components included in 49 CFR part 393. Hours of... hours following 8 consecutive hours off duty; after being on duty 15 hours, after being on duty more than 60 hours in any 7 consecutive days; or after being on duty more than 70 hours in any 8 consecutive...

Brain Injury in Canine Models of Cardiac Surgery

PubMed Central

Blue, Mary E.; Wilson, Mary Ann; Beaty, Claude A.; George, Timothy J.; Arnaoutakis, George J.; Haggerty, Kara A.; Jones, Melissa; Brawn, Jeffrey; Manmohan, Shaliza; Lange, Mary S.; Johnston, Michael V.; Baumgartner, William A.; Troncoso, Juan C.

2014-01-01

Neuropathology and neurologic impairment were characterized in a clinically relevant canine model of hypothermic (18°C) circulatory arrest (HCA) and cardiopulmonary bypass (CPB). Adult dogs underwent 2 hours of HCA (n = 39), 1 hour of HCA (n = 20), or standard CPB (n = 22) and survived 2 hours, 8 hours, 24 hours or 72 hours. Neurologic impairment and neuropathology were much more severe after 2-hour HCA than after 1-hour HCA or CPB; histopathology and neurologic deficit scores were significantly correlated. Apoptosis developed as early as 2 hours after injury and was most severe in the granule cells of hippocampal dentate gyrus. Necrosis evolved more slowly and was most severe in amygdala and pyramidal neurons in CA hippocampus. Neuronal injury was minimal up to 24 hours post-1-hour HCA, but 1 dog that survived to 72 hours showed substantial necrosis in the hippocampus, suggesting that with longer survival time the injury was worse. Although neuronal injury was minimal after CPB, we observed rare apoptotic and necrotic neurons in hippocampi and caudate nuclei. These results have important implications for CPB in humans and may help explain the subtle cognitive changes experienced by patients after CPB. PMID:25383634

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.

Effects of the 2011 duty hour reforms on interns and their patients: a prospective longitudinal cohort study.

PubMed

Sen, Srijan; Kranzler, Henry R; Didwania, Aashish K; Schwartz, Ann C; Amarnath, Sudha; Kolars, Joseph C; Dalack, Gregory W; Nichols, Breck; Guille, Constance

2013-04-22

In 2003, the first phase of duty hour requirements for US residency programs recommended by the Accreditation Council for Graduate Medical Education (ACGME) was implemented. Evidence suggests that this first phase of duty hour requirements resulted in a modest improvement in resident well-being and patient safety. To build on these initial changes, the ACGME recommended a new set of duty hour requirements that took effect in July 2011. To determine the effects of the 2011 duty hour reforms on first-year residents (interns) and their patients. As part of the Intern Health Study, we conducted a longitudinal cohort study comparing interns serving before (2009 and 2010) and interns serving after (2011) the implementation of the new duty hour requirements. Fifty-one residency programs at 14 university and community-based GME institutions. A total of 2323 medical interns. Self-reported duty hours, hours of sleep, depressive symptoms, well-being, and medical errors at 3, 6, 9, and 12 months of the internship year. Fifty-eight percent of invited interns chose to participate in the study. Reported duty hours decreased from an average of 67.0 hours per week before the new rules to 64.3 hours per week after the new rules were instituted (P < .001). Despite the decrease in duty hours, there were no significant changes in hours slept (6.8 → 7.0; P = .17), depressive symptoms (5.8 → 5.7; P = .55) or well-being score (48.5 → 48.4; P = .86) reported by interns. With the new duty hour rules, the percentage of interns who reported concern about making a serious medical error increased from 19.9% to 23.3% (P = .007). Although interns report working fewer hours under the new duty hour restrictions, this decrease has not been accompanied by an increase in hours of sleep or an improvement in depressive symptoms or well-being but has been accompanied by an unanticipated increase in self-reported medical errors.

With long hours of work, might depression then lurk? A nationwide prospective follow-up study among Danish senior medical consultants.

PubMed

Varma, Anshu; Marott, Jacob Louis; Stoltenberg, Christian Ditlev Gabriel; Wieclaw, Joanna; Kolstad, Henrik Albert; Bonde, Jens Peter Ellekilde

2012-09-01

The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship. A nationwide prospective cohort study of 2790 Danish senior medical consultants was conducted (61.7% response rate). With the consent of Danish Data Protection Agency, data from a questionnaire survey was linked with data from a Medical Products Agency Register. Long work hours were defined based on a self-reported average of weekly work hours >40, while redemption of anti-depressive (AD) drug prescriptions defined depression. Proportional hazards Cox regression analyses were conducted adjusting for gender, age, marital status, medical specialty, decision authority at work, work social support, quantitative work demands, and AD drugs prescribed before baseline. Long weekly work hours did not increase the risk of redeeming AD drug prescriptions at all times during follow-up compared to the reference of 37-40 work hours [41-44 hours: hazard ratio (HR) 0.95, 95% confidence interval (95% CI) 0.5-1.8; 45-49 hours: HR 0.88, 95% CI 0.4-1.8; 50-54 hours: HR 0.83, 95% CI 0.3-2.1; 55-59 hours: HR 0.67, 95% CI 0.2-2.9; ≥ 60 hours: HR 0.48, 95% CI 0.1-3.7]. The same result emerged when work hours was applied in a continuous form (from 25-36 hours to 37-40 hours to 41-44 hours and so on) (HR 0.93, 95% CI 0.76-1.13) and when robust analyses were conducted (data not shown). This study does not support the anticipation that long work hours increase the risk of depression. If anything, long work hours vaguely appear to decrease the risk of redeeming AD drug prescriptions.

Circadian variations of transferrin saturation levels in iron-overloaded patients: implications for the screening of C282Y-linked haemochromatosis.

PubMed

Guillygomarc'h, Anne; Christian, Jacquelinet; Romain, Moirand; Vincent, Quentin; Véronique, David; Deugnier, Yves

2003-01-01

The phenotypic screening for genetic haemochromatosis (GH) relies upon the determination of transferrin saturation (TS). In large-scale screening programs, the time of blood sampling can be uneasy to control. We studied the circadian variations of TS at 08.00 hours, 12.00 hours, 18.00 hours and 00.00 hours in 46 C282Y homozygous patients (GH) and 47 non-GH patients (NH), to determine whether the time of blood sampling influenced the results of screening. In both groups, there were significant circadian variations in TS, with the highest values at 08.00 hours and the lowest at 00.00 hours. For any given time-point, TS was significantly higher in the GH group when compared with the NH group (P < 0.0001). For both groups, there was a significant decrease in TS between 08.00 hours and 00.00 hours (P < 0.0001) but this decrease was not as significant in GH when compared with NH patients (interaction P < 0.0073). Receiver operating characteristics (ROC) curves generated for TS at 08.00 hours, 12.00 hours, 18.00 hours and 00.00 hours, presented the same efficiency of diagnosis of GH, with TS threshold varying between 64% at 08.00 hours and 36% at 00.00 hours. In conclusion, for screening studies of C282Y homozygosity, determination of transferrin saturation may be performed at any time during the day.

Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms.

PubMed

Hahn, Robert A; Kuzara, Jennifer L; Elder, Randy; Brewer, Robert; Chattopadhyay, Sajal; Fielding, Jonathan; Naimi, Timothy S; Toomey, Traci; Middleton, Jennifer Cook; Lawrence, Briana

2010-12-01

Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. Published by Elsevier Inc.

29 CFR 778.412 - Relationship between amount guaranteed and range of hours employee may be expected to work.

Code of Federal Regulations, 2011 CFR

2011-07-01

... employee may be expected to work. While the guaranteed pay may not cover more than 60 hours, the contract... contract for an employee whose duties necessitate irregular hours of work, the number of hours for which... to work. A guaranty of pay for 60 hours to an employee whose duties necessitate irregular hours of...

29 CFR 825.205 - Increments of FMLA leave for intermittent or reduced schedule leave.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee who would otherwise work 40 hours a week takes off 8 hours, the employee would use 1/5 of a week of FMLA leave. Similarly, if a full-time employee who would otherwise work 8-hour days works 4-hour... per week, but works only 20 hours a week under a reduced leave schedule, the employee's ten hours of...

29 CFR 531.36 - Nonovertime workweeks.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., where an employee works 40 hours a week at a cash wage rate of $1.60 an hour in a situation when that..., where an employee is employed at a rate of $1.80 an hour and during a particular workweek works 40 hours... employee employed at a rate of $1.65 an hour works 40 hours in a workweek and is paid only $54 in cash, $12...

Effects of the 2011 Duty Hour Reforms on Interns and Their Patients: A Prospective Longitudinal Cohort Study

PubMed Central

Sen, Srijan; Kranzler, Henry R.; Didwania, Aashish K.; Schwartz, Ann C.; Amarnath, Sudha; Kolars, Joseph C.; Dalack, Gregory W.; Nichols, Breck; Guille, Constance

2014-01-01

Background In 2003, the first phase of duty hour requirements for U.S. residency programs recommended by the Accreditation Council for Graduate Medical Education (ACGME) was implemented. Evidence suggests that this first phase of duty hour requirements resulted in a modest improvement in resident wellbeing and patient safety. To build on these initial changes, the ACGME recommended a new set of duty hour requirements that took effect in July 2011. We sought to determine the effects of the 2011 duty hour reforms on first year residents (interns) and their patients. Methods We conducted alongitudinal cohort study of 2323 interns entering one of 51 residency programs at 14 university and community-based GME institutions or graduating from one of four medical schools participating in the study. We compared self-reported duty hours, hours of sleep, depressive symptoms, well-being and medical errors at 3, 6, 9 and 12 months of the internship year between interns serving before (2009 and 2010) and interns serving after (2011) the implementation of the new duty-hour requirements. Results 58% of invited interns chose to participate in the study. Reported duty hours decreased from an average of 67.0 hours/week before the new rules to 64.3 hours/week after the new rules were instituted (p<0.001). Despite the decrease in duty hours, there were no significant changes in hours slept (7.0→6.8; p=0.17), depressive symptoms (5.8→5.7; p=NS) or well-being (48.5→48.4; p=0.86) reported by interns. With the new duty hour rules, the percentage of interns who reported committing a serious medical error increased from 19.9% to 23.3% (p=0.007). Conclusions Although interns report working fewer hours under the new duty hour restrictions, this decrease has not been accompanied by an increase in hours of sleep or an improvement in depressive symptoms or wellbeing but has been accompanied by an unanticipated increase in self-reported medical errors under the new duty hour restrictions. PMID:23529201

Transcriptional Profile of Brain Injury in Hypothermic Circulatory Arrest and Cardiopulmonary Bypass

PubMed Central

Allen, Jeremiah G.; Weiss, Eric S.; Wilson, Mary Ann; Arnaoutakis, George J.; Blue, Mary E.; Talbot, C. Conover; Jie, Chunfa; Lange, Mary S.; Troncoso, Juan C.; Johnston, Michael V.; Baumgartner, William A.

2011-01-01

Background Little is known about the molecular mechanisms of neurologic complications after hypothermic circulatory arrest (HCA) with cardiopulmonary bypass (CPB). Canine genome sequencing allows profiling of genomic changes after HCA and CPB alone. We hypothesize that gene regulation will increase with increased severity of injury. Methods Dogs underwent 2-hour HCA at 18°C (n = 10), 1-hour HCA (n = 8), or 2-hour CPB at 32°C alone (n = 8). In each group, half were sacrificed at 8 hours and half at 24 hours after treatment. After neurologic scoring, brains were harvested for genomic analysis. Hippocampal RNA isolates were analyzed using canine oligonucleotide expression arrays containing 42,028 probes. Results Consistent with prior work, dogs that underwent 2-hour HCA experienced severe neurologic injury. One hour of HCA caused intermediate clinical damage. Cardiopulmonary bypass alone yielded normal clinical scores. Cardiopulmonary bypass, 1-hour HCA, and 2-hour HCA groups historically demonstrated increasing degrees of histopathologic damage (previously published). Exploratory analysis revealed differences in significantly regulated genes (false discovery rate < 10%, absolute fold change ≥ 1.2), with increases in differential gene expression with injury severity. At 8 hours and 24 hours after insult, 2-hour HCA dogs had 502 and 1,057 genes regulated, respectively; 1-hour HCA dogs had 179 and 56 genes regulated; and CPB alone dogs had 5 and 0 genes regulated. Conclusions Our genomic profile of canine brains after HCA and CPB revealed 1-hour and 2-hour HCA induced markedly increased gene regulation, in contrast to the minimal effect of CPB alone. This adds to the body of neurologic literature supporting the safety of CPB alone and the minimal effect of CPB on a normal brain, while illuminating genomic results of both. PMID:20494057

Accuracy of the radioactive copper incorporation test in the diagnosis of Wilson disease.

PubMed

Członkowska, Anna; Rodo, Maria; Wierzchowska-Ciok, Agata; Smolinski, Lukasz; Litwin, Tomasz

2018-02-08

In Wilson disease (WD), copper accumulates in the liver and other tissues because of mutations in the ATP7B copper transporter gene. Early and effective anticopper treatment is crucial. However, routine diagnostic methods based on clinical findings, copper metabolism tests, liver biopsies and DNA analyses do not always provide a conclusive diagnosis. The aim was to evaluate radioactive copper incorporation as a diagnostic test. We included cases with a diagnosis of WD supported by radiocopper testing and later, when available, confirmed by DNA analysis. Incorporation of 64 Cu was measured at 2, 24 and 48 hours following intravenous injection. Diagnostic accuracy (area under the receiver operating characteristic curve [AUC]), sensitivity, specificity and predictive value were assessed for 24 hours/2 hours and 48 hours/2 hours 64 Cu ratios and compared with serum measurements of ceruloplasmin, copper, non-ceruloplasmin-bound copper and urinary 24-hours copper excretion. Patients having two pathogenic ATP7B mutations (homozygotes/compound heterozygotes) (n = 74) had significantly lower 24 hours/2 hours and 48 hours/2 hours 64 Cu ratios than heterozygote controls (n = 21) (mean 0.14 and 0.12 vs 0.49 and 0.63, respectively; both P < .001). Of note, 24 hours/2 hours and 48 hours/2 hours 64 Cu ratios had excellent diagnostic accuracy, with AUCs approaching 1, and only 24-hours urinary copper excretion displayed similar positive features. Other copper metabolism tests studied had lower accuracy, specificity and sensitivity. The radioactive copper test had excellent diagnostic accuracy and may be useful in the evaluation of new therapies aimed at restoring ATP7B function. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Association Between Short Sleep Duration and Risk Behavior Factors in Middle School Students.

PubMed

Owens, Judith; Wang, Guanghai; Lewin, Daniel; Skora, Elizabeth; Baylor, Allison

2017-01-01

To examine the association between self-reported sleep duration (SD) and peer/individual factors predictive of risky behaviors (risk behavior factors) in a large socioeconomically diverse school-based sample of early adolescents. Survey data collected from 10718 and 11240 eighth-grade students in 2010 and 2012, respectively, were analyzed. N/A. Self-reported school night SD was grouped as ≤4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and ≥10 hours. Scores on 10 peer/individual risk behavior factor scales were dichotomized according to national eigth-grade cut points. The percentage of students reporting an "optimal" SD of 9 hours was 14.8% and 15.6% in 2010 and 2012, respectively; 45.6% and 46.1% reported <7 hours. Adjusted for covariates of gender, race, and SES, multilevel logistic regression results showed that odds ratios (ORs) for 9 of 10 risk factor scales increased with SD <7 hours, with a dose-response effect for each hour less sleep compared to an SD of 9 hours. For example, ORs for students sleeping <7 hours ranged from 1.3 (early initiation of antisocial behavior) to 1.8 (early initiation of drug use). The risk factor scale ORs for <5 hours SD ranged from 3.0 (sensation seeking) to 6.4 (gang involvement). Middle school students are at high risk of insufficient sleep; in particular, an SD <7 hours is associated with increased risk behavior factors. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

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.

A real-time computer model to assess resident work-hours scenarios.

PubMed

McDonald, Furman S; Ramakrishna, Gautam; Schultz, Henry J

2002-07-01

To accurately model residents' work hours and assess options to forthrightly meet Residency Review Committee-Internal Medicine (RRC-IM) requirements. The requirements limiting residents' work hours are clearly defined by the Accreditation Council for Graduate Medical Education (ACGME) and the RRC-IM: "When averaged over any four-week rotation or assignment, residents must not spend more than 80 hours per week in patient care duties."(1) The call for the profession to realistically address work-hours violations is of paramount importance.(2) Unfortunately, work hours are hard to calculate. We developed an electronic model of residents' work-hours scenarios using Microsoft Excel 97. This model allows the input of multiple parameters (i.e., call frequency, call position, days off, short-call, weeks per rotation, outpatient weeks, clinic day of the week, additional time due to clinic) and start and stop times for post-call, non-call, short-call, and weekend days. For each resident on a rotation, the model graphically demonstrates call schedules, plots clinic days, and portrays all possible and preferred days off. We tested the model for accuracy in several scenarios. For example, the model predicted average work hours of 85.1 hours per week for fourth-night-call rotations. This was compared with logs of actual work hours of 84.6 hours per week. Model accuracy for this scenario was 99.4% (95% CI 96.2%-100%). The model prospectively predicted work hours of 89.9 hours/week in the cardiac intensive care unit (CCU). Subsequent surveys found mean CCU work hours of 88, 1 hours per week. Model accuracy for this scenario was 98% (95% CI 93.2-100%). Thus validated, we then used the model to test proposed scenarios for complying with RRC-IM limits. The flexibility of the model allowed demonstration of the full range of work-hours scenarios in every rotation of our 36-month program. Demonstrations of status-quo work-hours scenarios were presented to faculty as well as real-time demonstrations of the feasibility, or unfeasibility, of their proposed solutions. The model clearly demonstrated that non-call (i.e., short-call) admissions without concomitant decreases in overnight call frequency resulted in substantial increases in total work hours. Attempts to "get the resident out" an hour or two earlier each day had negligible effects on total hours and were unrealistic paper solutions. For fourth-night-call rotations, the addition of a "golden weekend" (i.e., a fifth day off per month) was found to significantly reduce work hours. The electronic model allowed the development of creative schedules for previously third-night-call rotations that limit resident work hours without decreasing continuity of care by scheduling overnight call every sixth night alternating with sixth-night-short-call rotations. Our electronic model is sufficiently robust to accurately estimate work hours on multiple and varied rotations. This model clearly demonstrates that it is very difficult to meet the RRC-IM work-hours limitations under standard fourth-night-call schedules with only four days off per month. We are successfully using our model to test proposed alternative scenarios, to overcome faculty misconceptions about resident work-hours "solutions," and to make changes to our call schedules that both are realistic for residents to accomplish and truly diminish total resident work hours toward the requirements of the RRC-IM.

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 worked per week during the last decade was observed for all physicians, which was temporally and geographically associated with lower physician fees.

Work and workload of Dutch primary care midwives in 2010.

PubMed

Wiegers, Therese A; Warmelink, J Catja; Spelten, Evelien R; Klomp, T; Hutton, Eileen K

2014-09-01

to re-assess the work and workload of primary care midwives in the Netherlands. in the Netherlands most midwives work in primary care as independent practitioners in a midwifery practice with two or more colleagues. Each practice provides 24/7 care coverage through office hours and on-call hours of the midwives. In 2006 the results of a time registration project of primary care midwives were published as part of a 4-year monitor study. This time the registration project was repeated, albeit on a smaller scale, in 2010. as part of a larger study (the Deliver study) all midwives working in 20 midwifery practices kept a time register 24 hours a day, for one week. They also filled out questionnaires about their background, work schedules and experiences of workload. A second component of this study collected data from all midwifery practices in the Netherlands and included questions about practice size (number of midwives and number of clients in the previous year). in 2010, primary care midwives actually worked on an average 32.6 hours per week and approximately 67% of their working time (almost 22 hours per week) was spent on client-related activities. On an average a midwife was on-call for 39 hours a week and almost 13 of the 32.6 hours of work took place during on-call-hours. This means that the total hours that an average midwife was involved in her work (either actually working or on-call) was almost 59 hours a week. Compared to 2004 the number of hours an average midwife was actually working increased by 4 hours (from 29 to 32.6 hours) whereas the total number of hours an average midwife was involved with her work decreased by 6 hours (from 65 to 59 hours). In 2010, compared to 2001-2004, the midwives spent proportionally less time on direct client care (67% versus 73%), although in actual number of hours this did not change much (22 versus 21). In 2009 the average workload of a midwife was 99 clients at booking, 56 at the start of labour, 33 at childbirth, and 90 clients in post partum care. the midwives worked on an average more hours in 2010 than they did in 2004 or 2001, but spent these extra hours increasingly on non-client-related activities. © 2013 Elsevier Ltd. All rights reserved.

Trends in the Work Hours of Physicians in the United States

PubMed Central

Staiger, Douglas O.; Auerbach, David I.; Buerhaus, Peter I.

2010-01-01

Context Recent trends in hours worked by physicians may affect workforce needs but have not been thoroughly analyzed. Objectives To estimate trends in hours worked by US physicians and assess for association with physician fees. Design, Setting, and Participants 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. Main Outcome Measure Self-reported hours worked in the week before the survey. Results 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). Conclusion A steady decrease in hours worked per week during the last decade was observed for all physicians, which was temporally and geographically associated with lower physician fees. PMID:20179284

Wrist activity in a woman: daily, weekly, menstrual, lunar, annual cycles?

PubMed

Binkley, S

1992-09-01

Wrist activity was monitored continuously for one year in a woman who went about her normal life. The year of data were analyzed for changes and rhythms--daily, weekly, menstrual, lunar, annual. For each day, average motions/5 minutes, activity onset, activity offset, alpha (duration of activity), and acrophase were measured. Periodograms and average daily wave forms were calculated. Well-defined, entrained, daily rest-activity cycles were observed throughout the year with periods close to 24 hours. There was weekend delay (0.7 hours) in onset, weekend decrease in alpha (1.0 hours), and weekend advance of acrophase (0.4 hours). Motions/5 minutes decreased 9%, onsets were 0.3 hours later, and alphas were 0.4 hours shorter on menstrual cycle days 8 through 18 which should have encompassed the time of ovulation. Lunar phase had no effect. Annual changes in onset (1.1 hours), offset (1.2 hours), and acrophase (1.1 hours) were attributed to the 1-hour change between standard and daylight savings time.

Inventory of File sref_em.t03z.pgrb221.p1.f06.grib2

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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.

A cross-sectional study of the association between working hours and sleep duration among the Japanese working population.

PubMed

Ohtsu, Tadahiro; Kaneita, Yoshitaka; Aritake, Sayaka; Mishima, Kazuo; Uchiyama, Makoto; Akashiba, Tsuneto; Uchimura, Naohisa; Nakaji, Shigeyuki; Munezawa, Takeshi; Kokaze, Akatsuki; Ohida, Takashi

2013-01-01

This study aimed to clarify the association between long working hours and short sleep duration among Japanese workers. We selected 4,000 households from across Japan by stratified random sampling and conducted an interview survey of a total of 662 participants (372 men; 290 women) in November 2009. Logistic regression analyses were performed using "sleep duration <6 hours per day" as a dependent variable to examine the association between working hours/overtime hours and short sleep duration. When male participants who worked for ≥7 but <9 hours per day were used as a reference, the odds ratio (OR) for short sleep duration in those who worked for ≥ 11 hours was 8.62 (95% confidence interval [CI]: 3.94-18.86). With regard to overtime hours among men, when participants without overtime were used as a reference, the OR for those whose period of overtime was ≥ 3 hours but <4 hours was 3.59 (95% CI: 1.42-9.08). For both men and women, those with long weekday working hours tended to have a short sleep duration during weekdays and holidays. It is essential to avoid working long hours in order to prevent short sleep duration.

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.

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...

76 FR 64781 - Airworthiness Directives; Airbus Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-19

...-Hours FedEx stated that they averaged 800 work-hours versus the 632 work- hours listed in the NPRM (76... work- hours, as specified for the additional actions, may be adequate if done in conjunction with the other modifications; however, additional work- hours will be required for airplanes that have been...

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...

77 FR 34946 - Information Collections Being Reviewed by the Federal Communications Commission Under Delegated...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

... Respondents and Responses: 505 respondents; 505 responses. Estimated Hours per Response: 0.5 hours. Frequency... site during hours of operation. OMB Control Number: 3060-0634. Title: Section 73.691, Visual Modulation... respondents; 46 responses. Estimated Hours per Response: One hour. Frequency of Response: Recordkeeping...

75 FR 42821 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

...: Businesses or other for-profits. Estimated Total Burden Hours: 209,820 hours. OMB Number: 1545-0181. Type of... Households. Estimated Total Burden Hours: 30,710 hours. OMB Number: 1545-0242. Type of Review: Extension... the law. Respondents: Private Sector: Businesses or other for-profits. Estimated Total Burden Hours: 4...

Inventory of File sref_em.t03z.pgrb212.p1.f06.grib2

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Inventory of File sref_nmb.t03z.pgrb221.p1.f06.grib2

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surface WEASD 6 hour fcst Water Equivalent of Accumulated Snow Depth [kg/m^2] 016 surface APCP 3-6 hour surface WEASD 3-6 hour acc Water Equivalent of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour surface NCPCP 3-6 hour acc Large-Scale Precipitation (non-convective) [kg/m^2] 404 surface SNOM 3-6 hour

Inventory of File sref_nmm.t03z.pgrb221.p1.f06.grib2

Science.gov Websites

surface WEASD 6 hour fcst Water Equivalent of Accumulated Snow Depth [kg/m^2] 016 surface APCP 3-6 hour surface WEASD 3-6 hour acc Water Equivalent of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour surface NCPCP 3-6 hour acc Large-Scale Precipitation (non-convective) [kg/m^2] 404 surface SNOM 3-6 hour

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Temperature [K] 002 surface DPT 3 hour fcst Dew Point Temperature [K] 003 surface SPFH 3 hour fcst Specific fcst Haines Index [Numeric] 026 surface TMP 2 hour fcst Temperature [K] 027 surface TMP 1 hour fcst Temperature [K] 028 surface DPT 2 hour fcst Dew Point Temperature [K] 029 surface DPT 1 hour fcst Dew Point

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Temperature [K] 002 surface DPT 12 hour fcst Dew Point Temperature [K] 003 surface SPFH 12 hour fcst Specific 11 hour fcst Temperature [K] 032 surface TMP 10 hour fcst Temperature [K] 033 surface DPT 11 hour fcst Dew Point Temperature [K] 034 surface DPT 10 hour fcst Dew Point Temperature [K] 035 surface TMAX

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Temperature [K] 002 surface DPT 3 hour fcst Dew Point Temperature [K] 003 surface SPFH 3 hour fcst Specific Temperature [K] 026 surface TMP 1 hour fcst Temperature [K] 027 surface DPT 2 hour fcst Dew Point Temperature [K] 028 surface DPT 1 hour fcst Dew Point Temperature [K] 029 surface TMAX 0-3 hour acc Maximum

Inventory of File gfs.t06z.smartguam18.tm00.grib2

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Temperature [K] 002 surface DPT 18 hour fcst Dew Point Temperature [K] 003 surface SPFH 18 hour fcst Specific TMP 17 hour fcst Temperature [K] 022 surface TMP 16 hour fcst Temperature [K] 023 surface DPT 17 hour fcst Dew Point Temperature [K] 024 surface DPT 16 hour fcst Dew Point Temperature [K] 025 surface TMAX

Impact of long farm working hours on child safety practices in agricultural settings.

PubMed

Marlenga, Barbara; Pahwa, Punam; Hagel, Louise; Dosman, James; Pickett, William; Brison, Robert J; Crowe, Trever; Koehncke, Niels; Snodgrass, Phyllis; Day, Lesley; Voaklander, Donald

2010-01-01

To characterize working hours of adult farm owner-operators and their spouses by season, and to examine associations between working hours and farm safety practices affecting children. We conducted a secondary analysis of cross-sectional survey data collected as part of an existing study of injury and its determinants. Owner-operators reported a median of 60 to 70 hours of farm work per week during warm weather months, with declines in hours over the winter. Spouses reported similar seasonal patterns, although their median reported hours were much lower. Longer farm working hours by owner-operators were marginally associated with increased exposure of teenagers to farm work hazards. Exposures of young children to worksite hazards rose in association with longer farm working hours by spouses. Exposures of children to farm worksite hazards and demands may be consequences of adult long working hours. © 2010 National Rural Health Association.

Early pleural fluid dynamics following video-assisted thoracoscopic lobectomy has limited clinical value

PubMed Central

Holbek, Bo Laksáfoss; Petersen, René Horsleben; Kehlet, Henrik

2017-01-01

The objective of this study was to evaluate the potential of predicting the pleural fluid output in patients after video-assisted thoracoscopic lobectomy of the lung. Detailed measurements of continuous fluid output were obtained prospectively using an electronic thoracic drainage device (Thopaz+™, Medela AG, Switzerland). Patients were divided into high (≥500 mL) and low (<500 mL) 24-hour fluid output, and detailed flow curves were plotted graphically to identify arithmetic patterns predicting fluid output in the early (≤24 hours) and later (24–48 hours) post-operative phase. Furthermore, multiple logistic regression analysis was used to predict high 24-hour fluid output using baseline data. Data were obtained from 50 patients, where 52% had a fluid output of <500 mL/24 hours. From visual assessment of flow curves, patients were grouped according to fluid output 6 hours postoperatively. An output ≥200 mL/6 hours was predictive of ‘high 24-hour fluid output’ (P<0.0001). However, 33% of patients with <200 mL/6 hours ended with a ‘high 24-hour fluid output’. Baseline data showed no predictive value of fluid production, and 24-hour fluid output had no predictive value of fluid output between 24 and 48 hours. Assessment of initial fluid production may predict high 24-hour fluid output (≥500 mL) but seems to lack clinical value in drain removal criteria. PMID:28840021

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.

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 workers.

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% thought training had suffered (p < 0.01). Faculty work hours have not increased in the 6 months after the institution of the 80-hour resident work week. However, the majority of the faculty feels that both patient care and resident education have deteriorated.

The Accreditation Council for Graduate Medical Education's limits on residents' work hours and patient safety. A study of resident experiences and perceptions before and after hours reductions.

PubMed

Jagsi, Reshma; Weinstein, Debra F; Shapiro, Jo; Kitch, Barrett T; Dorer, David; Weissman, Joel S

2008-03-10

Limiting resident work hours may improve patient safety, but unintended adverse effects are also possible. We sought to assess the impact of Accreditation Council for Graduate Medical Education resident work hour limits implemented on July 1, 2003, on resident experiences and perceptions regarding patient safety. All trainees in 76 accredited programs at 2 teaching hospitals were surveyed in 2003 (preimplementation) and 2004 (postimplementation) regarding their work hours and patient load; perceived relation of work hours, patient load, and fatigue to patient safety; and experiences with adverse events and medical errors. Based on reported weekly duty hours, 13 programs experiencing substantial hours reductions were classified into a "reduced-hours" group. Change scores in outcome measures before and after policy implementation in the reduced-hours programs were compared with those in "other programs" to control for temporal trends, using 2-way analysis of variance with interaction. A total of 1770 responses were obtained (response rate, 60.0%). Analysis was restricted to 1498 responses from respondents in clinical years of training. Residents in the reduced-hours group reported significant reductions in mean weekly duty hours (from 76.6 to 68.0 hours, P < .001), and the percentage working more than 80 hours per week decreased from 44.0% to 16.6% (P < .001). No significant increases in patient load while on call (patients admitted, covered, or cross covered) were observed. Between 2003 and 2004, there was a decrease in the proportion of residents in the reduced-hours programs indicating that working too many hours (63.2% vs 44.0%; P < .001) or cross covering too many patients (65.9% vs 46.9%; P = .001) contributed to mistakes in patient care. There were no significant reductions in these 2 measures in the other group, and the differences in differences were significant (P = .03 and P = .02, respectively). The number of residents in reduced-hours programs who reported committing at least 1 medical error within the past week remained high in both study years (32.9% in 2003 and 26.3% in 2004, P = .27). It is possible to reduce residents' hours without increasing patient load. Doing so may reduce the extent to which fatigue affects patient safety as perceived by these frontline providers.

Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey

PubMed Central

Sudarshan, Monisha; Hanna, Wael C.; Jamal, Mohammed H.; Nguyen, Lily H.P.; Fraser, Shannon A.

2012-01-01

Background The purpose of this study was to describe Canadian general surgery residents’ perceptions regarding potential implementation of work-hour restrictions. Methods An ethics review board–approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents’ responses. Results Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75–100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p < 0.001). Both seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51% juniors, p = 0.26) agreed with the adoption of the 80-hour work week. Conclusion There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week. PMID:22269303

Atrial ectopic activity in cryptogenic ischemic stroke and TIA: a risk factor for recurrence.

PubMed

Pinho, João; Braga, Carlos Galvão; Rocha, Sofia; Santos, Ana Filipa; Gomes, André; Cabreiro, Ana; Magalhães, Sónia; Ferreira, Carla

2015-02-01

To characterize atrial ectopic activity in patients with cryptogenic ischemic stroke (CIS) or transient ischemic attack (TIA) and determine its prognostic significance. Retrospective cohort study, in which 184 patients with CIS or TIA who had performed 24-hour Holter electrocardiogram were included. The median follow-up was 27.5 months. Baseline clinical and imagiologic characteristics, etiologic investigation results, and ischemic stroke and TIA recurrences information were collected. Number of atrial premature complexes (APCs) per hour was categorized as less than 10 APCs/hour, 10-30 APCs/hour, and more than 30 APCs/hour. Most of the patients had less than 10 APCs/hour (82.6%), 8.2% had 10-30 APCs/hour, and 9.2% had more than 30 APCs/hour. Patients with more than 30 APCs/hour had a greater median left atrium diameter than patients with 30 APCs/hour or less (42 mm vs. 38 mm; 95% confidence interval [CI], .50-7.00; P = .003). Annual recurrence rate of CIS or TIA was 2.9% in patients with less than 10 APCs/hour, 11.0% in 10-30 APCs/hour, and 22.6% in more than 30 APCs/hour (P = .001). More than 30 APCs/hour were independently associated with recurrence risk in multivariate survival analysis (hazard ratio, 3.40; 95% CI, 1.12-10.32; P = .030). In patients with CIS or TIA, frequent atrial ectopic activity (>30 APCs/h) was independently associated with increased risk of stroke or TIA recurrence. Further studies need to validate frequent atrial ectopic activity as a risk factor for recurrence in cryptogenic stroke and confirm its role as a predictor of occult atrial fibrillation. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Physiotherapy services provided outside of business hours in Australian hospitals: a national survey.

PubMed

Shaw, Kathryn D; Taylor, Nicholas F; Brusco, Natasha K

2013-06-01

Physiotherapy services provided outside of business hours may improve patient and hospital outcomes, but there is limited understanding of what services are provided. This study described current services provided outside of business hours across Australian hospitals. Design Descriptive, cross-sectional, Web-based survey. Participants A random sample of Australian hospitals from the public or private sector located in either metropolitan or rural/regional areas. A total of 112 completed surveys were submitted. The most common service outside of business hours was a Saturday service, provided by 61% of participating hospitals with a median (interquartile range [IQR]) of 1.0 hour (0.0 and 3.4) of physiotherapy per 30 beds. Sunday services were provided by 43% of hospitals, and services provided outside of business hours from Monday to Friday were provided by 14% of hospitals. More private hospitals provided some form of physiotherapy service outside of business hours (91%) than public hospitals (48%). More metropolitan hospitals provided some form of physiotherapy service outside of business hours (90%) than rural/regional hospitals (28%). Few of the hospitals providing sub-acute services had weekend physiotherapy (30%), but the majority of highly acute wards provided weekend physiotherapy (81%). Highly acute wards also provided more hours of service on a Saturday (median 8.1 hours per 30 beds, IQR 0.6-22.5) compared with acute wards (median 0.8 hours per 30 beds, IQR 0.0-2.8). There is limited availability of physiotherapy services in Australian hospitals outside of business hours. There are inequalities in physiotherapy services provided outside of business hours, with public, rural/regional and sub-acute facilities receiving fewer services outside of business hours than private, metropolitan and highly acute facilities. Copyright © 2012 John Wiley & Sons, Ltd.

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.

Are Canadian general surgery residents ready for the 80-hour work week? A nationwide survey.

PubMed

Sudarshan, Monisha; Hanna, Wael C; Jamal, Mohammed H; Nguyen, Lily H P; Fraser, Shannon A

2012-02-01

The purpose of this study was to describe Canadian general surgery residents' perceptions regarding potential implementation of work-hour restrictions. An ethics review board-approved, Web-based survey was submitted to all Canadian general surgery residency programs between April and July 2009. Questions evaluated the perceived effects of an 80-hour work week on length of training, operative exposure, learning and lifestyle. We used the Fisher exact test to compare senior and junior residents' responses. Of 360 residents, 158 responded (70 seniors and 88 juniors). Among them, 79% reported working 75-100 hours per week. About 74% of seniors believed that limiting their work hours would decrease their operative exposure; 43% of juniors agreed (p < 0.001). Both seniors and juniors thought limiting their work hours would improve their lifestyle (86% v. 96%, p = 0.12). Overall, 60% of residents did not believe limiting work hours would extend the length of their training. Regarding 24-hour call, 60% of juniors thought it was hazardous to their health; 30% of seniors agreed (p = 0.001). Both senior and junior residents thought abolishing 24-hour call would decrease their operative exposure (84% v. 70%, p = 0.21). Overall, 31% of residents supported abolishing 24-hour call. About 47% of residents (41% seniors, 51%juniors, p = 0.26) agreed with the adoption of the 80-hour work week. There is a training-level based dichotomy of opinion among general surgery residents in Canada regarding the perceived effects of work hour restrictions. Both groups have voted against abolishing 24-hour call, and neither group strongly supports the implementation of the 80-hour work week.

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.

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.

Inventory of File sref_nmb.t03z.pgrb212.p1.f06.grib2

Science.gov Websites

surface WEASD 6 hour fcst Water Equivalent of Accumulated Snow Depth [kg/m^2] 016 surface APCP 3-6 hour surface WEASD 3-6 hour acc Water Equivalent of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour (non-convective) [kg/m^2] 417 surface SNOM 3-6 hour acc Snow Melt [kg/m^2] 418 surface LHTFL 3-6 hour

Inventory of File sref_nmm.t03z.pgrb212.p1.f06.grib2

Science.gov Websites

surface WEASD 6 hour fcst Water Equivalent of Accumulated Snow Depth [kg/m^2] 016 surface APCP 3-6 hour surface WEASD 3-6 hour acc Water Equivalent of Accumulated Snow Depth [kg/m^2] 019 surface CSNOW 6 hour (non-convective) [kg/m^2] 417 surface SNOM 3-6 hour acc Snow Melt [kg/m^2] 418 surface LHTFL 0-6 hour

Inventory of File SN.2012091412.grib6th.f18.grib2

Science.gov Websites

ground UGRD 18 hour fcst U-Component of Wind [m/s] 003.2 35 m above ground VGRD 18 hour fcst V-Component of Wind [m/s] 004 surface TMP 18 hour fcst Temperature [K] 005 0.5 m underground TMP 18 hour fcst ] 008.1 10 mb UGRD 18 hour fcst U-Component of Wind [m/s] 008.2 10 mb VGRD 18 hour fcst V-Component of

The clinical effect of nicorandil on perioperative myocardial protection in patients undergoing elective PCI: A Systematic Review and Meta-Analysis.

PubMed

Ye, Ziliang; Su, Qiang; Li, Lang

2017-03-21

Many scholars have studied the effect of nicorandil on perioperative myocardial protection in patients undergoing elective percutaneous coronary intervention (PCI), but results are inconsistent. Therefore, we performed this meta-analysis. Finally, 16 articles, including 1616 patients, were included into this meta-analysis. Meta-analysis results showed that: (1) Nicorandil can reduce the level of CK-MB after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (2) Nicorandil can reduce the level of TnT after PCI, including at 6 hours, 12 hours, 18 hours and 24 hours. (3) Nicorandil can reduce the incidence of adverse reactions after PCI. (4) Nicorandil cannot reduce the level of MVP after PCI, including at 12 hours and 24 hours. (5) Subgroup analysis showed that nicorandil can reduce CK-MB and TnT level at 24 hours after PCI for Chinese's population (P < 0.05), but can not reduce CK-MB and TnT level at 24 hours after PCI for non Chinese's population (P > 0.05). Our meta-analysis indicate that nicorandil can reduce myocardial injury and reduce the incidence of adverse reaction caused by PCI for Chinese's population, but is not obvious for non Chinese's population. However, this conclusion still needs to be confirmed in the future.

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...

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...

77 FR 44059 - Federal Acquisition Regulation; Payments Under Time-and-Materials and Labor-Hour Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-26

...) Payments of this clause, but the ``hourly rate'' for labor hours expended in furnishing work not delivered...] RIN 9000-AM01 Federal Acquisition Regulation; Payments Under Time-and-Materials and Labor-Hour... the authorization to use time-and-materials and labor-hour contract payment requirements. DATES...

7 CFR 52.51 - Charges for inspection services on a contract basis.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 40 hours per week for each inspector assigned to perform the inspection services in accordance with... assigned at their regular hourly rate. When work is performed, an additional hour at the regular hourly rate will be charged for each hour worked. (4) Night differential. A 10 percent night differential...

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...

45 CFR 2400.43 - Required courses of graduate study.

Code of Federal Regulations, 2014 CFR

2014-10-01

... § 2400.43(b) must amount to at least 12 semester or 18 quarter hours or their credit hour equivalent of... credit hour equivalent of such study is strongly encouraged. (b) The courses that fulfill the required minimum of 12 semester hours or their credit hour equivalent of study of the United States Constitution...

45 CFR 2400.43 - Required courses of graduate study.

Code of Federal Regulations, 2011 CFR

2011-10-01

... § 2400.43(b) must amount to at least 12 semester or 18 quarter hours or their credit hour equivalent of... credit hour equivalent of such study is strongly encouraged. (b) The courses that fulfill the required minimum of 12 semester hours or their credit hour equivalent of study of the United States Constitution...

45 CFR 2400.43 - Required courses of graduate study.

Code of Federal Regulations, 2013 CFR

2013-10-01

... § 2400.43(b) must amount to at least 12 semester or 18 quarter hours or their credit hour equivalent of... credit hour equivalent of such study is strongly encouraged. (b) The courses that fulfill the required minimum of 12 semester hours or their credit hour equivalent of study of the United States Constitution...

77 FR 74269 - Agency Information Collection Activities; Revision of a Currently-Approved Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-13

... occasion. Estimated Total Annual Burden: 5,524,500 hours [Informational documents provided to prospective shippers at 43,500 hours + Written Cost estimates for prospective shippers at 4,620,000 hours + Service orders, bills of lading at 805,300 hours + In-transit service notifications at 22,600 hours + Complaint...

29 CFR 548.301 - Salaried employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... then be computed by dividing the $154 salary by 11 working days of 8 hours each, or 88 hours. The basic... the salary of $154 by 80 working hours, or 10 days of 8 hours each. The basic rate would therefore be... Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR REGULATIONS...

77 FR 42696 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... construction awards, 30 requests for amendments to non-construction awards, 2 project service maps). Average Hours Per Response: 2 hours for an amendment to a construction award, 1 hour for an amendment to a non-construction award, 6 hours for a project service map. Burden Hours: 1,242. Needs and Uses: A recipient must...

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 ...

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…

33 CFR 117.287 - Gulf Intracoastal Waterway.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., quarter-hour, half-hour, and three quarter-hour. (b-1) Stickney Point (SR 72) bridge, mile 68.6, at... hour, and 40 minutes after the hour. (g) The draw of the Treasure Island Causeway bridge, mile 119.0... each drawbridge listed in this section at anytime. (a-1) The draw of the Boca Grande Swingbridge, mile...

33 CFR 117.287 - Gulf Intracoastal Waterway.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., quarter-hour, half-hour, and three quarter-hour. (b-1) Stickney Point (SR 72) bridge, mile 68.6, at... hour, and 40 minutes after the hour. (g) The draw of the Treasure Island Causeway bridge, mile 119.0... each drawbridge listed in this section at anytime. (a-1) The draw of the Boca Grande Swingbridge, mile...

33 CFR 117.287 - Gulf Intracoastal Waterway.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., quarter-hour, half-hour, and three quarter-hour. (b-1) Stickney Point (SR 72) bridge, mile 68.6, at... hour, and 40 minutes after the hour. (g) The draw of the Treasure Island Causeway bridge, mile 119.0... each drawbridge listed in this section at anytime. (a-1) The draw of the Boca Grande Swingbridge, mile...

Efficiency and Safety of Prolonged Levosimendan Infusion in Patients with Acute Heart Failure

PubMed Central

Aidonidis, Georgios; Kanonidis, Ioannis; Koutsimanis, Vasileios; Neumann, Till; Erbel, Raimund; Sakadamis, Georgios

2011-01-01

Background. Levosimendan is an inotropic drug with unique pharmacological advantages in patients with acute heart failure. Scope of this study is to determine whether longer infusion patterns without the hypotension-inducing loading dose could justify an effective and safe alternative approach. Methods. 70 patients admitted to the emergencies with decompensated chronic heart failure received intravenously levosimendan without a loading dose up to 72 hours. Clinical parameters, BNP (Brain Natriuretic Peptide) and signal-averaged-ECG data (SAECG) were recorded up to 72 hours. Results. The 48-hour group demonstrated a statistically significant BNP decrease (P < .001) after 48 hours, which also maintained after 72 hours. The 72-hour group demonstrated a bordeline decrease of BNP after 48 hours (P = .039), necessitating an additional 24-hour infusion to achieve significant reduction after 72 hours (P < .004). SAECG data demonstrated a statistically significant decrease after 72 hours (P < .04). Apart from two deaths due to advanced heart failure, no major complications were observed. Conclusion. Prolonged infusion of levosimendan without a loading dose is associated with an acceptable clinical and neurohumoral response. PMID:21559263

Advancing circadian rhythms before eastward flight: a strategy to prevent or reduce jet lag.

PubMed

Eastman, Charmane I; Gazda, Clifford J; Burgess, Helen J; Crowley, Stephanie J; Fogg, Louis F

2005-01-01

To develop a practical pre-eastward flight treatment to advance circadian rhythms as much as possible but not misalign them with sleep. One group had their sleep schedule advanced by 1 hour per day and another by 2 hours per day. Baseline at home, treatment in lab. Young healthy adults (11 men, 15 women) between the ages of 22 and 36 years. Three days of a gradually advancing sleep schedule (1 or 2 hours per day) plus intermittent morning bright light (one-half hour approximately 5000 lux, one-half hour of <60 lux) for 3.5 hours. The dim light melatonin onset was assessed before and after the 3-day treatment. Subjects completed daily sleep logs and symptom questionnaires and wore wrist activity monitors. The dim light melatonin onset advanced more in the 2-hours-per-day group than in the 1-hour-per-day group (median phase advances of 1.9 and 1.4 hours), but the difference between the means (1.8 and 1.5 hours) was not statistically significant. By the third treatment day, circadian rhythms were misaligned relative to the sleep schedule, and subjects had difficulty falling asleep in the 2-hours-per-day group, but this was not the case in the 1-hour-per-day group. Nevertheless, the 2-hours-per-day group did slightly better on the symptom questionnaires. In general, sleep disturbance and other side effects were small. A gradually advancing sleep schedule with intermittent morning bright light can be used to advance circadian rhythms before eastward flight and, thus, theoretically, prevent or reduce subsequent jet lag. Given the morning light treatment used here, advancing the sleep schedule 2 hours per day is not better than advancing it 1 hour per day because it was too fast for the advance in circadian rhythms. A diagram is provided to help the traveler plan a preflight schedule.

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.

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.

A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules.

PubMed

Short, Michelle A; Agostini, Alexandra; Lushington, Kurt; Dorrian, Jillian

2015-09-01

The aim of this review was to identify which limited wake shift work schedules (LWSW) best promote sleep, alertness, and performance. LWSW are fixed work/rest cycles where the time-at-work does is ≤8 hours and there is >1 rest period per day, on average, for ≥2 consecutive days. These schedules are commonly used in safety-critical industries such as transport and maritime industries. Literature was sourced using PubMed, Embase, PsycInfo, Scopus, and Google Scholar databases. We identified 20 independent studies (plus a further 2 overlapping studies), including 5 laboratory and 17 field-based studies focused on maritime watch keepers, ship bridge officers, and long-haul train drivers. The measurement of outcome measures was varied, incorporating subjective and objective measures of sleep: sleep diaries (N=5), actigraphy (N=4), and polysomnography, (N=3); sleepiness: Karolinska Sleepiness Scale (N=5), visual analog scale (VAS) alertness (N=2) and author-derived measures (N=2); and performance: Psychomotor Vigilance Test (PVT) (N=5), Reaction Time or Vigilance tasks (N=4), Vector and Letter Cancellation Test (N=1), and subjective performance (N=2). Of the three primary rosters examined (6 hours-on/6 hours-off, 8 hours-on/8 hours-off and 4 hours-on/8 hours-off), the 4 hours-on/8 hours-off roster was associated with better sleep and lower levels of sleepiness. Individuals working 4 hours-on/8 hours-off rosters averaged 1 hour more sleep per night than those working 6 hours-on/6 hours-off and 1.3 hours more sleep than those working 8 hours-on/8 hours-off (P<0.01). More broadly, findings indicate that LWSW schedules were associated with better sleep and lower sleepines in the case of (i) shorter time-at-work, (ii) more frequent rest breaks, (iii) shifts that start and end at the same clock time every 24 hours, and (iv) work shifts commencing in the daytime (as opposed to night). The findings for performance remain incomplete due to the small number of studies containing a performance measure and the heterogeneity of performance measures within those that did. The literature supports the utility of LWSW in industries where individuals sleep at or near the workplace as they facilitate at least some sleep during the biological night and minimize deficits associated with time-on-shift with shorter shifts. Overall, the 4 hour-on/8 hour-off roster best promoted sleep and minimized sleepiness compared to other LWSW schedules. Nevertheless, and considering the safety-critical nature of industries which employ LWSW, the limited literature needs to be greatly expanded with specific focus on the consequences for performance and comparison to mainstream rosters.

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 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.

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

USN Manpower Determination Decision Making: A Case Study Using Imprint Pro to Validate the LCS Core Crew Manning Solution

DTIC Science & Technology

2014-12-01

available time consists of 56 hours of sleep (8 hours per 24 hour period), 14 hours for eating (messing), and 17 hours of free time (which includes 3 hours...experiences changes to their sleeping, eating , and working habits that then changes their body temperature peak times, respiratory rate, and hormone...training, personal hygiene, sleeping, and eating . The unplanned events are represented by the yellow tags in Figure 11 and represent emergencies that

Inventory of File gfs.t06z.wafs_grb45f06.nouswafs.grib

Science.gov Websites

Wind [m/s] 004 100 mb VGRD 6 hour fcst V-Component of Wind [m/s] 005 125 mb HGT 6 hour fcst Wind [m/s] 008 125 mb VGRD 6 hour fcst V-Component of Wind [m/s] 009 150 mb HGT 6 hour fcst Wind [m/s] 012 150 mb VGRD 6 hour fcst V-Component of Wind [m/s] 013 175 mb HGT 6 hour fcst

A Study on Watt-hour Meter Data Acquisition Method Based on RFID Technology

NASA Astrophysics Data System (ADS)

Chen, Xiangqun; Huang, Rui; Shen, Liman; Chen, Hao; Xiong, Dezhi; Xiao, Xiangqi; Liu, Mouhai; Xu, Renheng

2018-03-01

Considering that traditional watt-hour meter data acquisition was subjected to the influence of distance and occlusion, a watt-hour meter data acquisition method based on RFID technology was proposed in this paper. In detail, RFID electronic tag was embedded in the watt-hour meter to identify the meter and record electric energy information, which made RFID based wireless data acquisition for watt-hour meter come true. Eventually, overall lifecycle management of watt-hour meter is realized.

42 CFR 84.103 - Man tests; performance requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... inspired air shall not exceed— °F. °C. 1/4 hour or less 0-100 135 57 1/4 hour to 3/4 hour 0-50 50-100 125 1 110 52 1 43 1 to 2 hours 0-50 50-100 115 1105 46 141 3 hours 0-50 50-100 110 1100 43 1 38 4 hours 0-50... 42 Public Health 1 2011-10-01 2011-10-01 false Man tests; performance requirements. 84.103 Section...

Dedicated Shift Wrap-up Time Does Not Improve Resident Sign-out Volume or Efficiency.

PubMed

Jeanmonod, Rebecca K; Brook, Christopher; Winther, Mark; Pathak, Soma; Boyd, Molly

2010-02-01

Sign-out (SO) is a challenge to the emergency physician. Some training programs have instituted overlapping 9-hour shifts. The residents see patients for eight hours, and have one hour of wrap-up time. This hour helps them complete patient care, leaving fewer patients to sign-out. We examined whether this strategy impacts SO burden. This is a retrospective review of patients evaluated by emergency medicine (EM) residents working 9-hour (eight hours of patient care, one hour wrap-up time) and 12-hour shifts (12 hours patient care, no reserved time for wrap-up). Data were collected by reviewing the clinical tracker. A patient was assigned to the resident who initiated care and dictated the chart. SO was defined as any patient in the ED without disposition at change of shift. Patient turn-around-time (TAT) was also recorded. One-hundred sixty-one postgraduate-year-one resident (PGY1), 264 postgraduate-year-two resident (PGY2), and 193 postgraduate-year-three resident (PGY3) shifts were included. PGY1s signed out 1.9 patients per 12-hour shift. PGY2s signed out 2.3 patients on 12-hour shifts and 1.8 patients on 9-hour shifts. PGY3s signed out 2.1 patients on 12-hour shifts and 2.0 patients on 9-hour shifts. When we controlled for patients seen per hour, SO burden was constant by class regardless of shift length, with PGY2s signing out 18% of patients seen compared to 15% for PGY3s. PGY1s signed out 18% of patients seen. TAT for patients seen by PGY1s and PGY2s was similar, at 189 and 187 minutes, respectively. TAT for patients seen by PGY3s was significantly less at 175 minutes. The additional hour devoted to wrapping up patients in the ED had no affect on SO burden. The SO burden represented a fixed percentage of the total number of patients seen by the residents. PGY3s sign-out a smaller percentage of patients seen compared to other classes, and have faster TATs.

Association of Resident Duty Hour Restrictions, Level of Trainee, and Number of Available Residents with Mortality in the Neonatal Intensive Care Unit.

PubMed

Beltempo, Marc; Clement, Karin; Lacroix, Guy; Bélanger, Sylvie; Julien, Anne-Sophie; Piedboeuf, Bruno

2018-02-08

 This article assesses the effect of reducing consecutive hours worked by residents from 24 to 16 hours on yearly total hours worked per resident in the neonatal intensive care unit (NICU) and evaluates the association of resident duty hour reform, level of trainee, and the number of residents present at admission with mortality in the NICU.  This is a 6-year retrospective cohort study including all pediatric residents working in a Level 3 NICU ( N  = 185) and infants admitted to the NICU ( N  = 8,159). Adjusted odds ratios (aOR) were estimated for mortality with respect to Epoch (2008-2011 [24-hour shifts] versus 2011-2014 [16-hour shifts]), level of trainee, and the number of residents present at admission.  The reduction in maximum consecutive hours worked was associated with a significant reduction of the median yearly total hours worked per resident in the NICU (381 hour vs. 276 hour, p  < 0.01). Early mortality rate was 1.2% (50/4,107) before the resident duty hour reform and 0.8% (33/4,052) after the reform (aOR, 0.57; 95% confidence interval [CI], 0.33-0.98). Neither level of trainee (aOR, 1.22; 95% CI, 0.71-2.10; junior vs. senior) nor the number of residents present at admission (aOR, 2.08; 95% CI, 0.43-10.02, 5-8 residents vs. 0-2 residents) were associated with early mortality. Resident duty hour reform was not associated with hospital mortality (aOR, 0.73; 95% CI, 0.50-1.07; after vs. before resident duty hour reform).  Resident duty hour restrictions were associated with a reduction in the number of yearly hours worked by residents in the NICU as well as a significant decrease in adjusted odds of early mortality but not of hospital mortality in admitted neonates. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hemostatic profile and safety of pooled cryoprecipitate up to 120 hours after thawing.

PubMed

Lokhandwala, Parvez M; O'Neal, Adrian; Patel, Eshan U; Brunker, Patricia A R; Gehrie, Eric A; Zheng, Gang; Kickler, Thomas S; Ness, Paul M; Tobian, Aaron A R

2018-05-01

AABB standards state that cryoprecipitate should be transfused within 4 to 6 hours after thawing. We evaluated coagulation factor levels and sterility of thawed pooled cryoprecipitate to assess whether shelf life can be safely extended. Donor cryoprecipitate pools (n = 20, 10 group A, 10 group O) were held at ambient temperature and sampled at 0, 4, 8, 24, 48, 72, 96, and 120 hours post-thawing for fibrinogen, Factor (F)VIII, and von Willebrand factor (vWF) levels. Samples were tested at 0 and 120 hours for sterility (BacT/Alert system). Sixty additional cryoprecipitate pools were evaluated after 72 hours. Longitudinal differences in component levels were determined by linear fixed-effects regression. Group O cryoprecipitate had significantly lower FVIII (p = 0.002) and vWF activity (p = 0.006) compared to group A at 0 hours, but were not statistically different in fibrinogen levels (p = 0.33). Fibrinogen levels were stable over 5 days: 501 ± 81 mg/unit (mean ± standard deviation) at 0 hours to 506 ± 102 mg/unit at 120 hours (p = 0.73). Similarly, there was no decline in vWF activity: 200 ± 53 IU/unit at 0 hours to 209 ± 57 IU/unit at 120 hours (p = 0.084). The FVIII activity significantly declined on average by 9.6 IU (95% confidence interval, 5.5-13.8) between 0 hours (111 ± 33 IU/unit) and 120 hours post-thaw (101 ± 33) (p < 0.001). No organisms were detected when cryoprecipitate pools were cultured at 0 hours, but at 120 hours Staphylococcus epidermidis was identified from one pool, potentially a contaminant introduced during repeated sampling. No cultures were positive among the 60 additional cryoprecipitate pools assessed at 72 hours. Extended cryoprecipitate storage at ambient temperature did not affect fibrinogen levels over 120 hours. Sterility of products held at ambient temperature for an extended period of time could be assessed by secondary culture. © 2018 AABB.

Diversity and Similarity of Anesthesia Procedures in the United States During and Among Regular Work Hours, Evenings, and Weekends.

PubMed

Dexter, Franklin; Epstein, Richard H; Dutton, Richard P; Kordylewski, Hubert; Ledolter, Johannes; Rosenberg, Henry; Hindman, Bradley J

2016-12-01

Anesthesiologists providing care during off hours (ie, weekends or holidays, or cases started during the evening or late afternoon) are more likely to care for patients at greater risk of sustaining major adverse events than when they work during regular hours (eg, Monday through Friday, from 7:00 AM to 2:59 PM). We consider the logical inconsistency of using subspecialty teams during regular hours but not during weekends or evenings. We analyzed data from the Anesthesia Quality Institute's National Anesthesia Clinical Outcomes Registry (NACOR). Among the hospitals in the United States, we estimated the average number of common types of anesthesia procedures (ie, diversity measured as inverse of Herfindahl index), and the average difference in the number of common procedures between 2 off-hours periods (regular hours versus weekends, and regular hours versus evenings). We also used NACOR data to estimate the average similarity in the distributions of procedures between regular hours and weekends and between regular hours and evenings in US facilities. Results are reported as mean ± standard error of the mean among 399 facilities nationwide with weekend cases. The distributions of common procedures were moderately similar (ie, not large, <.8) between regular hours and evenings (similarity index .59 ± .01) and between regular hours and weekends (similarity index, .55 ± .02). For most facilities, the number of common procedures differed by <5 procedures between regular hours and evenings (74.4% of facilities, P < .0001) and between regular hours and weekends (64.7% of facilities, P < .0001). The average number of common procedures was 13.59 ± .12 for regular hours, 13.12 ± .13 for evenings, and 9.43 ± .13 for weekends. The pairwise differences by facility were .13 ± .07 procedures (P = .090) between regular hours and evenings and 3.37 ± .12 procedures (P < .0001) between regular hours and weekends. In contrast, the differences were -5.18 ± .12 and 7.59 ± .13, respectively, when calculated using nationally pooled data. This was because the numbers of common procedures were 32.23 ± .05, 37.41 ± .11, and 24.64 ± .12 for regular hours, evenings, and weekends, respectively (ie, >2x the number of common procedures calculated by facility). The numbers of procedures commonly performed at most facilities are fewer in number than those that are commonly performed nationally. Thus, decisions on anesthesia specialization should be based on quantitative analysis of local data rather than national recommendations using pooled data. By facility, the number of different procedures that take place during regular hours and off hours (diversity) is essentially the same, but there is only moderate similarity in the procedures performed. Thus, at many facilities, anesthesiologists who work principally within a single specialty during regular work hours will likely not have substantial contemporary experience with many procedures performed during off hours.

49 CFR 229.117 - Speed indicators.

Code of Federal Regulations, 2012 CFR

2012-10-01

... locomotive at speeds in excess of 20 miles per hour shall be equipped with a speed indicator which is— (1) Accurate within ±3 miles per hour of actual speed at speeds of 10 to 30 miles per hour and accurate within ±5 miles per hour at speeds above 30 miles per hour; and (2) Clearly readable from the engineer's...

49 CFR 229.117 - Speed indicators.

Code of Federal Regulations, 2013 CFR

2013-10-01

... locomotive at speeds in excess of 20 miles per hour shall be equipped with a speed indicator which is— (1) Accurate within ±3 miles per hour of actual speed at speeds of 10 to 30 miles per hour and accurate within ±5 miles per hour at speeds above 30 miles per hour; and (2) Clearly readable from the engineer's...

49 CFR 229.117 - Speed indicators.

Code of Federal Regulations, 2014 CFR

2014-10-01

... locomotive at speeds in excess of 20 miles per hour shall be equipped with a speed indicator which is— (1) Accurate within ±3 miles per hour of actual speed at speeds of 10 to 30 miles per hour and accurate within ±5 miles per hour at speeds above 30 miles per hour; and (2) Clearly readable from the engineer's...

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...

5 CFR 551.423 - Time spent in training or attending a lecture, meeting, or conference.

Code of Federal Regulations, 2011 CFR

2011-01-01

... MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work... working hours shall be considered hours of work. (2) Time spent in training outside regular working hours shall be considered hours of work if: (i) The employee is directed to participate in the training by his...

11 CFR 114.9 - Use of corporate or labor organization facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... activity that does not exceed one hour per week or four hours per month, regardless of whether the activity... voluntary individual Internet activities (as defined in 11 CFR 100.94), in excess of one hour per week or...) Any individual volunteer activity that does not exceed one hour per week or four hours per month...

78 FR 26233 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... Replace fire seal (up to 4) 8 work-hours x $85 per hour = 8,010 8,690 $680. Authority for This Rulemaking... ``New Service Information'' section above: ``Labor cost'' increased to 28 work-hours (14 hours per.... Action Labor cost Parts cost product operators General visual inspection and 28 work-hours x $85 per $2...

29 CFR 778.311 - Flat rate for special job performed in overtime hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... times the applicable rate to pieceworkers for work performed during overtime hours, as discussed in... basis under discussion. (1) An employment agreement calls for the payment of $5 per hour for work during... $7.50 per hour for work during hours outside the basic workday or workweek. It further provides that...

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...

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

"Office Hours Are Kind of Weird": Reclaiming a Resource to Foster Student-Faculty Interaction

ERIC Educational Resources Information Center

Smith, Margaret; Chen, Yujie; Berndtson, Rachel; Burson, Kristen M.; Griffin, Whitney

2017-01-01

Office hours reserve time and space for student-faculty interaction, a benchmark for engaging students in educationally purposive activities. Our study finds a mismatch between the institutionally intended purpose of office hours and student perceptions of office hours. We examine student perceptions of office hours with results from a survey…

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…

Alternative Fuels Data Center: U.S. Truck Stop Electrification Locations

Science.gov Websites

bays) Media: Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see : Internet, Wireless Payment: American Express, Cash, MasterCard, VISA Access: Public - see hours Hours: 24 bays) Media: Internet Payment: Gift Card, MasterCard, VISA Access: Public - see hours Hours: 24 hours

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.

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

Long working hours, occupational health and the changing nature of work organization.

PubMed

Johnson, Jeffrey V; Lipscomb, Jane

2006-11-01

The impact of long working hours on health has been of major concern since the late 19th Century. Working hours are again increasing in the US. An overview of historical, sociological, and health-related research presented at an international conference on long working hours is discussed as an introduction to a special section in this issue. Research indicates that long working hours are polarizing along class lines with professionals working regular though longer hours and less well-educated workers having fewer though more irregular hours. Extended and irregular hours are associated with acute reactions such as stress and fatigue, adverse health behavior such as smoking, and chronic outcomes such as cardiovascular and musculoskeletal disorders. Improved methodologies are needed to track exposure to long working hours and irregular shifts longitudinally. Research should focus on the adverse impact that sleep-deprived and stressed workers may have on the health of the public they serve. A variety of protective efforts should be undertaken and evaluated. Copyright (c) 2006 Wiley-Liss, Inc.

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 hours and various health effects in Korean workers. PMID:24472333

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...

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.

Validity and reproducibility of self-reported working hours among Japanese male employees.

PubMed

Imai, Teppei; Kuwahara, Keisuke; Miyamoto, Toshiaki; Okazaki, Hiroko; Nishihara, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Dohi, Seitaro

2016-07-22

Working long hours is a potential health hazard. Although self-reporting of working hours in various time frames has been used in epidemiologic studies, its validity is unclear. The objective of this study was to examine the validity and reproducibility of self-reported working hours among Japanese male employees. The participants were 164 male employees of four large-scale companies in Japan. For validity, the Spearman correlation between self-reported working hours in the second survey and the working hours recorded by the company was calculated for the following four time frames: daily working hours, monthly overtime working hours in the last month, average overtime working hours in the last 3 months, and the frequency of long working months (≥45 h/month) within the last 12 months. For reproducibility, the intraclass correlation between the first (September 2013) and second surveys (December 2013) was calculated for each of the four time frames. The Spearman correlations between self-reported working hours and those based on company records were 0.74, 0.81, 0.85, and 0.89 for daily, monthly, 3-monthly, and yearly time periods, respectively. The intraclass correlations for self-reported working hours between the two questionnaire surveys were 0.63, 0.66, 0.73, and 0.87 for the respective time frames. The results of the present study among Japanese male employees suggest that the validity of self-reported working hours is high for all four time frames, whereas the reproducibility is moderate to high.

Global Positioning System (GPS) Precipitable Water in Forecasting Lightning at Spaceport Canaveral

NASA Technical Reports Server (NTRS)

Kehrer, Kristen C.; Graf, Brian; Roeder, William

2006-01-01

This paper evaluates the use of precipitable water (PW) from Global Positioning System (GPS) in lightning prediction. Additional independent verification of an earlier model is performed. This earlier model used binary logistic regression with the following four predictor variables optimally selected from a candidate list of 23 candidate predictors: the current precipitable water value for a given time of the day, the change in GPS-PW over the past 9 hours, the KIndex, and the electric field mill value. This earlier model was not optimized for any specific forecast interval, but showed promise for 6 hour and 1.5 hour forecasts. Two new models were developed and verified. These new models were optimized for two operationally significant forecast intervals. The first model was optimized for the 0.5 hour lightning advisories issued by the 45th Weather Squadron. An additional 1.5 hours was allowed for sensor dwell, communication, calculation, analysis, and advisory decision by the forecaster. Therefore the 0.5 hour advisory model became a 2 hour forecast model for lightning within the 45th Weather Squadron advisory areas. The second model was optimized for major ground processing operations supported by the 45th Weather Squadron, which can require lightning forecasts with a lead-time of up to 7.5 hours. Using the same 1.5 lag as in the other new model, this became a 9 hour forecast model for lightning within 37 km (20 NM)) of the 45th Weather Squadron advisory areas. The two new models were built using binary logistic regression from a list of 26 candidate predictor variables: the current GPS-PW value, the change of GPS-PW over 0.5 hour increments from 0.5 to 12 hours, and the K-index. The new 2 hour model found the following for predictors to be statistically significant, listed in decreasing order of contribution to the forecast: the 0.5 hour change in GPS-PW, the 7.5 hour change in GPS-PW, the current GPS-PW value, and the KIndex. The new 9 hour forecast model found the following five independent variables to be statistically significant, listed in decreasing order of contribution to the forecast: the current GPSPW value, the 8.5 hour change in GPS-PW, the 3.5 hour change in GPS-PW, the 12 hour change in GPS-PW, and the K-Index. In both models, the GPS-PW parameters had better correlation to the lightning forecast than the K-Index, a widely used thunderstorm index. Possible future improvements to this study are discussed.

45 CFR 261.60 - What hours of participation may a State report for a work-eligible individual?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Participation Information? § 261.60 What hours of participation may a State report for a work-eligible... calculating the work participation rates for a month, actual hours may include the hours for which an... participation for up to six months based on current, documented actual hours of work. Any time a State receives...

78 FR 4759 - Airworthiness Directives; Bell Helicopter Textron, Inc. (Bell) Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-23

.... Reviewing the helicopter records and determining the total factored hours TIS will require about 3 work... inspection and MPI will require about 35 work hours at an average labor rate of $85 per work hour, for a... inspection cycle. To replace a yoke will require about 32 work hours at an average labor rate of $85 per hour...

76 FR 21869 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-19

... tentatively estimates that each staff member will spend approximately six hours per work week for six months... determined as follows: Seven employees x (six hours/week/employee x 24 weeks) = 1,008 hours. Assuming the... employees x (six hours/week/employee x 24 weeks) = 432 hours. Assuming the employees are at the Level III...

29 CFR 531.37 - Overtime workweeks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... thus entitled to receive a total of $103.50 for the week ((40 hours × $2.25=$90)+(4 hours × $3.37 1/2..., whose maximum nonovertime workweek under section 7(a) of the Act is 40 hours, works 44 hours during a... compensation of $4.50 in cash for the 4 overtime hours must, therefore, be paid by the employer, to meet the...

5 CFR 551.432 - Sleep time.

Code of Federal Regulations, 2011 CFR

2011-01-01

... amount of bona fide sleep and meal time that may be excluded from hours of work may not exceed 8 hours in... considered hours of work. (e) On-duty sleep and meal time during regularly scheduled hours for which standby... firefighters compensated under 5 U.S.C. 5545b, on-duty sleep and meal time may not be excluded from hours of...

5 CFR 551.432 - Sleep time.

Code of Federal Regulations, 2010 CFR

2010-01-01

... amount of bona fide sleep and meal time that may be excluded from hours of work may not exceed 8 hours in... considered hours of work. (e) On-duty sleep and meal time during regularly scheduled hours for which standby... firefighters compensated under 5 U.S.C. 5545b, on-duty sleep and meal time may not be excluded from hours of...

Credit Hours with No Set Time: A Study of Credit Policies in Asynchronous Online Education

ERIC Educational Resources Information Center

Prasuhn, Frederick Carl

2014-01-01

U.S. public university system policies were examined to learn how credit hours were determined for asynchronous online education. Findings indicated that (a) credit hour meaning and use are not consistent, (b) primary responsibility for credit hour decisions was at the local level, and (c) no policies exist to guide credit hour application for…

76 FR 52665 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... measures that the Agency may take to help consumers make informed dietary choices. To help design and... complete a 15-minute (0.25 hour) pretest. The total for the pretest activities is 57 hours (12 hours + 45...,322 hours published in the 60-day notice and reflects 20 fewer hours for pretest invitation and 476...

Relations of Work Identity, Family Identity, Situational Demands, and Sex with Employee Work Hours

ERIC Educational Resources Information Center

Greenhaus, Jeffrey H.; Peng, Ann C.; Allen, Tammy D.

2012-01-01

This study examined relations of multiple indicators of work identity and family identity with the number of weekly hours worked by 193 married business professionals. We found that men generally worked long hours regardless of the situational demands to work long hours and the strength of their work and family identities. Women's work hours, on…

78 FR 42946 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Public...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-18

... counseling and activities, and will be implemented in New York City. It will be tailored to bisexual and... hours). Health History Questionnaire.... 40 1 12/60 480/60 (8 hours). Focus Group (study midpoint).... 40 1 1 40 hours. Focus Group (study completion).. 40 1 1 40 hours. Total 129 hours. Keith A. Tucker...

29 CFR 778.326 - Reduction of regular overtime workweek without reduction of take-home pay.

Code of Federal Regulations, 2010 CFR

2010-07-01

... working long hours. In arrangements of this type, no additional financial pressure would fall upon the... take-home pay. 778.326 Section 778.326 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR... was hired at an hourly rate of $5 an hour and regularly worked 50 hours, earning $275 as his total...

78 FR 68757 - Atlantic Highly Migratory Species; Vessel Monitoring Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

... vessel that declares out of the HMS fishery long-term declaration by as much as 4 hours if it declares... hours a day, 7 days a week to provide hourly position reports for the duration of the long-term... to use VMS, to provide hourly position reports 24 hours a day, 7 days a week (24/7) via VMS. The...

Application of autoclaving-cooling cycling treatment to improve resistant starch content of corn-based rice analogues

NASA Astrophysics Data System (ADS)

Hidayat, B.; Muslihudin, M.; Akmal, S.

2018-01-01

Resistant starch is one important component determining the characteristics of a functional food. The aim of the research was to determine the cooling time optimum in the autoclaving-cooling treatment to increase the resistance starch content corn-based rice analogues, with 6 level of cooling time (0 hours/control, 12 hours, 24 hours, 36 hours, 48 hours and 60 hours). The results showed that cooling at 4°C for 60 hours would increase the resistant starch content (6.27% to 15.38%), dietary fiber content (14.53% to 20.17%); and decrease the digestible starch content (61.81% to 52.70%). Cooling time level at 4°C for 24 hours, would increase the sensory score of corn-based rice analogues then back down until cooling time level of 60 hours. Microscopic analysis of granular structure using SEM indicated that cooling time had a linear correlation with cracks intensity on the granule surface of the corn-based rice analogues. The high content of resistant starch showed that the application of cooling time level at 4°C for 24 hours would improve the functional properties of corn-based rice analogues with sensory characteristics remain favorable to panelists.

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.

Intraocular pressure elevation after cataract surgery and its prevention by oral acetazolamide in eyes with pseudoexfoliation syndrome.

PubMed

Hayashi, Ken; Yoshida, Motoaki; Sato, Tatsuhiko; Manabe, Shin-Ichi; Yoshimura, Koichi

2018-02-01

To examine whether intraocular pressure (IOP) increases immediately after cataract surgery in eyes with pseudoexfoliation (PXF) syndrome and to assess whether orally administered acetazolamide can prevent the IOP elevation. Hayashi Eye Hospital, Fukuoka, Japan. Prospective case series. Patients with PXF syndrome scheduled for phacoemulsification were randomly assigned to 1 of 3 groups: (1) oral acetazolamide administered 1 hour preoperatively (preoperative administration group), (2) administered 3 hours postoperatively (postoperative administration group), and (3) not administered (no administration group). The IOP was measured using a rebound tonometer 1 hour preoperatively, upon completion of surgery, and at 1, 3, 5, 7, and 24 hours postoperatively. The study comprised 96 patients (96 eyes). The mean IOP increased at 3, 5, and 7 hours postoperatively in all groups. At 1 hour and 3 hours postoperatively, the IOP was significantly lower in the preoperative administration group than in the postoperative group and no administration group (P ≤ .001). At 5, 7, and 24 hours postoperatively, the IOP was significantly lower in the preoperative group and postoperative administration group than in the no administration group (P ≤. 045). An IOP spike higher than 25 mm Hg occurred less frequently in the preoperative administration group than in the postoperative administration group and the no administration group (P = .038). Intraocular pressure increased at 3, 5, and 7 hours after cataract surgery in eyes with PXF syndrome. Oral acetazolamide administered 1 hour preoperatively reduced the IOP elevation throughout the 24-hour follow-up; acetazolamide administered 3 hours postoperatively reduced the elevation at 5 hours postoperatively and thereafter. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Associations of Work Hours with Carotid Intima Media Thickness and Ankle-Brachial Index: The Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Charles, Luenda E.; Fekedulegn, Desta; Burchfiel, Cecil M.; Fujishiro, Kaori; Landsbergis, Paul; Roux, Ana V. Diez; MacDonald, Leslie; Foy, Capri G.; Andrew, Michael E.; Stukovsky, Karen Hinckley; Baron, Sherry

2014-01-01

Objectives Long working hours may be associated with cardiovascular disease (CVD). The objective was to investigate cross-sectional associations of work hours with carotid intima media thickness (CIMT) and ankle brachial index (ABI). Methods Participants were 1,694 women and 1,868 men from the Multi-Ethnic Study of Atherosclerosis. CIMT and ABI were measured using standard protocols. Information on work hours was obtained from questionnaires. Mean values of CIMT and ABI were examined across five categories of hours worked per week (≤20, 21-39, 40, 41-50, >50) using ANOVA/ANCOVA. P-values for trend were obtained from linear regression models. Results Mean age of participants was 56.9±8.4 years; 52.4% were men. Distinct patterns of association between work hours and the subclinical CVD biomarkers were found for women and men, although this heterogeneity by gender was not statistically significant. Among women only, work hours were positively associated with common (but not internal) CIMT (p=0.073) after full risk factor adjustment. Compared to women working 40 hours, those working >50 hours were more likely to have an ABI <1 (vs. 1-1.4) (OR=1.85, 95% CI=1.01-3.38). In men, work hours and ABI were inversely associated (p=0.046). There was some evidence that the association between work hours and ABI was modified by occupational category (interaction p=0.061). Among persons classified as Management/Professionals, longer work hours was associated with lower ABI (p=0.015). No significant associations were observed among other occupational groups. Conclusion Working longer hours may be associated with subclinical CVD. These associations should be investigated using longitudinal studies. PMID:22767870

Work hours, weight status, and weight-related behaviors: a study of metro transit workers.

PubMed

Escoto, Kamisha H; French, Simone A; Harnack, Lisa J; Toomey, Traci L; Hannan, Peter J; Mitchell, Nathan R

2010-12-20

Associations between hours worked per week and Body Mass Index (BMI), food intake, physical activity, and perceptions of eating healthy at work were examined in a sample of transit workers. Survey data were collected from 1086 transit workers. Participants reported hours worked per week, food choices, leisure-time physical activity and perceptions of the work environment with regard to healthy eating. Height and weight were measured for each participant. Multivariate linear and logistic regressions were conducted to examine associations between work hours and behavioral variables. Associations were examined in the full sample and stratified by gender. Transit workers working in the highest work hour categories had higher BMI and poorer dietary habits, with results differing by gender. Working 50 or more hours per week was associated with higher BMI among men but not women. Additionally, working 50 or more hours per week was significantly associated with higher frequency of accessing cold beverage, cold food, and snack vending machines among men. Working 40 or more hours per week was associated with higher frequency of accessing cold food vending machines among women. Reported frequency of fruit and vegetable intake was highest among women working 50 or more hours per week. Intake of sweets, sugar sweetened beverages, and fast food did not vary with work hours in men or women. Physical activity and perception of ease of eating healthy at work were not associated with work hours in men or women. Long work hours were associated with more frequent use of garage vending machines and higher BMI in transit workers, with associations found primarily among men. Long work hours may increase dependence upon food availability at the worksite, which highlights the importance of availability of healthy food choices.

Medical Decisions of Pediatric Residents Turn Riskier after a 24-Hour Call with No Sleep.

PubMed

Aran, Adi; Wasserteil, Netanel; Gross, Itai; Mendlovic, Joseph; Pollak, Yehuda

2017-01-01

Despite a gradual reduction in the workload during residency, 24-hour calls are still an integral part of most training programs. While sleep deprivation increases the risk propensity, the impact on medical risk taking has not been studied. This study aimed to assess the clinical decision making and psychomotor performance of pediatric residents following a limited nap time during a 24-hour call. A neurocognitive battery (IntegNeuro) and a medical decision questionnaire were completed by 44 pediatric residents at 2 time points: after a 24-hour call and following 3 nights with no calls (sleep ≥5 hours). To monitor sleep, residents wore actigraphs and completed sleep logs. Nap time during the shift was <1 hour in 14 cases (32%), 1 to 2 hours in 16 cases (35%), and 2 to 3 hours in 14 cases (32%). Residents who napped less than 1 hour chose the riskier medical option in 50% of cases compared with 36% when answering the same questionnaire after 3 nights with no calls (P = 0.002). This effect was not found in residents who napped 1 to 2 hours (no change in risk taking) or 2 to 3 hours (4% decreased risk taking) (difference between groups, P = 0.001). Risk-taking tendency inversely correlated with sustained attention scores (Pearson = -0.433, P = 0.003). Sustained attention was the neurocognitive domain most affected by sleep deprivation (effect size = 0.29, P = 0.025). This study suggests that residents napping less than an hour during a night shift are prone to riskier clinical decisions. Hence, enabling residents to nap at least 1 hour during shifts is recommended. © The Author(s) 2016.

Working hours and roster structures of surgical trainees in Australia and New Zealand.

PubMed

O'Grady, Gregory; Loveday, Benjamin; Harper, Simon; Adams, Brandon; Civil, Ian D; Peters, Matthew

2010-12-01

The working hours of surgical trainees are a subject of international debate. Excessive working hours are fatiguing, and compromise performance, learning and work-life balance. However, reducing hours can impact on continuity of care, training experience and service provision. This study defines the current working hours of Australasian trainees, to inform the working hours debate in our regions. An online survey was conducted of all current Australasian trainees. Questions determined hours spent at work (AW) and off-site on-call (OC) per week, and roster structures were evaluated by training year, specialty and location. The response rate was 55.3%. Trainees averaged 61.4 ± 11.7 h/week AW, with 5% working ≥80 h. OC shifts were worked by 73.5%, for an average of 27.8 ± 14.3 h/week. Trainees of all levels worked similar hours (P= 0.10); however, neurosurgical trainees worked longer hours than most other specialties (P < 0.01). Tertiary centre rotations involved longer AW hours (P= 0.01) and rural rotations more OC (P < 0.001). Long days (>12 h) were worked by 86%; median frequency 1:4.4 days; median duration 15 h. OC shifts of 24-h duration were worked by 75%; median frequency 1:4.2 days; median sleep: 5-7 h/shift; median uninterrupted sleep: 3-5 h/shift. This study has quantified the working hours and roster structures of Australasian surgical trainees. By international standards, Australasian trainee working hours are around average. However, some rosters demand long hours and/or induce chronic sleep loss, placing some trainees at risk of fatigue. Ongoing efforts are needed to promote safe rostering practices. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

Work hours, weight status, and weight-related behaviors: a study of metro transit workers

PubMed Central

2010-01-01

Background Associations between hours worked per week and Body Mass Index (BMI), food intake, physical activity, and perceptions of eating healthy at work were examined in a sample of transit workers. Methods Survey data were collected from 1086 transit workers. Participants reported hours worked per week, food choices, leisure-time physical activity and perceptions of the work environment with regard to healthy eating. Height and weight were measured for each participant. Multivariate linear and logistic regressions were conducted to examine associations between work hours and behavioral variables. Associations were examined in the full sample and stratified by gender. Results Transit workers working in the highest work hour categories had higher BMI and poorer dietary habits, with results differing by gender. Working 50 or more hours per week was associated with higher BMI among men but not women. Additionally, working 50 or more hours per week was significantly associated with higher frequency of accessing cold beverage, cold food, and snack vending machines among men. Working 40 or more hours per week was associated with higher frequency of accessing cold food vending machines among women. Reported frequency of fruit and vegetable intake was highest among women working 50 or more hours per week. Intake of sweets, sugar sweetened beverages, and fast food did not vary with work hours in men or women. Physical activity and perception of ease of eating healthy at work were not associated with work hours in men or women. Conclusions Long work hours were associated with more frequent use of garage vending machines and higher BMI in transit workers, with associations found primarily among men. Long work hours may increase dependence upon food availability at the worksite, which highlights the importance of availability of healthy food choices. PMID:21172014

Side effects of oral misoprostol during the first 24 hours after administration in the third stage of labour.

PubMed

Lumbiganon, Pisake; Villar, José; Piaggio, Gilda; Gülmezoglu, A Metin; Adetoro, Lekan; Carroli, Guillermo

2002-11-01

To evaluate the side effects of 600 microg misoprostol orally during the first 24 hours after administration in the third stage of labour. Double blind randomised controlled trial. Tertiary care hospitals in Nigeria and Thailand. All women participating in the WHO Misoprostol trial in these two hospitals between January 1, 1999 and June 17, 1999. All women were followed up during the first 24 hours postpartum to evaluate the occurrence of shivering, nausea, vomiting, diarrhoea and other misoprostol-related side effects. Rates of shivering, nausea, vomiting, diarrhoea and pyrexia within 1 hour and in the intervals 2-6, 7-12, 13-18 and 19-24 hours after delivery. A total of 1686 women were enrolled. Women who received misoprostol had higher incidence than the oxytocin group of 'any' shivering in the first hour (RR 6.4, 95% CI 3.9 to 10.4) and the period covering 2-6 hours following delivery (RR 4.7, 95% CI 1.9 to 11.2). Pyrexia was also more common in the misoprostol group in both the same time intervals (RR 2.8, 95% CI 1.4 to 5.3 and RR 6.3, 95% CI 3.7 to 10.8, respectively). Diarrhoea was not present in the first hour in either group but appeared in the second time period (2-6 hours) and third time period (7-12 hours) more frequently in the misoprostol group than with oxytocin. The increased incidence of shivering and pyrexia that occurs with postpartum use of misoprostol persists up to 6 hours following delivery. Approximately 5% of women experience diarrhoea that starts after 1 hour and subsides within 12 hours.

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

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.

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. ...

Interns' compliance with accreditation council for graduate medical education work-hour limits.

PubMed

Landrigan, Christopher P; Barger, Laura K; Cade, Brian E; Ayas, Najib T; Czeisler, Charles A

2006-09-06

Sleep deprivation is associated with increased risk of serious medical errors and motor vehicle crashes among interns. The Accreditation Council for Graduate Medical Education (ACGME) introduced duty-hour standards in 2003 to reduce work hours. To estimate compliance with the ACGME duty-hour standards among interns. National prospective cohort study with monthly Web-based survey assessment of intern work and sleep hours using a validated instrument, conducted preimplementation (July 2002 through May 2003) and postimplementation (July 2003 through May 2004) of ACGME standards. Participants were 4015 of the approximately 37 253 interns in US residency programs in all specialties during this time; they completed 29 477 reports of their work and sleep hours. Overall and monthly rates of compliance with the ACGME standards. Postimplementation, 1068 (83.6%; 95% confidence interval [CI], 81.4%-85.5%) of 1278 of interns reported work hours in violation of the standards during 1 or more months. Working shifts greater than 30 consecutive hours was reported by 67.4% (95% CI, 64.8%-70.0%). Averaged over 4 weeks, 43.0% (95% CI, 40.3%-45.7%) reported working more than 80 hours weekly, and 43.7% (95% CI, 41.0%-46.5%) reported not having 1 day in 7 off work duties. Violations were reported during 3765 (44.0%; 95% CI, 43.0%-45.1%) of the 8553 intern-months assessed postimplementation (including vacation and ambulatory rotations), and during 2660 (61.5%; 95% CI, 60.0%-62.9%) of 4327 intern-months during which interns worked exclusively in inpatient settings. Postimplementation, 29.0% (95% CI, 28.7%-29.7%) of reported work weeks were more than 80 hours per week, 12.1% (95% CI, 11.8%-12.6%) were 90 or more hours per week, and 3.9% (95% CI, 3.7%-4.2%) were 100 or more hours per week. Comparing preimplementation to postimplementation responses, reported mean work duration decreased 5.8% from 70.7 (95% CI, 70.5-70.9) hours to 66.6 (95% CI, 66.3-66.9) hours per week (P<.001), and reported mean sleep duration increased 6.1% (22 minutes) from 5.91 (95% CI, 5.88-5.94) hours to 6.27 (95% CI, 6.23-6.31) hours per night (P<.001). However, reported mean sleep during extended shifts decreased 4.5%, from 2.69 (95% CI, 2.66-2.73) hours to 2.57 (95% CI, 2.52-2.62) hours (P<.001). In the first year following implementation of the ACGME duty-hour standards, interns commonly reported noncompliance with these requirements.

Thermal Interference Fit Anode Assembly for Cathodic Protection

DTIC Science & Technology

2018-02-22

than an inside diameter of the cylindrical anode, is subject to the low temperature for a minimum of six hours and preferably twenty- four hours to...degrees Fahrenheit after a minimum of six hours and preferably twenty-four hours. The anode 10 is immediately fused to the mounting bolt 20 by hand...degrees Fahrenheit after a minimum of six hours and preferably twenty-four hours. The anode is then hand pressed onto the mounting bolt to bottom out on the non-anodized face in order to form a single fused assembly.

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.

Toward a new paradigm in graduate medical education in the United States: elimination of the 24-hour call.

PubMed

Mautone, Susan G

2009-12-01

Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour "nap" break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P  =  .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new "normal" for our program.

AUTORADIOGRAPHIC STUDY OF DNA SYNTHESIS AND THE CELL CYCLE IN SPERMATOGONIA AND SPERMATOCYTES OF MOUSE TESTIS USING TRITIATED THYMIDINE

PubMed Central

Monesi, Valerio

1962-01-01

Mice were injected intraperitoneally with 15 µc of H3-thymidine. The time course of the labeling in spermatogonia and spermatocytes was studied by using autoradiography on 5 µ sections stained by the periodic acid-Schiff method and hematoxylin over a period of 57 hours after injection. Four generations of type A (called AI, AII, AIII, and AIV), one of intermediate, and one of type B spermatogonia occur in one cycle of the seminiferous epithelium. The average life span is about the same in all spermatogonia, i.e., about 27 to 30.5 hours. The average pre-DNA synthetic time, including the mitotic stages from metaphase through telophase and the portion of interphase preceding DNA synthesis, is also not very different, ranging between 7.5 and 10.5 hours. A remarkable difference exists, however, in the duration of DNA synthesis and of the post-DNA synthetic period. The average DNA synthetic time is very long and is highly variable in type B (14.5 hours), a little shorter and less variable in intermediate (12.5 hours) and AIV (13 hours) spermatogonia, and much shorter and very constant in AIII (8 hours), AII and AI (7 to 7.5 hours) spermatogonia. Conversely, the average post-DNA synthetic time, corresponding essentially to the duration of the prophase, is short and very constant in type B (4.5 hours), longer and variable in intermediate (6 hours) and AIV (8 hours) spermatogonia, and much longer and much more variable in AIII (11 hours), AII and AI (14 hours) spermatogonia. The premeiotic synthesis of DNA takes place in primary spermatocytes during the resting phase and terminates just before the visible onset of the meiotic prophase. Its average duration is 14 hours. No further synthesis of DNA takes place in later stages of spermatogenesis. PMID:14475361

Results of medical countermeasure drills among 72 cities readiness initiative metropolitan statistical areas, 2008-2009.

PubMed

Jones, Jaime R; Neff, Linda J; Ely, Elizabeth K; Parker, Andrew M

2012-12-01

The Cities Readiness Initiative is a federally funded program designed to assist 72 metropolitan statistical areas (MSAs) in preparing to dispense life-saving medical countermeasures within 48 hours of a public health emergency. Beginning in 2008, the 72 MSAs were required to conduct 3 drills related to the distribution and dispensing of emergency medical countermeasures. The report describes the results of the first year of pilot data for medical countermeasure drills conducted by the MSAs. The MSAs were provided templates with key metrics for 5 functional elements critical for a successful dispensing campaign: personnel call down, site activation, facility setup, pick-list generation, and dispensing throughput. Drill submissions were compiled into single data sets for each of the 5 drills. Analyses were conducted to determine whether the measures were comparable across business and non-business hours. Descriptive statistics were computed for each of the key metrics identified in the 5 drills. Most drills were conducted on Mondays and Wednesdays during business hours (8:00 am-5:00 pm). The median completion time for the personnel call-down drill was 1 hour during business hours (n = 287) and 55 minutes during non-business hours (n = 136). Site-activation drills were completed in a median of 30 minutes during business hours and 5 minutes during non-business hours. Facility setup drills were completed more rapidly during business hours (75 minutes) compared with non-business hours (96 minutes). During business hours, pick lists were generated in a median of 3 minutes compared with 5 minutes during non-business hours. Aggregate results from the dispensing throughput drills demonstrated that the median observed throughput during business hours (60 people/h) was higher than that during non-business hours (43 people/h). The results of the analyses from this pilot sample of drill submissions provide a baseline for the determination of a national standard in operational capabilities for local jurisdictions to achieve in their planning efforts for a mass dispensing campaign during an emergency.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts.

PubMed

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

2017-04-01

Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts

PubMed Central

Dinges, David F.; Shea, Judy A.; Small, Dylan S.; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J.; Novak, Cristina; Bellini, Lisa M.; Volpp, Kevin G.

2017-01-01

Abstract Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep–wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Results: Interns averaged 6.93 hours (95% confidence interval [CI] 6.84–7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06–7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02–2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post‐call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69–3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56–1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Conclusions: Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged. PMID:28329124

Evaluation of a new rapid readout biological indicator for use in 132°C and 135°C vacuum-assisted steam sterilization cycles.

PubMed

Schneider, Philip M

2014-02-01

Sterilization is a process that cannot be inspected or tested in a practical manner to assure that all microorganisms have been inactivated. The process must therefore be validated for all of the specific items processed or monitored on a per cycle basis. A new, faster rapid readout biological indicator (RRBI) has been developed for use in 132°C and 135°C vacuum-assisted steam sterilization cycles. The aim of this study was to evaluate the performance of this new 1-hour readout RRBI at 132°C in side-by-side testing with an existing 3-hour readout RRBI and also evaluate the performance of the new RRBI in 135°C cycles. Readout responses of 1 hour (fluorescent) and 48 hours and 7 days (growth) of the new RRBI were compared with 3-hour, 48-hour, and 7-day readouts of the 3-hour RRBI following exposures in 132°C cycles using a highly controlled test vessel, ie, a steam resistometer. Additional testing of the 1-hour RRBIs was also performed in 135°C cycles. The number and percentage of fluorescent-positive 1-hour RRBIs were virtually identical to those of the 3-hour RRBIs after 1 and 3 hours of incubation, respectively. Testing of the 1-hour RRBI in 135°C cycles paralleled the results of the testing at 132°C but with the expected shorter exposure times. The results of this study suggest that the 1-hour RRBI is equivalent to the 3-hour RRBI and would be suitable for use in monitoring dynamic air removal steam sterilization cycles at both 132°C and 135°C per recommended practice guidelines. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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.

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.

When more is less: An examination of the relationship between hours in telework and role overload.

PubMed

Duxbury, Linda; Halinski, Michael

2014-01-01

Proponents of telework arrangements assert that those who telework have more control over their work and family domains than their counterparts who are not permitted to work from home. Using Karasek's theory we hypothesized that the relationship between demands (hours in work per week; hours in childcare per week) and strain (work role overload; family role overload) would be moderated by the number of hours the employee spent per week teleworking (control). To determine how the number of telework hours relates to work role overload and family role overload, we follow the test for moderation and mediation using hierarchical multiple regression analysis as outlined by Frazier et al. [50] We used survey data collected from 1,806 male and female professional employees who spent at least one hour per week working from home during regular hours (i.e. teleworking). As hypothesized, the number of hours in telework per week negatively moderated the relation between work demands (total hours in paid employment per week) and work strain (work role overload). Contrary to our hypothesis, the number of hours in telework per week only partially mediated the relation between family demands (hours a week in childcare) and family role overload (strain). The findings from this study support the idea that the control offered by telework is domain specific (helps employees meet demands at work but not at home).

Relationship of 24-hour urinary free cortisol to 4-hour salivary morning and afternoon cortisol and cortisone as measured by a time-integrated oral diffusion sink.

PubMed

Kathol, R G; Poland, R E; Stokes, P E; Wade, S

1995-05-01

The relationship between salivary corticosteroids integrated over 4-hour periods and urinary free cortisol collected over 24 hours was investigated in normal controls. Twenty-one normal volunteers wore "oral diffusion sink" sampling devices in their mouths for two 4-hour periods (08:00-12:00 hours and 13:00-17:00 hours) and on the same day collected a 24-hour urine specimen. Time-integrated salivary corticosteroid concentrations were determined from the sample devices and urinary free cortisol was measured. Salivary corticosteroids were not consistently higher in the morning than in the afternoon period and did not differ between men and women. Urinary free cortisol levels were higher in women. No salivary corticosteroids measure was significantly correlated with urinary free cortisol. We conclude that time-integrated salivary corticosteroids do not reflect urinary free cortisol levels in normal controls.

Reciprocal Relations Between Objectively Measured Sleep Patterns and Diurnal Cortisol Rhythms in Late Adolescents

PubMed Central

Zeiders, Katharine H.; Doane Sampey, Leah D.; Adam, Emma K.

2011-01-01

Purpose To examine how hours of sleep and wake times relate to between-person differences and day-to-day changes in diurnal cortisol rhythms in late adolescents Methods Older adolescents (N = 119) provided six cortisol samples (wakeup, +30min, + 2 hours, +8 hours, + 12 hours, and bedtime) on each of three consecutive days while wearing an actigraph. We examined how average (across 3 days) and day-to-day changes in hours of sleep and wake times related to diurnal cortisol patterns. Results On average, greater hours of sleep related steeper decline in cortisol across the days. Day-to-day analyses revealed that prior night’s hours of sleep predicted steeper diurnal slopes the next day, while greater waking cortisol levels and steeper slopes predicted greater hours of sleep and a later wake time the next day. Conclusions Our results suggest a bidirectional relationship between sleep and HPA axis activity. PMID:21575815

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.

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.

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.

A new preoxygenation procedure for extravehicular activity (EVA).

PubMed

Webb, J T; Pilmanis, A A

1998-01-01

A 10.2 psi staged-decompression schedule or a 4-hour preoxygenation at 14.7 psi is required prior to extravehicular activity (EVA) to reduce decompression sickness (DCS) risk. Results of recent research at the Air Force Research Laboratory (AFRL) showed that a 1-hour resting preoxygenation followed by a 4-hour, 4.3 psi exposure resulted in 77% DCS risk (N=26), while the same profile beginning with 10 min of exercise at 75% of VO2peak during preoxygenation reduced the DCS risk to 42% (P<.03; N=26). A 4-hour preoxygenation without exercise followed by the 4.3 psi exposure resulted in 47% DCS risk (N=30). The 1-hour preoxygenation with exercise and the 4-hour preoxygenation without exercise results were not significantly different. Elimination of either 3 hours of preoxygenation or 12 hours of staged-decompression are compelling reasons to consider incorporation of exercise-enhanced preoxygenation.

21 CFR 1.99 - Costs chargeable in connection with relabeling and reconditioning inadmissible imports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... officer (GS-11/4) and the analyst (GS-12/4) is computed as follows: Hours Gross number of working hours in... d 208 Sick leave—13 d 104 Total 384 Net number of working hours 1,696 Gross number of working hours in 52 40-hr weeks 2,080 Working hour equivalent of Government contributions for employee retirement...

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...

76 FR 46305 - Eligibility Criteria for Sites Recruiting National Health Service Corps Scholars

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... 4 work days per week, with no more than 12 hours of work to be performed in any 24-hour period. Time... may be compressed into no less than 2 work days per week, with no more than 12 hours of work to be...-approved service site(s), during normally scheduled office hours. The remaining 4 hours per week must be...

45 CFR 2543.84 - Contract Work Hours and Safety Standards Act.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Contract Work Hours and Safety Standards Act. 2543... laborer on the basis of a standard work week of 40 hours. Work in excess of the standard work week is... pay for all hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable...

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…

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…

14 CFR 61.411 - What aeronautical experience must I have to apply for a flight instructor certificate with a...

Code of Federal Regulations, 2013 CFR

2013-01-01

...-engine class privileges, (1) 150 hours of flight time as a pilot, (i) 100 hours of flight time as pilot in command in powered aircraft,(ii) 50 hours of flight time in a single-engine airplane, (iii) 25 hours of cross-country flight time, (iv) 10 hours of cross-country flight time in a single-engine...

14 CFR 61.411 - What aeronautical experience must I have to apply for a flight instructor certificate with a...

Code of Federal Regulations, 2012 CFR

2012-01-01

...-engine class privileges, (1) 150 hours of flight time as a pilot, (i) 100 hours of flight time as pilot in command in powered aircraft,(ii) 50 hours of flight time in a single-engine airplane, (iii) 25 hours of cross-country flight time, (iv) 10 hours of cross-country flight time in a single-engine...

14 CFR 61.411 - What aeronautical experience must I have to apply for a flight instructor certificate with a...

Code of Federal Regulations, 2014 CFR

2014-01-01

...-engine class privileges, (1) 150 hours of flight time as a pilot, (i) 100 hours of flight time as pilot in command in powered aircraft,(ii) 50 hours of flight time in a single-engine airplane, (iii) 25 hours of cross-country flight time, (iv) 10 hours of cross-country flight time in a single-engine...

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…

40 CFR 86.1912 - How do I determine whether an engine meets the vehicle-pass criteria?

Code of Federal Regulations, 2012 CFR

2012-07-01

..., depending on the pollutant, as follows: (i) NMHC: 0.17 grams per brake horsepower-hour. (ii) CO: 0.60 grams per brake horsepower-hour. (iii) NOX: 0.50 grams per brake horsepower-hour. (iv) PM: 0.10 grams per brake horsepower-hour. (v) NOX + NMHC: 0.67 grams per brake horsepower-hour. (4) Accuracy margins for...

40 CFR 86.1912 - How do I determine whether an engine meets the vehicle-pass criteria?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., depending on the pollutant, as follows: (i) NMHC: 0.17 grams per brake horsepower-hour. (ii) CO: 0.60 grams per brake horsepower-hour. (iii) NOX: 0.50 grams per brake horsepower-hour. (iv) PM: 0.10 grams per brake horsepower-hour. (v) NOX + NMHC: 0.67 grams per brake horsepower-hour. (4) Accuracy margins for...

40 CFR 86.1912 - How do I determine whether an engine meets the vehicle-pass criteria?

Code of Federal Regulations, 2014 CFR

2014-07-01

..., depending on the pollutant, as follows: (i) NMHC: 0.17 grams per brake horsepower-hour. (ii) CO: 0.60 grams per brake horsepower-hour. (iii) NOX: 0.50 grams per brake horsepower-hour. (iv) PM: 0.10 grams per brake horsepower-hour. (v) NOX + NMHC: 0.67 grams per brake horsepower-hour. (4) Accuracy margins for...

77 FR 23635 - Fisheries of the Northeastern United States; Atlantic Mackerel, Squid, and Butterfish Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-20

... beginning at 0001 hours and ending at 2400 hours, provided that the fishery has not been closed because 95... is defined as the 24-hr period beginning at 0001 hours and ending at 2400 hours, provided that the... and ending at 2400 hours, provided that the fishery has not been closed because 90 percent of the Tier...

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.

Diagnostic value of potassium level in a spot urine sample as an index of 24-hour urinary potassium excretion in unselected patients hospitalized in a hypertension unit

PubMed Central

Symonides, Bartosz; Wojciechowska, Ewa; Gryglas, Adam; Gaciong, Zbigniew

2017-01-01

Background Primary hyperaldosteronism may be associated with elevated 24-hour urinary potassium excretion. We evaluated the diagnostic value of spot urine (SU) potassium as an index of 24-hour urinary potassium excretion. Methods We measured SU and 24-hour urinary collection potassium and creatinine in 382 patients. Correlations between SU and 24-hour collections were assessed for potassium levels and potassium/creatinine ratios. We used the PAHO formula to estimate 24-hour urinary potassium excretion based on SU potassium level. The agreement between estimated and measured 24-hour urinary potassium excretion was evaluated using the Bland-Altman method. To evaluate diagnostic performance of SU potassium, we calculated areas under the curve (AUC) for SU potassium/creatinine ratio and 24-hour urinary potassium excretion estimated using the PAHO formula. Results Strongest correlation between SU and 24-hour collection was found for potassium/creatinine ratio (r = 0.69, P<0.001). The PAHO formula underestimated 24-hour urinary potassium excretion by mean 8.3±18 mmol/d (95% limits of agreement -28 to +44 mmol/d). Diagnostic performance of SU potassium/creatinine ratio was borderline good only if 24-hour urinary potassium excretion was largely elevated (AUC 0.802 for 120 mmol K+/24 h) but poor with lower values (AUC 0.696 for 100 mmol K+/24 h, 0.636 for 80 mmol K+/24 h, 0.675 for 40 mmol K+/24 h). Diagnostic performance of 24-hour urinary potassium excretion estimated by the PAHO formula was excellent with values above 120 mmol/d and good with lower values (AUC 0.941 for 120 mmol K+/24 h, 0.819 for 100 mmol K+/24 h, 0.823 for 80 mmol K+/24 h, 0.836 for 40 mmol K+/24 h). Conclusions Spot urine potassium/creatinine ratio might be a marker of increased 24-hour urinary potassium excretion and a potentially useful screening test when reliable 24-hour urine collection is not available. The PAHO formula allowed estimation of the 24-hour urinary potassium excretion based on SU measurements with reasonable clinical accuracy. PMID:28662194

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.

Viewpoints from generation X: a survey of candidate and associate viewpoints on resident duty-hour regulations.

PubMed

Underwood, Willie; Boyd, Anne J; Fletcher, Kathlyn E; Lypson, Monica L

2004-06-01

The American Medical Student Association, the Committee of Interns and Residents, and Public Citizen petitioned the Occupational Safety and Health Administration for national resident duty-hour limitations. Subsequently, federal legislation was introduced to limit resident duty hours. To preempt the federal government, the Accreditation of Graduate Medical Education implemented resident duty-hour guidelines. To evaluate the viewpoints and attitudes of surgical resident and staff physicians as they pertain to the national resident duty-hour guidelines, we asked attendees of the American College of Surgeons' Candidate Associate Society Forum during the American College of Surgeons Clinical Congress meeting in 2001 to complete a self-administered questionnaire. Analyses were performed to determine the frequency of response for each survey item. Eighty-six of the 102 (84%) surgeons who attended the American College of Surgeons Forum completed the survey. Most disagreed with the federal government involvement in regulating duty hours. Although most agreed that residents should not be on call more than every third night, viewpoints varied on the other duty-hour guidelines. Most (63.4%) reported that residents should work 81 to 100 hours per week, but 11% reported that residents should work > 101 hours per week and 25.6% reported that

Standardization of renal function evaluation in Wistar rats (Rattus norvegicus) from the Federal University of Juiz de Fora's colony.

PubMed

de Castro, Bárbara Bruna Abreu; Colugnati, Fernando Antonio Basile; Cenedeze, Marcos Antonio; Suassuna, Paulo Giovanni de Albuquerque; Pinheiro, Hélady Sanders

2014-01-01

There is great interest in the use of animal models in the study of renal pathophysiology requires standardization of parameters. Standardize assessment of renal function in rats from in the Center for Reproductive Biology of Federal University of Juiz de Fora's colony. Thirty Wistar rats were used and performed measurements of creatinine (serum and urine), serum urea and proteinuria. Were evaluated: the urine collection interval in metabolic cages (24 hours or 12 hours), the need for 12-hour fast, the need of urine and serum deproteinization for creatinine measurement, need of serum deproteinization in animals with acute kidney injury to a spectrophotometer and ELISA, and the comparison of 24-hour proteinuria (PT 24 hours) with the protein/creatinine ratio (rP/C). Means were compared by the Student's t test, Pearson correlation, Bland-Altman plot for agreement and linear regression model to estimate PT 24 hours from rP/C. The 24 hours urine output was greater than 12 hours, interfering with the creatinine clearance calculation. In the fasting group showed less water intake and lower urinary creatinine. There was great variability for the deproteinized whey and readings performed in the two devices were similar. There was a strong correlation between PT 24 hours and rP/C and the equation was generated: PT 24 hours = (8.6113 x rP/C) + 1.0869. Was standardized: 24-hour urine collection without fasting. The deproteinization showed no benefit. The measurements were performed with spectrophotometer reliability. It generated a practical formula for estimating PT 24 hours through rP/C.

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.

Validity and reproducibility of self-reported working hours among Japanese male employees

PubMed Central

Imai, Teppei; Kuwahara, Keisuke; Miyamoto, Toshiaki; Okazaki, Hiroko; Nishihara, Akiko; Kabe, Isamu; Mizoue, Tetsuya; Dohi, Seitaro

2016-01-01

Objective: Working long hours is a potential health hazard. Although self-reporting of working hours in various time frames has been used in epidemiologic studies, its validity is unclear. The objective of this study was to examine the validity and reproducibility of self-reported working hours among Japanese male employees. Methods: The participants were 164 male employees of four large-scale companies in Japan. For validity, the Spearman correlation between self-reported working hours in the second survey and the working hours recorded by the company was calculated for the following four time frames: daily working hours, monthly overtime working hours in the last month, average overtime working hours in the last 3 months, and the frequency of long working months (≥45 h/month) within the last 12 months. For reproducibility, the intraclass correlation between the first (September 2013) and second surveys (December 2013) was calculated for each of the four time frames. Results: The Spearman correlations between self-reported working hours and those based on company records were 0.74, 0.81, 0.85, and 0.89 for daily, monthly, 3-monthly, and yearly time periods, respectively. The intraclass correlations for self-reported working hours between the two questionnaire surveys were 0.63, 0.66, 0.73, and 0.87 for the respective time frames. Conclusions: The results of the present study among Japanese male employees suggest that the validity of self-reported working hours is high for all four time frames, whereas the reproducibility is moderate to high. PMID:27265530

Self-Reported Sleep Duration and Self-Rated Health in Young Adults.

PubMed

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-07-15

This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Approximately 30% of participants slept 7-8 hours, 17.4% were short sleepers (categories < 6 hours and 6-7 hours), and 53.9% were long sleepers (categories 8-10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7-8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6-7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. © 2017 American Academy of Sleep Medicine

Germination of Phaseolus vulgaris

PubMed Central

Gillard, Douglas F.; Walton, Daniel C.

1973-01-01

Soluble proteins from excised Phaseolus vulgaris axes incubated for 1 hour in 3H or 14C- amino acid mixtures at different times during the period leading up to initiation of cell elongation were compared by acrylamide gel electrophoresis. Differences in electrophoretic patterns were found when proteins from axes incubated during the 1st hour of imbibition were compared with proteins from axes incubated during the hour when cell elongation was initiated. These differences greatly diminished by the 2nd hour of imbibition which suggests that they were due primarily to incomplete axis imbibition. A 5-hour actinomycin D treatment which reduced amino acid incorporation by 40% in the 5th hour had no apparent effect on the electrophoretic pattern during that hour. PMID:16658484

[Staff Satisfaction within Duty Hour Models: Longitudinal Survey on Suitability and Legal Conformity at a Surgical Maximum Care Department].

PubMed

Langelotz, C; Koplin, G; Pascher, A; Lohmann, R; Köhler, A; Pratschke, J; Haase, O

2017-12-01

Background Between the conflicting requirements of clinic organisation, the European Working Time Directive, patient safety, an increasing lack of junior staff, and competitiveness, the development of ideal duty hour models is vital to ensure maximum quality of care within the legal requirements. To achieve this, it is useful to evaluate the actual effects of duty hour models on staff satisfaction. Materials and Methods After the traditional 24-hour duty shift was given up in a surgical maximum care centre in 2007, an 18-hour duty shift was implemented, followed by a 12-hour shift in 2008, to improve handovers and reduce loss of information. The effects on work organisation, quality of life and salary were analysed in an anonymous survey in 2008. The staff survey was repeated in 2014. Results With a response rate of 95% of questionnaires in 2008 and a 93% response rate in 2014, the 12-hour duty model received negative ratings due to its high duty frequency and subsequent social strain. Also the physical strain and chronic tiredness were rated as most severe in the 12-hour rota. The 18-hour duty shift was the model of choice amongst staff. The 24-hour duty model was rated as the best compromise between the requirements of work organisation and staff satisfaction, and therefore this duty model was adapted accordingly in 2015. Conclusion The essential basis of a surgical department is a duty hour model suited to the requirements of work organisation, the Working Time Directive and the needs of the surgical staff. A 12-hour duty model can be ideal for work organisation, but only if augmented with an adequate number of staff members, the implementation of this model is possible without the frequency of 12-hour shifts being too high associated with strain on surgical staff and a perceived deterioration of quality of life. A staff survey should be performed on a regular basis to assess the actual effects of duty hour models and enable further optimisation. The much criticised 24-hour duty model seems to be much better than its reputation, if augmented by additional staff members in the evening hours. Georg Thieme Verlag KG Stuttgart · New York.

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.

Differences in duty hours and their relationship with academic parameters between preliminary and categorical general surgery residents.

PubMed

Eid, Joseph J; Zendejas, Benjamin; Heller, Stephanie F; Farley, David R

2015-01-01

There is the perceived notion that nondesignated preliminary general surgery (P-GS) interns are treated differently (i.e., overworked) than their categorical GS (C-GS) counterparts are treated, or in an effort to prove themselves worthy of a categorical position, nondesignated preliminary residents may self-choose to work more. Empirical evidence examining duty-hour differences between P-GS and C-GS residents is lacking. We retrospectively reviewed 4 academic years (July 2009 to June 2013) of our self-entered duty-hour database. Duty hours were averaged over 4-week periods and then averaged annually for each intern. Duty-hour averages and the percentage of conference attendance between P-GS and C-GS interns were compared. Sensitivity analyses were conducted to evaluate the effect of the 2011 duty-hour regulations, attendance to educational activities, seasonal variations in workload, and the Match Day effect. A total of 70 P-GS and 43 C-GS interns were compared. Duty-hour averages (±standard deviation, range) were 64.4h/wk (±4.6; 45-70) for the P-GS interns and 64.1h/wk (±3.9; 57-72) for the C-GS interns, p = 0.8. Mean (±standard deviation, range) conference attendance was 61% (±17; 33-89) for the P-GS interns and 66% (±18; 44-85) for the C-GS interns (p = 0.13). Duty-hour averages for both the groups positively correlated with conference attendance (r = 0.27, p = <0.001). The P-GS and the C-GS interns worked on average 4.8 hours more a week after the implementation of the 2011 Accreditation Council of Graduate Medical Education duty-hour regulations when compared with before implementation (66.7 ± 4.1 vs 62 ± 3.1, p < 0.0001), with no difference between both the groups. No seasonal variation in duty hours was encountered for either group. For the P-GS interns, no difference in duty hours was observed before or after the Match Day. At our institution, the P-GS and the C-GS interns have equivalent duty-hour periods and similar conference attendance. An expected, a positive correlation was observed between duty hours and conference attendance. Average weekly duty hours increased by almost 5 hours after the implementation of the 2011 duty-hour regulations. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

78 FR 36199 - Indian Self-Determination and Education Assistance Contracts; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... 1 to 1040 hours, with an average of 11 hours per response'' it should read ``Estimated Time per Response: Varies from 1 to 1040 hours, with an average of 15.968 hours per response.'' Dated: June 10, 2013...

Inventory of File nam.t00z.awip2006.tm00.grib2

Science.gov Websites

Pressure Reduced to MSL [Pa] 002 1 hybrid level RIME 6 hour fcst Rime Factor [non-dim] 003 surface VIS 6 ] 013 surface TMP 6 hour fcst Temperature [K] 014 surface WEASD 6 hour fcst Water Equivalent of ACPCP 0-6 hour acc Convective Precipitation [kg/m^2] 021 surface WEASD 0-6 hour acc Water Equivalent of

29 CFR 778.602 - Special overtime provisions under section 7(b).

Code of Federal Regulations, 2010 CFR

2010-07-01

... applicable weekly maximum, whichever number of hours is greater. Thus, if his total hours of work in the... section 7(b) at an hourly rate of $5.20 and works the following schedule: Hours M T W T F S S Tot. Worked... remaining 56 hours (56×$5.20) in the amonut of $291.20 or a total of $384.80 for the week. If the employee...

20 CFR 416.1861 - Deciding whether you are a child: Are you a student?

Code of Federal Regulations, 2010 CFR

2010-04-01

... hours a week under a semester or quarter system; (2) In grades 7-12 for at least 12 hours a week; (3) In... least 15 hours a week if the training involves shop practice or 12 hours a week if it does not involve... school law of the State or other jurisdiction in which you reside and for at least 12 hours a week. (c...

78 FR 74218 - Agency Information Collection Activities: Request for Comments for a New Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... Transportation, Leo O'Brien Federal Building, Room 715, Albany, NY 12207. Office hours are from 7:30 a.m. to 4:00... Departments of Transportation = 50 (1 hour each) + [up to 10 individuals x up to 5 hours of meeting and travel] = up to 100 hours; State Enforcement Personnel = 50 (1 hour each) + [up to 10 individuals x up to 5...

Inventory of File gfs.t06z.smartguam06.tm00.grib2

Science.gov Websites

(0=sea, 1=land) [Proportion] 009 surface APCP 3-6 hour acc Total Precipitation [kg/m^2] 010 surface ] 020 surface TMAX 3-6 hour acc Maximum Temperature [K] 021 surface TMIN 3-6 hour acc Minimum Temperature [K] 022 surface MAXRH 3-6 hour acc Maximum Relative Humidity [%] 023 surface MINRH 3-6 hour acc

Inventory of File gfs.t06z.smartguam15.tm00.grib2

Science.gov Websites

hour fcst Visibility [m] 014 planetary boundary layer WDIR 15 hour fcst Wind Direction (from which blowing) [degtrue] 015 planetary boundary layer WIND 15 hour fcst Wind Speed [m/s] 016 planetary boundary layer RH 15 hour fcst Relative Humidity [%] 017 planetary boundary layer DIST 15 hour fcst Geometric

Inventory of File gfs.t06z.pgrb2b.1p00.f006

Science.gov Websites

mb UGRD 6 hour fcst U-Component of Wind [m/s] 005 1 mb VGRD 6 hour fcst V-Component of Wind [m/s] 006 hour fcst U-Component of Wind [m/s] 013 2 mb VGRD 6 hour fcst V-Component of Wind [m/s] 014 2 mb ABSV 6 fcst U-Component of Wind [m/s] 021 3 mb VGRD 6 hour fcst V-Component of Wind [m/s] 022 3 mb ABSV 6 hour

Inventory of File gfs.t06z.pgrb2b.0p25.f006

Science.gov Websites

mb UGRD 6 hour fcst U-Component of Wind [m/s] 005 1 mb VGRD 6 hour fcst V-Component of Wind [m/s] 006 hour fcst U-Component of Wind [m/s] 013 2 mb VGRD 6 hour fcst V-Component of Wind [m/s] 014 2 mb ABSV 6 fcst U-Component of Wind [m/s] 021 3 mb VGRD 6 hour fcst V-Component of Wind [m/s] 022 3 mb ABSV 6 hour

Inventory of File gfs.t06z.pgrb2b.0p50.f006

Science.gov Websites

mb UGRD 6 hour fcst U-Component of Wind [m/s] 005 1 mb VGRD 6 hour fcst V-Component of Wind [m/s] 006 hour fcst U-Component of Wind [m/s] 013 2 mb VGRD 6 hour fcst V-Component of Wind [m/s] 014 2 mb ABSV 6 fcst U-Component of Wind [m/s] 021 3 mb VGRD 6 hour fcst V-Component of Wind [m/s] 022 3 mb ABSV 6 hour

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.

[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.

General practice after-hours incentive funding: a rationale for change.

PubMed

Neil, Amanda L; Nelson, Mark R; Richardson, Tracy; Mann-Leonard, Meghan; Palmer, Andrew J

2015-07-20

After-hours incentive funding for general practice was introduced in 1998 through the introduction of the Practice Incentives Program (PIP). In 2010, a national audit of the PIP identified after-hours incentive funding as having the greatest levels of non-compliance across 12 PIP components. The audit specified the need for secondary data sources to ensure practice compliance. In this article, we examine the drivers of the 1998-2013 PIP mechanism to inform development of a fair, transparent and auditable after-hours incentive funding scheme for Tasmania. The PIP after-hours incentive funding mechanism paid, at diminishing levels, for anticipated burden of care (practice size), claimed method of providing care (stream) and remoteness of practice. Increasing remoteness rather than practice size or stream is the primary determinant of urgent after-hours attendances per practice in Tasmania; after-hours attendances to residential aged care facilities are unrelated to individual practice location or stream but concentrated in urban areas. The PIP after-hours incentive funding mechanism does not preferentially support practices that provide after-hours care and arguably led to perverse incentives. A new after-hours incentive funding mechanism embodying pre-specified objectives - such as support for (unavoidable) burden and/or provision of care to residential aged care facilities - is required. Claimed provision is considered an inappropriate funding determinant.

Recommendations for NRC policy on shift scheduling and overtime at nuclear power plants

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

Lewis, P.M.

1985-07-01

This report contains the Pacific Northwest Laboratory's (PNL's) recommendations to the US Nuclear Regulatory Commission (NRC) for an NRC policy on shift scheduling and hours of work (including overtime) for control room operators and other safety-related personnel in nuclear power plants. First, it is recommended that NRC make three additions to its present policy on overtime: (1) limit personnel to 112 hours of work in a 14-day period, 192 hours in 28 days, and 2260 hours in one year; exceeding these limits would require plant manager approval; (2) add a requirement that licensees obtain approval from NRC if plant personnelmore » are expected to exceed 72 hours of work in a 7-day period, 132 hours in 14 days, 228 hours in 28 days, and 2300 hours in one year; and (3) make the policy a requirement, rather than a nonbinding recommendation. Second, it is recommended that licensees be required to obtain NRC approval to adopt a routine 12-hour/day shift schedule. Third, it is recommended that NRC add several nonbinding recommendations concerning routine 8-hour/day schedules. Finally, because additional data can strengthen the basis for future NRC policy on overtime, five methods are suggested for collecting data on overtime and its effects. 44 refs., 10 tabs.« less

How Familiar are Clinician Teammates in the Emergency Department?

PubMed Central

Patterson, P. Daniel; Pfeiffer, Anthony J.; Lave, Judith R.; Weaver, Matthew D.; Abebe, Kaleab; Krackhardt, David; Arnold, Robert M.; Yealy, Donald M.

2016-01-01

Objectives Lack of familiarity between teammates is linked to worsened safety in high-risk settings. The Emergency Department (ED) is a high-risk health care setting where unfamiliar teams are created by diversity in clinician shift schedules and flexibility in clinician movement across the department. We sought to characterize familiarity between clinician teammates in one urban teaching hospital Emergency Department (ED) over a 22-week study period. Methods We used a retrospective study design of shift-scheduling data to calculate the mean weekly hours of familiarity between teammates at the dyadic level, and the proportion of clinicians with a minimum of 2-hours, 5-hours, 10-hours, and 20-hours of familiarity at any given hour during the study period. Results Mean weekly hours of familiarity between ED clinician dyads was 2 hours (SD 1.5). At any given hour over the study period, the proportion of clinicians with a minimum of 2, 5, 10, or 20-hours of familiarity was 80%, 51%, 27%, and 0.8%, respectively. Conclusions In our study, few clinicians could be described as having a high level of familiarity with teammates. The limited familiarity between ED clinicians identified in this study may be a natural feature of ED care delivery in academic settings. We provide a template for measurement of ED team familiarity. PMID:24351519

Work hours and incidence of hypertension among Spanish university graduates: the Seguimiento Universidad de Navarra prospective cohort.

PubMed

Pimenta, Adriano M; Beunza, Juan J; Bes-Rastrollo, Maira; Alonso, Alvaro; López, Celeste N; Velásquez-Meléndez, Gustavo; Martínez-González, Miguel A

2009-01-01

The aim of this study was to assess the association between work hours and incidence of hypertension in 8779 participants of a Spanish dynamic prospective cohort of university graduates. The baseline questionnaire included information about the weekly number of hours the participants devoted to work and to home chores. The work hours were grouped into four categories: 39 or less, 40-49, 50-59, and at least 60 for men; 29 or less, 30-39, 40-49, and at least 50 for women. We added up the number of hours working and spent in home chores in what we called 'total activity hours' that was categorized in quartiles, specific by sex. A participant was classified as an incident case of hypertension if he/she was initially free of hypertension at baseline and reported a physician-made diagnosis of hypertension in at least one of the follow-up questionnaires. The associations between work hours or 'total activity hours' and incidence of hypertension were estimated by calculating the multivariable-adjusted odds ratio and its 95% confidence interval, using logistic regression models. The cumulative incidence of hypertension during 4.2 years median follow-up was 5.8%. No association was found between work hours or 'total activity hours' and incidence of hypertension in either sex. The results of our study do not support any association between work hours and incidence of hypertension. Further longitudinal studies in the general population should be conducted to test this relationship.

Work hours reform: perceptions and desires of contemporary surgical residents.

PubMed

Whang, Edward E; Perez, Alexander; Ito, Hiromichi; Mello, Michelle M; Ashley, Stanley W; Zinner, Michael J

2003-10-01

New Accreditation Council for Graduate Medical Education (ACGME) requirements on resident duty hours are scheduled to undergo nationwide implementation in July 2003. General surgery residents, because of their long duty hours, are likely to be among those most affected by changes imposed to comply with the ACGME requirements. There are few contemporary data on their attitudes toward work hours reform. The study entailed a region-wide survey of residents enrolled in general surgery residencies in New England to characterize the perceptions and desires of surgical residents on the issue of work hours reform. Respondents reported working a mean of 105 +/- 0.7 hours per week, considerably more than the 80-hour limit stipulated by the ACGME. Of the respondents, 81% reported that sleep deprivation had negatively affected their work. A strong majority of respondents believe that work hours reform would improve their quality of life but less than one half expect it to have a positive impact on patient care. A greater percentage of senior residents than junior residents (p < 0.05) have negative perceptions of work hour limitations, particularly with respect to consequences for patient care. Other findings suggest that residents who have actually experienced work hour restrictions are less positive about such restrictions than these residents who had not yet experienced them. Changes imposed by residency programs to comply with work hour requirements might have detrimental effects on senior residents and patient care. The impact of such changes should be carefully monitored as the ACGME requirements are implemented.

A comparison of graft and patient outcomes following kidney transplantation in extended hour and conventional haemodialysis patients.

PubMed

See, Emily J; Hawley, Carmel M; Cho, Yeoungjee; Toussaint, Nigel D; Agar, John Wm; Pascoe, Elaine M; Lim, Wai H; Francis, Ross S; Collins, Michael G; Johnson, David W

2018-01-08

Differences in early graft function between kidney transplant recipients previously managed with either haemodialysis (HD) or peritoneal dialysis are well described. However, only two single-centre studies have compared graft and patient outcomes between extended hour and conventional HD patients, with conflicting results. This study compared the outcomes of all extended hour (≥24 hours/week) and conventional HD patients transplanted in Australia and New Zealand between 2000 and 2014. The primary outcome was delayed graft function (DGF), defined in an ordinal manner as either a spontaneous fall in serum creatinine of less than 10% within 24 hours, or the need for dialysis within 72 hours following transplantation. Secondary outcomes included the requirement for dialysis within 72 hours post-transplant, acute rejection, estimated glomerular filtration rate at 12 months, death-censored graft failure, all-cause and cardiovascular mortality, and a composite of graft failure and mortality. A total of 4,935 HD patients (378 extended hour HD, 4,557 conventional HD) received a kidney transplant during the study period. Extended hour HD was associated with an increased likelihood of DGF compared with conventional HD (adjusted proportional odds ratio 1.33; 95% confidence interval 1.06-1.67). There was no significant difference between extended hour and conventional HD in terms of any of the secondary outcomes. Compared to conventional HD, extended hour HD was associated with DGF, although long-term graft and patient outcomes were not different. This article is protected by copyright. All rights reserved.

Significance of off-hours in centralized primary percutaneous coronary intervention network.

PubMed

Becker, David; Soos, Pal; Berta, Balazs; Nagy, Andrea; Fulop, Gabor; Szabo, Gyorgy; Barczi, Gyorgy; Belicza, Eva; Martai, Istvan; Merkely, Béla

2009-10-01

To analyze the efficacy of a regionally organized primary percutaneous coronary intervention (PCI) network at the Heart Center, Semmelweis University Budapest, part of the "Budapest model," and the factors that influence it. In order to investigate the differences between regular and off-hours patient care in a 24-hour myocardial infarction primary care system, we included 1890 consecutive, unselected patients with ST-segment elevation myocardial infarction and followed them until at least one year. The follow-up was complete for all participants. The difference between regular hours and off-hours mortality was not significant either after 30 days (8.6% vs 8.8%, respectively) or after 1 year (15.3% vs 14.7%, respectively). The rate of patients with re-infarction, frequency of re-intervention, and major adverse cardiac events, including death, re-infarction, re-intervention, and coronary artery bypass graft surgery, were similar in both patient groups. The time delay between the onset of chest pain and arrival to the clinic was 5.9+/-5.8 hours (mean+/- standard deviation) during regular hours and 5.2+/-4.6 hours during off-hours (P=0.235). Direct transport caused significant decrease in the 30-day and 1-year mortality independent of duty time (7.2% vs 9.9%, P=0.027; 12.6% vs 16.7%, P=0.028; respectively). Centralized primary PCI network of the "Budapest model" achieved the same level of patient care during both off-hours and regular hours.

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.

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.

Immune cell infiltration in malignant middle cerebral artery infarction: comparison with transient cerebral ischemia

PubMed Central

Chu, Hannah X; Kim, Hyun Ah; Lee, Seyoung; Moore, Jeffrey P; Chan, Christopher T; Vinh, Antony; Gelderblom, Mathias; Arumugam, Thiruma V; Broughton, Brad RS; Drummond, Grant R; Sobey, Christopher G

2014-01-01

We tested whether significant leukocyte infiltration occurs in a mouse model of permanent cerebral ischemia. C57BL6/J male mice underwent either permanent (3 or 24 hours) or transient (1 or 2 hours+22- to 23-hour reperfusion) middle cerebral artery occlusion (MCAO). Using flow cytometry, we observed ∼15,000 leukocytes (CD45+high cells) in the ischemic hemisphere as early as 3 hours after permanent MCAO (pMCAO), comprising ∼40% lymphoid cells and ∼60% myeloid cells. Neutrophils were the predominant cell type entering the brain, and were increased to ∼5,000 as early as 3 hours after pMCAO. Several cell types (monocytes, macrophages, B lymphocytes, CD8+ T lymphocytes, and natural killer cells) were also increased at 3 hours to levels sustained for 24 hours, whereas others (CD4+ T cells, natural killer T cells, and dendritic cells) were unchanged at 3 hours, but were increased by 24 hours after pMCAO. Immunohistochemical analysis revealed that leukocytes typically had entered and widely dispersed throughout the parenchyma of the infarct within 3 hours. Moreover, compared with pMCAO, there were ∼50% fewer infiltrating leukocytes at 24 hours after transient MCAO (tMCAO), independent of infarct size. Microglial cell numbers were bilaterally increased in both models. These findings indicate that a profound infiltration of inflammatory cells occurs in the brain early after focal ischemia, especially without reperfusion. PMID:24326388

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.

Effect of depth and duration of cooling on deaths in the NICU among neonates with hypoxic ischemic encephalopathy: a randomized clinical trial.

PubMed

Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; McDonald, Scott A; Das, Abhik; Tyson, Jon E; Poindexter, Brenda B; Schibler, Kurt; Bell, Edward F; Heyne, Roy J; Pedroza, Claudia; Bara, Rebecca; Van Meurs, Krisa P; Grisby, Cathy; Huitema, Carolyn M Petrie; Garg, Meena; Ehrenkranz, Richard A; Shepherd, Edward G; Chalak, Lina F; Hamrick, Shannon E G; Khan, Amir M; Reynolds, Anne Marie; Laughon, Matthew M; Truog, William E; Dysart, Kevin C; Carlo, Waldemar A; Walsh, Michele C; Watterberg, Kristi L; Higgins, Rosemary D

Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. A randomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours' vs 120 hours' duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92-2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69-2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07-0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. clinicaltrials.gov Identifier: NCT01192776.

Optimization of conditions for long-term prefreezing storage of brown bear sperm before cryopreservation.

PubMed

López-Urueña, E; Alvarez, M; Gomes-Alves, S; Anel-López, L; Martínez-Rodríguez, C; Manrique, P; Borragan, S; Anel, L; de Paz, P

2015-10-15

Brown bear ejaculates are usually collected in field conditions and may need to be shipped to a laboratory for the application of reproductive biotechnologies before cryopreservation. The aim of this study was to extend the prefreezing step to 48 hours (1 hour vs. long-term storage [LS] to 24 and 48 hours) to enable the sample to be transported. The effects of storage temperature (experiment 1), glycerol concentration (experiment 2), and dilution rate (experiment 3) on sperm were evaluated. Electroejaculates from brown bears were stored under different experimental conditions and cryopreserved. The sperm motility and viability, apoptotic status, and acrosomal status of sperm were assessed before freezing (prefreezing), after thawing, and after 2-hour incubation at 37 °C (thermal stress test). In all experiments, one control sample was frozen using a standard protocol (control). In experiment 1, three temperatures during LS with 6% glycerol were tested: 5 °C (T5), 15 °C (T15), and room temperature (RT). The LS-T5 sample yielded the highest postthawing results for viability (42.4%), progressive motility (15.6%), and intact acrosome (83.1%) after 24 hours in comparison with the other temperatures (P < 0.05); for 48 hours, the LS-T5 sample reached higher total and progressive motility (25.9% and 9%, respectively) and nonapoptotic values (36.5%). Recovery rates revealed susceptibility to freezing at LS-15 or LS-RT samples at 24 hours (viability) or 48 hours (viability and motility). In experiment 2, samples were stored at 5 °C up to 48 hours and three glycerol concentrations were evaluated: 0% (0Gly), 3% (3Gly), and 6% (6Gly). Postthawing viability and motility increased progressively with the percentage of glycerol for 24 hours at 5 °C; 6% glycerol during 48-hour storage had beneficial effects on sperm cryopreservation. Besides, 6% glycerol had a clearly superior freezability for viability (42.7% and 40.8% for 24 hours and 48 hours, respectively) and motility (24 hours: total, 44.1%; progressive, 17.1%; 48 hours: total, 38.4%; progressive, 16%). In experiment 3, samples were stored up to 48 hours at 5 °C with 6% of glycerol and two dilution methods were evaluated: dilution 1:1 (average: 1782 × 10(6) sperm/mL; low) or final dilution (100 × 10(6) sperm/mL; high). Both dilution rates showed similar postthawing and postincubation results within 24 hours of long-term storage. After 48 hours, high dilution supported better postthawing quality. Both dilutions showed similar resistance to cryopreservation, except after 48 hours, when the high dilution reached a higher percent recovery rate of viability (38.8% vs. 21.6%, P < 0.05). In conclusion, our results suggested that the best conditions for long-term prefreezing storage (up to 48 hours) of brown bear electroejaculates are at 5 °C, at a concentration of 100 × 10(6) sperm/mL, and with 6% glycerol. Copyright © 2015 Elsevier Inc. All rights reserved.

16 CFR 305.17 - Television labeling.

Code of Federal Regulations, 2013 CFR

2013-01-01

... this part and based on a usage rate of 5 hours in on mode and 19 hours in standby (sleep) mode per day... rate of 5 hours in on mode and 19 hours in sleep (standby) mode per day. (8) No marks or information...

16 CFR 305.17 - Television labeling.

Code of Federal Regulations, 2012 CFR

2012-01-01

... this part and based on a usage rate of 5 hours in on mode and 19 hours in standby (sleep) mode per day... rate of 5 hours in on mode and 19 hours in sleep (standby) mode per day. (8) No marks or information...

[NRH2 induces cell apoptosis of cerebral tissues around hematomas after intracerebral hemorrhage through up-regulating proNGF, sortilin and p75NTR expressions].

PubMed

Zeng, Zhiqing; Liu, Hong; Jiang, Di

2015-04-01

To observe the expressions of neurotrophin receptor homolog 2 (NRH2), nerve growth factor precursor (proNGF), sortilin and neurotrophin receptor p75 (p75NTR) in cerebral tissues around hematomas in the different periods after intracerebral hemorrhage, and explore their relationships to cell apoptosis. The specimens of cerebral tissues around hematomas were collected from the patients undergoing hematoma removal operation after intracerebral hemorrhage. These specimens were divided into four groups, namely ≤ 6 hours, 6-24 hours(including 24 hours), 24-72 hours (including 72 hours) and over 72 hours according to the time from intracerebral hemorrhage to specimen collection. At the same time, 10 brain tissues distant to hemorrhage that dropped in the operative process were collected as a control group. Apoptosis index (AI) was examined in brain cells by terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labeling (TUNEL). The expressions of NRH2, proNGF, sortilin and p75NTR mRNAs and proteins in brain tissues were detected through real-time quantitative PCR and Western blotting, respectively. Also, the expressions of Bcl-2 and Bax in brain tissues were analyzed using Western blotting. In vitro cultured astrocytes of rat cortex were transfected by NRH2 siRNA or scramble siRNA. The expressions of proNGF, sortilin and p75NTR proteins were detected using Western blotting. AI was higher in all groups of hemorrhage for 6 hours or longer than that in control and ≤ 6 hours groups, and AI in the group of 24-72 hours after intracerebral hemorrhage was the highest. However, there was no significant difference in AI between ≤ 6 hours group and control group. With the extension of intracerebral hemorrhage time, the expression levels of proNGF and p75NTR mRNAs and proteins were gradually elevated, reached the peak in 24-72 hours, and maintained a higher level after 72 hours, whereas there were no significant differences in the above indicators between ≤ 6 hours group and control group. In comparison with control group and ≤ 6 hours group, the expression levels of NRH2 and sortilin mRNAs and proteins and Bax expression started to increase in 6-24 hours, reached the peak in 24-72 hours, and then stayed a higher level after 72 hours, whereas there were no significant differences in the above indicators between ≤ 6 hours group and control group. There was no obvious change in Bcl-2 expression level between ≤ 6 hours group and control group. The level of Bcl-2 decreased in all groups of intracerebral hemorrhage for over 6 hours, and reached the nadir in 24-72 hours. Astrocytes transfected with NRH2 siRNA displayed a significant decrease in proNGF, sortilin and p75NTR protein levels as compared with scramble siRNA or blank control groups. The expression of NRH2 would increase in the cerebral tissues around hematomas after intracerebral hemorrhage. NRH2 might enhance the ratio of Bax/Bcl-2 by promoting the expressions of proNGF, sortilin and p75NTR, thereby inducing brain cell apoptosis.

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion.

PubMed

Paruthi, Shalini; Brooks, Lee J; D'Ambrosio, Carolyn; Hall, Wendy A; Kotagal, Suresh; Lloyd, Robin M; Malow, Beth A; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F; Rosen, Carol L; Troester, Matthew M; Wise, Merrill S

2016-11-15

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. A commentary on this article apears in this issue on page 1439. © 2016 American Academy of Sleep Medicine

Allocation of Physician Time in Ambulatory Practice: A Time and Motion Study in 4 Specialties.

PubMed

Sinsky, Christine; Colligan, Lacey; Li, Ling; Prgomet, Mirela; Reynolds, Sam; Goeders, Lindsey; Westbrook, Johanna; Tutty, Michael; Blike, George

2016-12-06

Little is known about how physician time is allocated in ambulatory care. To describe how physician time is spent in ambulatory practice. Quantitative direct observational time and motion study (during office hours) and self-reported diary (after hours). U.S. ambulatory care in 4 specialties in 4 states (Illinois, New Hampshire, Virginia, and Washington). 57 U.S. physicians in family medicine, internal medicine, cardiology, and orthopedics who were observed for 430 hours, 21 of whom also completed after-hours diaries. Proportions of time spent on 4 activities (direct clinical face time, electronic health record [EHR] and desk work, administrative tasks, and other tasks) and self-reported after-hours work. During the office day, physicians spent 27.0% of their total time on direct clinical face time with patients and 49.2% of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9% of the time on direct clinical face time and 37.0% on EHR and desk work. The 21 physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted mostly to EHR tasks. Data were gathered in self-selected, high-performing practices and may not be generalizable to other settings. The descriptive study design did not support formal statistical comparisons by physician and practice characteristics. For every hour physicians provide direct clinical face time to patients, nearly 2 additional hours is spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another 1 to 2 hours of personal time each night doing additional computer and other clerical work. American Medical Association.

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.

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.

Self-Reported Sleep Duration and Self-Rated Health in Young Adults

PubMed Central

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-01-01

Study Objectives: This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. Methods: In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Results: Approximately 30% of participants slept 7–8 hours, 17.4% were short sleepers (categories < 6 hours and 6–7 hours), and 53.9% were long sleepers (categories 8–10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7–8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6–7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Conclusions: Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. Citation: Štefan L, Juranko D, Prosoli R, Barić R, Sporiš G. Self-reported sleep duration and self-rated health in young adults. J Clin Sleep Med. 2017;13(7):899–904. PMID:28502281

Off-Hour Admission and Outcomes in Patients with Acute Intracerebral Hemorrhage in the INTERACT2 Trial.

PubMed

Sato, Shoichiro; Arima, Hisatomi; Heeley, Emma; Hirakawa, Yoichiro; Delcourt, Candice; Lindley, Richard I; Robinson, Thompson; Huang, Yining; Morgenstern, Lewis; Stapf, Christian; Wang, Jiguang; Chalmers, John; Anderson, Craig S

2015-01-01

Conflicting data exist of an association between off-hour (weekend, holiday, or night-time) hospital admission and adverse outcome in intracerebral hemorrhage (ICH). We determined the association between off-hour admissions and poor clinical outcome, and of any differential effect of early intensive blood pressure (BP) lowering treatment between off- and on-hour admissions, among participants of the Intensive BP Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). Subsidiary analysis of INTERACT2, a multinational, multicenter, clinical trial of patients with spontaneous ICH with elevated systolic BP, randomly assigned to intensive (target systolic BP <140 mm Hg) or guideline-based (<180 mm Hg) BP management. Primary outcome was death or major disability (modified Rankin scale of 3-6) at 90 days. Off-hour admission was defined as night-time (4:30 p.m. to 8:30 a.m.) on weekdays, weekends (Saturday and Sunday), and public holidays in each participating country. Of 2,794 patients with information on the primary outcome, 1,770 (63%) were admitted to study centers during off-hours. Off-hour admission was not associated with risk of poor outcome at 90 days (53% off-hour vs. 55% on-hour; p = 0.49), even after adjustment for comorbid risk factors (odds ratio 0.92; 95% CI 0.76-1.12). Consistency exists in the effects of intensive BP lowering between off- and on-hour admission (p = 0.85 for homogeneity). Off-hour admission was not associated with increased risks of death or major disability among trial protocol participants with acute ICH. Intensive BP lowering can provide similar treatment effect irrespective of admission hours. © 2015 S. Karger AG, Basel.

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

Long working hours directly and indirectly (via short sleep duration) induce headache even in healthy white-collar men: cross-sectional and 1-year follow-up analyses.

PubMed

Nagaya, Teruo; Hibino, Minoru; Kondo, Yasuaki

2018-01-01

Headache in employees may be linked with both overwork and sleep restriction induced by long working hours. Inter-relationships among working hours, sleep duration and headache were investigated. Cross-sectional analyses for prevalent headache (n = 35,908) and 1-year follow-up analyses for incident headache (n = 19,788) were conducted in apparently healthy white-collar men aged 25-59 years. Headache (yes/no), working hours and sleep duration were based on self-administered questionnaire. After determination of relationships between working hours and sleep duration, logistic regression analysis estimated odds ratio (OR) and 95% confidence interval for prevalent and incident headache according to working hours (35-44, 45-49, 50-59 and ≥60 h/week) and sleep duration (≥7, 6-6.9, 5-5.9 and <5 h/day), and tested linear trends in OR. Additionally, interactive effects of working hours and sleep duration on OR were checked. Covariates in the analyses were age, body mass index, drinking, smoking and exercise. Prevalent and incident headache was found in 1979 (5.5%) men and 707 (3.6%) men, respectively. Working hours were inversely associated with sleep duration. OR for prevalent and incident headache rose with increasing working hours and with reducing sleep duration, regardless of influences of the covariates. Working hours and sleep duration had no interactive effects on OR for prevalent or incident headache. The results indicate that long working hours directly and indirectly (via short sleep duration) induce headache even in apparently healthy white-collar men. Headache in employees may be useful for early detection of adverse health effects by long working hours.

The association between long working hours and the metabolic syndrome: evidences from the 5th Korean National Health and Nutrition Examination Survey of 2010 and 2012.

PubMed

Jeong, Jae Uk; Jeon, Man Joong; Sakong, Joon

2014-01-01

This study was conducted in order to evaluate the association between the working hours of Korean employees and the metabolic syndrome and the effects of long working hours on metabolic syndrome based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012). Based on the 5th Korean National Health and Nutrition Examination Survey (2010-2012), 4,456 Korean employees without shift work, aged over 15, who work 30 hours or more per week were targeted in this study. The association between the general characteristics, including age, smoking, alcohol drinking, exercise, and the metabolic syndrome criteria defined by International Diabetes Federation (IDF) and weekly working hours were analyzed. In addition, the association between weekly working hours and the metabolic syndrome of the subjects stratified by gender was analyzed through multiple logistic regression analyses and generalized linear mixed model after adjusting the general characteristics. In the results of stratified analysis by gender, in male subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In female subjects, in comparison with the 30-39 weekly working hours group, there were no significant adjusted odds ratios to the other working hours groups. In addition, no trend associations were observed among weekly working hour groups in both stratified genders. No significant differences in prevalence of metabolic syndrome of the subjects stratified by gender were found according to weekly increasing working hours. However, due to some limitations of this study, further prospective studies may be necessary for verification.

Effect of working hours and precarious employment on depressive symptoms in South Korean employees: a longitudinal study.

PubMed

Kim, Woorim; Park, Eun-Cheol; Lee, Tae-Hoon; Kim, Tae Hyun

2016-12-01

Long working hours and precarious employment are relatively common in South Korea. Since both can impact on mental health, this study examined their independent and combined effects on depressive symptoms of employees. Data were from the Korean Welfare Panel Study (KOWEPS), 2010-2013. A total of 2733 full-time employees without depressive symptoms were analysed. Hierarchical logistic regression models were used to investigate the effect of the number of working hours per week (eg, 35-40 hours, 41-52 hours, 53-68 hours, and >68 hours) and employment status (permanent vs precarious employment) on depressive symptoms, measured using the Center for Epidemiological Studies Depression (CES-D) 11 scale. Compared with individuals working 35-40 hours/week, employees working above 68 hours (OR 1.57, 95% CI 1.05 to 2.34) had higher odds of depressive symptoms after full adjustment. Similarly, precarious employees (OR 1.34, 95% CI 1.02 to 1.75) showed worse mental health than permanent employees. In the combined effect model, employees in precarious employment who worked above 68 hours/week (OR, 2.03 95% CI 1.08 to 3.83) exhibited the highest odds of depressive symptoms compared with permanent employees working 35 to 40 hours/week. Long work hours and precarious employment status were associated with higher odds of depressive symptoms. The findings highlight the importance of monitoring and addressing the vulnerable groups of employees to reduce the mental health burden of economically active individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Inventory of File nam.t00z.hawaiinest.hiresf06.tm00.gr

Science.gov Websites

Water Equivalent [kg/m^2/s] 628 surface NCPCP 3-6 hour acc Large-Scale Precipitation (non-convective [non-dim] 010 1 hybrid level HGT 6 hour fcst Geopotential Height [gpm] 011 1 hybrid level TMP 6 hour [non-dim] 056 50 mb HGT 6 hour fcst Geopotential Height [gpm] 057 50 mb TMP 6 hour fcst Temperature [K

Inventory of File nam.t00z.firewxnest.hiresf06.tm00.gr

Science.gov Websites

Water Equivalent [kg/m^2/s] 628 surface NCPCP 5-6 hour acc Large-Scale Precipitation (non-convective [non-dim] 010 1 hybrid level HGT 6 hour fcst Geopotential Height [gpm] 011 1 hybrid level TMP 6 hour [non-dim] 056 50 mb HGT 6 hour fcst Geopotential Height [gpm] 057 50 mb TMP 6 hour fcst Temperature [K

Inventory of File nam.t00z.alaskanest.hiresf06.tm00.gr

Science.gov Websites

Water Equivalent [kg/m^2/s] 628 surface NCPCP 3-6 hour acc Large-Scale Precipitation (non-convective [non-dim] 010 1 hybrid level HGT 6 hour fcst Geopotential Height [gpm] 011 1 hybrid level TMP 6 hour [non-dim] 056 50 mb HGT 6 hour fcst Geopotential Height [gpm] 057 50 mb TMP 6 hour fcst Temperature [K

Inventory of File nam.t00z.conusnest.hiresf06.tm00.gri

Science.gov Websites

Water Equivalent [kg/m^2/s] 628 surface NCPCP 3-6 hour acc Large-Scale Precipitation (non-convective [non-dim] 010 1 hybrid level HGT 6 hour fcst Geopotential Height [gpm] 011 1 hybrid level TMP 6 hour [non-dim] 056 50 mb HGT 6 hour fcst Geopotential Height [gpm] 057 50 mb TMP 6 hour fcst Temperature [K

29 CFR 794.142 - Special compensation when overtime in excess of 12 daily or 56 weekly hours is worked in the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee in a workweek when his hours worked do not exceed 56 in the week; and for all weekly overtime hours in excess of 56 which he works in a workweek when he does not work more than 12 hours in any day. When an employee works in excess of both the daily and weekly maximum hours standards in any workweek...

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...

Inventory of File naefs_ge90pt.t12z.pgrb2a_bcf06

Science.gov Websites

hour fcst Temperature [K] unknown derived fcst 012 925 mb TMP 6 hour fcst Temperature [K] unknown derived fcst 013 850 mb TMP 6 hour fcst Temperature [K] unknown derived fcst 014 700 mb TMP 6 hour fcst Temperature [K] unknown derived fcst 015 500 mb TMP 6 hour fcst Temperature [K] unknown derived fcst 016 250

Inventory of File gfs.t06z.smartguam24.tm00.grib2

Science.gov Websites

boundary layer WDIR 24 hour fcst Wind Direction (from which blowing) [degtrue] 016 planetary boundary layer WIND 24 hour fcst Wind Speed [m/s] 017 planetary boundary layer RH 24 hour fcst Relative Humidity [%] 018 planetary boundary layer DIST 24 hour fcst Geometric Height [m] 019 surface 4LFTX 24 hour fcst

Impact of the Accreditation Council for Graduate Medical Education work-hour regulations on neurosurgical resident education and productivity.

PubMed

Jagannathan, Jay; Vates, G Edward; Pouratian, Nader; Sheehan, Jason P; Patrie, James; Grady, M Sean; Jane, John A

2009-05-01

Recently, the Institute of Medicine examined resident duty hours and their impact on patient safety. Experts have suggested that reducing resident work hours to 56 hours per week would further decrease medical errors. Although some reports have indicated that cutbacks in resident duty hours reduce errors and make resident life safer, few authors have specifically analyzed the effect of the Accreditation Council for Graduate Medical Education (ACGME) duty-hour limits on neurosurgical resident education and the perceived quality of training. The authors have evaluated multiple objective surrogate markers of resident performance and quality of training to determine the impact of the 80-hour workweek. The United States Medical Licensing Examination (USMLE) Step 1 data on neurosurgical applicants entering ACGME-accredited programs between 1998 and 2007 (before and after the implementation of the work-hour rules) were obtained from the Society of Neurological Surgeons. The American Board of Neurological Surgery (ABNS) written examination scores for this group of residents were also acquired. Resident registration for and presentations at the American Association of Neurological Surgeons (AANS) annual meetings between 2002 and 2007 were examined as a measure of resident academic productivity. As a case example, the authors analyzed the distribution of resident training hours in the University of Virginia (UVA) neurosurgical training program before and after the institution of the 80-hour workweek. Finally, program directors and chief residents in ACGME-accredited programs were surveyed regarding the effects of the 80-hour workweek on patient care, resident training, surgical experience, patient safety, and patient access to quality care. Respondents were also queried about their perceptions of a 56-hour workweek. Despite stable mean USMLE Step 1 scores for matched applicants to neurosurgery programs between 2000 and 2008, ABNS written examination scores for residents taking the exam for self-assessment decreased from 310 in 2002 to 259 in 2006 (16% decrease, p < 0.05). The mean scores for applicants completing the written examination for credit also did not change significantly during this period. Although there was an increase in the number of resident registrations to the AANS meetings, the number of abstracts presented by residents decreased from 345 in 2002 to 318 in 2007 (7% decrease, p < 0.05). An analysis of the UVA experience suggested that the 80-hour workweek leads to a notable increase in on-call duty hours with a profound decrease in the number of hours spent in conference and the operating room. Survey responses were obtained from 110 program directors (78% response rate) and 122 chief residents (76% response rate). Most chief residents and program directors believed the 80-hour workweek compromised resident training (96%) and decreased resident surgical experience (98%). Respondents also believed that the 80-hour workweek threatened patient safety (96% of program directors and 78% of chief residents) and access to quality care (82% of program directors and 87% of chief residents). When asked about the effects of a 56-hour workweek, all program directors and 98% of the chief residents indicated that resident training and surgical education would be further compromised. Most respondents (95% of program directors and 84% of chief residents) also believed that additional work-hour restrictions would jeopardize patient care. Neurological surgery continues to attract top-quality resident applicants. Test scores and levels of participation in national conferences, however, indicate that the 80-hour workweek may adversely affect resident training. Subjectively, neurosurgical program directors and chief residents believe that the 80-hour workweek makes neurosurgical training and the care of patients more difficult. Based on experience with the 80-hour workweek, educators think that a 56-hour workweek would further compromise neurosurgical training and patient care in the US.

Association between Sleep Duration and 24-Hour Urine Free Cortisol in the MrOS Sleep Study

PubMed Central

Rao, Madhu N.; Blackwell, Terri; Redline, Susan; Punjabi, Naresh M.; Barrett-Connor, Elizabeth; Neylan, Thomas C.; Stone, Katie L.

2013-01-01

Context Short sleep duration is associated with adverse health outcomes, but the mechanisms involved are unknown. It has been postulated that short sleep duration may elevate cortisol levels, but studies have had conflicting results. It is unclear whether these differing findings may be due to methodological issues, such as assessment of sleep duration. Specifically, objective versus subjective methods of measuring habitual sleep duration may account for the conflicting results found in epidemiological studies. Objective Our goal was to determine whether habitual sleep duration, measured objectively (by actigraphy) and subjectively (by self-report), was associated with 24-hour urine free cortisol (UFC), a measure of integrated cortisol secretion. Our secondary goal was to determine whether slow wave sleep (SWS, determined by polysomnography) was associated with 24-hour UFC. Design/Setting Cross sectional study of community dwelling older men. Patients/Participants 325 men (mean age = 76.6 years, SD = 5.5) from the Portland site of the MrOS Sleep Study, who underwent 24-hour urine collection, polysomnography, actigraphy and sleep questionnaire. Primary Outcome 24-hour UFC. Results In this study of community dwelling older men, self-reported sleep duration was inversely related to 24-hour UFC levels. Participants reporting <5 hours of habitual sleep had an adjusted mean 24-hour UFC of 29.8 ug, compared to 28.0 ug in participants reporting >5 to <8 hours of sleep 25.5 ug in those reporting >8 hours of habitual sleep. However, sleep duration determined by actigraphy was not associated with 24-hour UFC in either univariable or multivariable regression models. SWS was not associated with 24-hour UFC. Conclusion Objectively measured (i.e., actigraphic) sleep duration is not associated with 24-hour UFC in these community dwelling older men. This finding, together with prior studies, suggests that elevated levels of integrated cortisol secretion is not the mechanisms by which short sleep duration leads to adverse health outcomes. PMID:24228086

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

Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations

PubMed Central

Arndt, Brian G.; Beasley, John W.; Watkinson, Michelle D.; Temte, Jonathan L.; Tuan, Wen-Jan; Sinsky, Christine A.; Gilchrist, Valerie J.

2017-01-01

PURPOSE Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non–face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours. METHODS We conducted a retrospective cohort study of 142 family medicine physicians in a single system in southern Wisconsin. All Epic (Epic Systems Corporation) EHR interactions were captured from “event logging” records over a 3-year period for both direct patient care and non–face-to-face activities, and were validated by direct observation. EHR events were assigned to 1 of 15 EHR task categories and allocated to either during or after clinic hours. RESULTS Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours. Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2%). Inbox management accounted for another 85 minutes (23.7%). CONCLUSIONS Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. EHR event logs can identify areas of EHR-related work that could be delegated, thus reducing workload, improving professional satisfaction, and decreasing burnout. Direct time-motion observations validated EHR-event log data as a reliable source of information regarding clinician time allocation. PMID:28893811

Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations.

PubMed

Arndt, Brian G; Beasley, John W; Watkinson, Michelle D; Temte, Jonathan L; Tuan, Wen-Jan; Sinsky, Christine A; Gilchrist, Valerie J

2017-09-01

Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non-face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 am to 6:00 pm Monday through Friday) and outside clinic hours. We conducted a retrospective cohort study of 142 family medicine physicians in a single system in southern Wisconsin. All Epic (Epic Systems Corporation) EHR interactions were captured from "event logging" records over a 3-year period for both direct patient care and non-face-to-face activities, and were validated by direct observation. EHR events were assigned to 1 of 15 EHR task categories and allocated to either during or after clinic hours. Clinicians spent 355 minutes (5.9 hours) of an 11.4-hour workday in the EHR per weekday per 1.0 clinical full-time equivalent: 269 minutes (4.5 hours) during clinic hours and 86 minutes (1.4 hours) after clinic hours. Clerical and administrative tasks including documentation, order entry, billing and coding, and system security accounted for nearly one-half of the total EHR time (157 minutes, 44.2%). Inbox management accounted for another 85 minutes (23.7%). Primary care physicians spend more than one-half of their workday, nearly 6 hours, interacting with the EHR during and after clinic hours. EHR event logs can identify areas of EHR-related work that could be delegated, thus reducing workload, improving professional satisfaction, and decreasing burnout. Direct time-motion observations validated EHR-event log data as a reliable source of information regarding clinician time allocation. © 2017 Annals of Family Medicine, Inc.

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...

Prostate Cancer Research Training in Health Disparities for Minority Undergraduates

DTIC Science & Technology

2013-04-01

medical school, one has been admitted to school of dentistry , one is already in a graduate program, and a fifth has applied to graduate school...2 hour Environmental Health 2 hours Behavioral Methods 2 hours Biostatistics : Data Analysis (Hands-On) 3 hours

45 CFR 261.60 - What hours of participation may a State report for a work-eligible individual?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Verification Plan. (e) A State may count supervised homework time and up to one hour of unsupervised homework time for each hour of class time. Total homework time counted for participation cannot exceed the hours...

45 CFR 261.60 - What hours of participation may a State report for a work-eligible individual?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Verification Plan. (e) A State may count supervised homework time and up to one hour of unsupervised homework time for each hour of class time. Total homework time counted for participation cannot exceed the hours...

Temperature cycling periods affect growth and tuberization in potatoes under continuous irradiation

NASA Technical Reports Server (NTRS)

Cao, W.; Tibbitts, T. W.

1992-01-01

Plants of the potato (Solanum tuberosum L.) cultivars Denali, Norland, Haig and Kennebec were grown for 42 days under three temperature cycling periods (thermoperiods) with continuous irradiation in two repeated experiments to help determine if temperature cycling might be varied to optimize tuber development of potatoes in controlled environments. Thermoperiods of 6/6 hours, 12/12 hours and 24/24 hours were established with the same temperature change of 22/14C and same controlled vapor pressure deficit of 0.60 kPa. The thermoperiod of 24/24 hours significantly promoted tuber initiation but slowed tuber enlargement in all four cultivars, compared to the thermoperiods of 6/6 hours and 12/12 hours. Denali' produced the highest tuber and total dry weights under the 6/6 hours thermoperiod. Kennebec' produced the highest tuber dry weight under the 12/12 hours thermoperiod. Thermoperiods had no significant effect on shoot and root dry weights of any cultivars. The major effect of thermoperiods was on initiation and enlargement of tubers.

Evaluation of the 12-hour shift trial in a regional intensive care unit.

PubMed

Dwyer, Trudy; Jamieson, Lynn; Moxham, Lorna; Austen, Debbie; Smith, Karen

2007-10-01

Given the shortage of critical care nurses, emphasis has been placed upon improving their working lives through the implementation of flexible work hours. This descriptive exploratory study evaluated the effects of the implementation of the 12-hour roster in a regional intensive care unit (ICU). Staff (n = 19) completed a survey 12 weeks following the implementation of the 12-hour roster. The study demonstrated widespread acceptance (92%) positive impact on physical and psychological well-being and increased work satisfaction (58%) for the nursing participants. Similarly, nurses working both the 8- and 12-hour rosters (75%), the doctors and allied health care workers all identified increased continuity of patient care as an outcome of the 12-hour shift. Participants strongly agreed that 12-hour rostering was a good recruitment (67%) and retention (75%) strategy. In an environment with considerable shortages of experienced critical care nurses, the use of flexible shift patterns such as the 12-hour roster was a positive recruitment and recruitment strategy.

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.

Sleep deprivation during a specific 3-hour time window post-training impairs hippocampal synaptic plasticity and memory

PubMed Central

Prince, Toni-Moi; Wimmer, Mathieu; Choi, Jennifer; Havekes, Robbert; Aton, Sara; Abel, Ted

2014-01-01

Sleep deprivation disrupts hippocampal function and plasticity. In particular, long-term memory consolidation is impaired by sleep deprivation, suggesting that a specific critical period exists following learning during which sleep is necessary. To elucidate the impact of sleep deprivation on long-term memory consolidation and synaptic plasticity, long-term memory was assessed when mice were sleep deprived following training in the hippocampus-dependent object place recognition task. We found that 3 hours of sleep deprivation significantly impaired memory when deprivation began 1 hour after training. In contrast, 3 hours of deprivation beginning immediately post-training did not impair spatial memory. Furthermore, a 3-hour sleep deprivation beginning 1 hour after training impaired hippocampal long-term potentiation (LTP), whereas sleep deprivation immediately after training did not affect LTP. Together, our findings define a specific 3-hour critical period, extending from 1 to 4 hours after training, during which sleep deprivation impairs hippocampal function. PMID:24380868

Optimal Fasting Time before Measurement of Serum Triglyceride Levels in Healthy Volunteers.

PubMed

Pongsuthana, Surapun; Tivatunsakul, Naris

2016-02-01

Coronary heart disease is a major public health problem. Elevated triglyceride levels are a risk factor for atherosclerosis and coronary heart disease. Food intake interferes with the measurement of serum triglyceride levels, and in previous studies, fasting for 12 hours was recommended before blood sampling. In real-world practice, long fasting times cause patient discomfort and poor compliance, and the present study was, therefore, designed to determine the appropriate fasting time prior to measuring serum triglyceride levels. To determine the appropriate fasting time before measuring serum triglyceride levels. This was a pilot study performed using healthy volunteers aged between 20 and 30 years old from November 2013 to December 2013 at Rajavithi Hospital. The first blood sample was measured in the morning after fasting over 12 hours. The subjects then took their regular breakfast, after which they fasted for 8 hours. Blood samples were taken 6 and 8 hours later and sent to the laboratory for measurement of serum triglyceride levels. 40 volunteers, of whom 25 were female, were enrolled. Their mean age was 25.9 ± 2.81 years old, and their mean weight, height, and body mass index were 61.5 ± 12.5 kg, 167.2 ± 8.3 cm and 21.84 ± 3.1 kg/m2, respectively. Mean fasting serum triglyceride level at 12 hours was 80.23 ± 36.33 mg/dl, at 6 hours it was 110.65 ± 73.45 mg/dl, and at 8 hours it was 75.62 ± 46.81 mg/dl. The group fasting for 12 hours had significantly lower serum triglyceride levels than the group fasting for 6 hours (p-value = 0.003), but no significant difference was found between the group fasting for 12 hours and the one fasting for 8 hours (p-value = 0.493). The present study showed no significant difference in triglyceride levels in patients who had fasted or 8 hours and those who had done so for 12 hours. Fasting for only 8 hours before measurement of serum triglyceride may be sufficient.

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 accreditation, and thus programs will need a way to accurately capture consistent resident work hour data. Further studies are indicated to determine the most accurate way of assessing house staff work hours.

Deep eutectic solvent (DES) as a pretreatment for oil palm empty fruit bunch (OPEFB) in production of sugar

NASA Astrophysics Data System (ADS)

Nor, Nur Atikah Md; Mustapha, Wan Aida Wan; Hassan, Osman

2015-09-01

Oil Palm Empty Fruit Bunch (OPEFB) was pretreated using Deep Eutectic Solvent (DES) at different parameters to enable a highest yield of sugar. DES is a combination of two or more cheap and safe components to form a eutectic mixture through hydrogen bond interaction, which has a melting point lower than that of each component. DES can be used to replace ionic liquids (ILs), which are more expensive and toxic. In this study, OPEFB was pretreated with DES mixture of choline chloride: urea in 1:2 molar ratio. The pretreatment was performed at temperature 110°C and 80°C for 4 hours and 1 hour. Pretreatment A (110°C, 4 hours), B (110°C, 1 hour), C (80°C, 4 hours) and D (80°C, 1 hour). Enzymatic hydrolysis was done by using the combination of two enzymes, namely, Cellic Ctec2 and Cellic Htec2. The treated fiber is tested for crystallinity using XRD and functional group analysis using FTIR, to check the effect of the pretreatment on the fiber and compared it with the untreated fiber. From XRD analysis, DES successfully gave an effect towards degree of crystallinity of cellulose. Pretreatment A (110°C, 4 hours) and B (110°C, 1 hour) successfully reduce the percentage of crystallinity while pretreatment C (80°C, 4 hours) and D (80°C, 1 hour) increased the percentage of crystallinity. From FTIR analysis, DES cannot remove the functional group of lignin and hemicellulose but it is believed that DES can expose the structure of cellulose. Upon enzymatic hydrolysis, DES-treated fiber successfully produced sugar but not significantly when compared with raw. Pretreatment A (110°C, 4 hours), B (110°C, 1 hour), C (80°C, 4 hours) and D (80°C, 1 hour) produced glucose at the amount of 60.47 mg/ml, 66.33 mg/ml, 61.96 mg/ml and 59.12 mg/ml respectively. However, pretreatment C gave the highest xylose (70.01 mg/ml) production compared to other DES pretreatments.

Association Between Resident Perceptions of Patient Safety and Duty Hour Violations.

PubMed

Matulewicz, Richard S; Odell, David D; Chung, Jeanette W; Ban, Kristen A; Yang, Anthony D; Bilimoria, Karl Y

2017-02-01

Residents are often required to balance whether to adhere to duty hour policies or violate them to care for patients and obtain educational experiences. Little is known about why residents violate duty hour policies and whether there is a relationship between how often residents violate duty hours and concerns about patient safety. Our objective was to assess the association between resident duty hour violations and resident concerns about patient safety. We analyzed survey data collected from surgery residents who completed the 2015 American Board of Surgery In-Training Examination, excluding those in the Flexible Policy arm of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial. Perceptions of how duty hour restrictions affect patient safety were dichotomized as either "positive/neutral" or "negative." Resident duty hour violations in a typical month were separated as "frequently" (≥3 times) or "infrequently" (<3 times). Rates were compared and regression models were used to examine the association between negative perceptions and duty hour violations, adjusting for resident and program-level covariates. Overall, 25.3% of trainees under current policies perceived that current ACGME duty hour policies negatively affected patient safety. This negative perception increased with PGY level (PGY1: 18.5%, PGY2 to 3: 22.6%, PGY4 to 5: 32.0%; p < 0.001). Residents with negative perceptions more often reported frequent duty violations (positive/neutral: 20.0% vs negative: 32.7%; p < 0.001). After adjustment for covariates, a negative perception of how duty hour policies affect patient safety was significantly associated with a higher likelihood of frequent duty hour violations among all trainees grouped together (odds ratio [OR] = 1.89; 95% CI, 1.60-2.22), and separately for interns (OR = 2.59; 95% CI, 1.70-3.93), junior (OR = 1.62; 95% CI 1.22-2.16), and senior residents (OR = 1.99; 95% CI, 1.54-2.58). Trainees who reported perceiving negative effects of duty hour policies on patient safety were more likely to report frequent duty hour violations. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Association between general practice characteristics and use of out-of-hours GP cooperatives.

PubMed

Smits, Marleen; Peters, Yvonne; Broers, Sanne; Keizer, Ellen; Wensing, Michel; Giesen, Paul

2015-05-01

The use of out-of-hours healthcare services for non-urgent health problems is believed to be related to the organisation of daytime primary care but insight into underlying mechanisms is limited. Our objective was to examine the association between daytime general practice characteristics and the use of out-of-hours care GP cooperatives. A cross-sectional observational study in 100 general practices in the Netherlands, connected to five GP cooperatives. In each GP cooperative, we took a purposeful sample of the 10 general practices with the highest use of out-of-hours care and the 10 practices with the lowest use. Practice and population characteristics were obtained by questionnaires, interviews, data extraction from patient registration systems and telephone accessibility measurements. To examine which aspects of practice organisation were associated with patients' use of out-of-hours care, we performed logistic regression analyses (low versus high out-of-hours care use), correcting for population characteristics. The mean out-of-hours care use in the high use group of general practices was 1.8 times higher than in the low use group. Day time primary care practices with more young children and foreigners in their patient populations and with a shorter distance to the GP cooperative had higher out-of-hours primary care use. In addition, longer telephone waiting times and lower personal availability for palliative patients in daily practice were associated with higher use of out-of-hours care. Moreover, out-of-hours care use was higher when practices performed more diagnostic tests and therapeutic procedures and had more assistant employment hours per 1000 patients. Several other aspects of practice management showed some non-significant trends: high utilising general practices tended to have longer waiting times for non-urgent appointments, lower availability of a telephone consulting hour, lower availability for consultations after 5 p.m., and less frequent holiday openings. Besides patient population characteristics, organisational characteristics of general practices are associated with lower use of out-of-hours care. Improving accessibility and availability of day time primary day care might be a potential effective way to improve the efficient use of out-of-hours care services.

Work hours and self-reported hypertension among working people in California.

PubMed

Yang, Haiou; Schnall, Peter L; Jauregui, Maritza; Su, Ta-Chen; Baker, Dean

2006-10-01

Among the risk factors for hypertension, stress, especially work stress, has drawn increasing attention. Another potential work-related risk factor for hypertension identified in the past few years is work hours. This article presents an analysis of work hours and self-reported hypertension among the working population in the state of California. The data set used for this study comes from the Public Use File of the 2001 California Health Interview Survey. The logistic regression analysis shows a positive association between hours worked per week and likelihood of having self-reported hypertension. Compared with those working between 11 and 39 hours per week, individuals working 40 hours per week were 14% (95% CI: 1.01 to 1.28) more likely to report hypertension, those who worked between 41 and 50 hours per week were 17% (95% CI: 1.04 to 1.33) more likely to report hypertension, and those who worked >or=51 hours per week were 29% (95% CI: 1.10 to 1.52) more likely to report hypertension after controlling for various potentially confounding variables, including demographic and biological risk factors and socioeconomic status. This analysis provides evidence of a positive association between work hours and hypertension in the California working population.

Long-term hot-hardness characteristics of five through-hardened bearing steels

NASA Technical Reports Server (NTRS)

Anderson, N. E.

1978-01-01

Five vacuum-melted bearing steels tempered to various room temperature hardnesses: AISI 52100 and the tool steels AISI M-1, AISI M-50, Halmo, and WB-49 were studied. Hardness measurements were taken on AISI 52100 at room temperature and at elevated temperatures after soaking it at temperatures to 478 K (400 F) for as long as 1000 hours. Hardness measurements were also taken on the tool steels after soaking them at temperatures to 700 K (800 F) for as long at 1000 hours. None of the tool steel tempered during soaking and AISI 52100 did not temper when soaked at 366 K (200 F) for 1000 hours. However, AISI 52100 that was initially hardened to room temperature hardness of 62.5 or 64.5 lost hardness during the first 500 hours of the 1000-hour soak tests at temperatures greater than 394 K (250 F), but it maintained its hardness during the final 500 hours of soaking. Similarly, AISI 52100 initially hardened to room temperature hardness of 60.5 lost hardness during the first 500 hours of the 1000-hour soaking at temperatures greater than 422 K (300 F), but it maintained its hardness during the final 500 hours of soaking.

Effect of drying on the porosity of the hydroxyapatite and cellulose nata de coco compositeas bone graft candidate

NASA Astrophysics Data System (ADS)

Anitasari, S.; Mu’ti, A.; Hutahaean, YO

2018-04-01

Bone graft is used to replace bone parts damaged by illness and accident. As a bone replacement material, the bone graft should be able to stimulate the process of the osteogenesis. The process of osteogenesis is influenced by the osteoconductive properties of a biomaterial, that porosity affects this process. The shells of blood scallop (Anadaragranosa) are producing hydroxyapatite (HAp),having high compressive strength, biocompatibility and osteoconductive properties, but low porosity while cellulose nata de coco (Cnc) have low compressive strength but high porosity. Therefore, the combination of two biomaterials are expected to produce composite that have high osteoconductive properties. The purpose of this research wasknowing the porosity of HAp/Cnc composite which wasbeingprecipitated for 5 hours, 15 hours, 25 hours and wasdried for 24 hours, 48 hours and 72 hours. This research usedwise drop technique to synthesis HAp powder and cellulose immersion technique for synthesis of HAp/Cnc. Results of this research, there was difference in porosity between HAp/Cnc that was precipitated for 5 hours, 15 hours and 25 hours, as well as was dried for 1 day, 2 days and 3 days. The conclusion, the synthesis of HAp/Cncwasuseful as bone graft candidate.

Exposure to bright light for several hours during the daytime lowers tympanic temperature.

PubMed

Aizawa, S; Tokura, H

1997-11-01

The present study investigates the effect on thympanic temperature of exposure to different light intensities for several hours during the daytime. Nine healthy young adult volunteers (two male, seven female) were exposed to bright light of 4000 lx or dim light of 100 lx during the daytime from 0930 to 1800 hours; the light condition was then kept at 100 lx for a further hour. Tympanic temperature was measured continuously at a neutral condition (28 degrees C, 60% relative humidity) from 1000 to 1800 hours. Urinary samples were collected from 1100 to 1900 hours every 2 h, and melatonin excretion rate was measured by enzyme immunoassay. Of nine subjects, six showed clearly lower tympanic temperatures in the bright compared with the dim condition from 1400 to 1800 hours. Average tympanic temperatures were significantly lower in the bright than in the dim condition from 1645 to 1800 hours. Melatonin excretion rate tended to be higher in the bright than in the dim condition. It was concluded that exposure to bright light of 4000 lx during the daytime for several hours could reduce tympanic temperature, compared with that measured in dim light of 100 lx.

Exposure to bright light for several hours during the daytime lowers tympanic temperature

NASA Astrophysics Data System (ADS)

Aizawa, Seika; Tokura, H.

The present study investigates the effect on thympanic temperature of exposure to different light intensities for several hours during the daytime. Nine healthy young adult volunteers (two male, seven female) were exposed to bright light of 4000 lx or dim light of 100 lx during the daytime from 0930 to 1800 hours; the light condition was then kept at 100 lx for a further hour. Tympanic temperature was measured continuously at a neutral condition (28° C, 60% relative humidity) from 1000 to 1800 hours. Urinary samples were collected from 1100 to 1900 hours every 2 h, and melatonin excretion rate was measured by enzyme immunoassay. Of nine subjects, six showed clearly lower tympanic temperatures in the bright compared with the dim condition from 1400 to 1800 hours. Average tympanic temperatures were significantly lower in the bright than in the dim condition from 1645 to 1800 hours. Melatonin excretion rate tended to be higher in the bright than in the dim condition. It was concluded that exposure to bright light of 4000 lx during the daytime for several hours could reduce tympanic temperature, compared with that measured in dim light of 100 lx.

Influence of light and darkness on the behaviour of Dermanyssus gallinae on layer farms.

PubMed

Sokół, R; Szkamelski, A; Barski, D

2008-01-01

The behaviour of Dermanyssus gallinae was investigated on two layer farms where two different light programs were introduced in the 40th week of hen life. In layer house No. 1, light was applied continuously for 16 hours during the day, while layer house No. 2 was subjected to 4 hours of light and 2 hours of darkness applied alternately during the day. To monitor the level of red mite infestation, 30 tube traps were placed in every layer house corridor at a height of 1.5 m above the floor. In the first layer house, 280 Dermanyssus gallinae females, 50 nymph larvae and 198 eggs were found in 100 mg of tube trap material during 16 hours of the light phase, while during the 8-hour darkness phase, 1240 females, 70 nymph larvae and 110 eggs were collected. In the other layer house (with an alternating light phase of 4 hours and a darkness phase of 2 hours per day), 387 Dermanyssus gallinae females, 401 nymph larvae and 1060 eggs were found in trap tubes over the 8-hour dark phase, while 343 females, 202 nymph larvae and 1106 eggs were discovered over the 16-hour light phase.

Termination of pregnancy by extraamniotic prostaglandins and the synergistic action of oxytocin.

PubMed

Embrey, M P; Hillier, K; Mahendran, P

1973-01-01

This study determines the efficacy of extraamniotic administration of prostaglandins E2 and F2alpha (PGE2 and PGF2alpha) in abortion induction. The method consists of introducing a Foley catheter (14 gauge) through the cervix with the aid of a speculum so that the inflated balloon lies just within the internal os. The balloon volume varies from 30 ml at 12 weeks to 40 ml at 16 weeks gestation and over. Following an initial test dose, a fully effective dose of 200 mcg PGE2 or 750 mcg PGF2alpha is instilled for diffusion into the extraovular space; this dose is repeated at 2 hourly intervals. An automatic pump may also be used to administer the PG. The pattern of uterine contractility with this method is similar to that seen with intravenous therapy. Of 163 consecutive cases analyzed, 144 (88%) achieved abortions within 36 hours, 72% aborted within 24 hours and 94% within 48 hours. Mean abortion time was 22.2 hours. No significant difference was seen in the success rate or abortion time between 21 patients in their 1st trimester of pregnancy and 142 patients in the 2nd trimester. In primigravidas, abortion (within 36 hours) was successful in 87% of the cases; mean abortion time was 24.0 hours. Multigravidas had higher success rate (90%) and shorter mean abortion time (20.4 hours). Comparison of results obtained separately with PGF2alpha and PGE2 shows the superiority of PGE2. Of 93 patients receiving PGF2alpha, 85% aborted within 36 hours (mean abortion time, 24.9 hours). Of 70 PGE2-treated patients, 93% aborted within 36 hours (p=.01) (mean abortion time, 19.4 hours). When parity was considered, PGE2 came out superior again over PGF2alpha. In primigravidas, only 84% of PGF2alpha-treated patients had abortion within 36 hours compared to 90% for PGE2-treated patients. In multigravidas, the success rates at 36 hours were 86% for PGF2alpha and 95% for PGE2. Side effects were minimal. In another trial, intravenous oxytocin was used in addition to extraamniotic PG, resulting in a very substantial decrease in mean abortion time. This method is a simple, effective abortion technique which can be carried out in most cases on a 24-hour basis.

Temporal integration characteristics of the axial and choroidal responses to myopic defocus induced by prior form deprivation versus positive spectacle lens wear in chickens.

PubMed

Nickla, Debora L; Sharda, Vandhana; Troilo, David

2005-04-01

In chicks, the temporal response characteristics to form deprivation and to spectacle lens wear (myopic and hyperopic defocus) show essential differences, suggesting that the emmetropization system "weights" the visual signals differently. To further explore how the eye integrates opposing visual signals, we examined the responses to myopic defocus induced by prior form deprivation vs. that induced by positive spectacle lenses, in both cases alternating with form deprivation. Three experimental paradigms were used: 1) Form deprivation was induced by monocular occluders for 7 days. Over the subsequent 7 days, the occluders were removed daily for 12 hours (n = 13), 4 hours (n = 7), 2 hours (n = 7), or 0 hours (n = 6). 2) Birds were form-deprived on day 12. Over the subsequent 7 days, occluders were replaced with a +10 D lens for 2 hours per day (n = 13). 3) Starting at day 11, a +10 D lens was placed over one eye for 2 hours (n = 13), 3 hours (n = 5), or 6 hours (n = 10) per day and were otherwise untreated. Ocular dimensions were measured with high-frequency A-scan ultrasonography; refractive errors were measured by streak retinoscopy at various intervals. In recovering eyes, 2 hours per day of myopic defocus was as effective as 12 hours at inducing refractive and axial recovery (change in refractive error: +10 D vs. +13 D, respectively). By contrast, 2 hours of lens-induced defocus (alternating with form deprivation) was not sufficient to induce refractive or axial compensation (change in refractive error: -1.7 D). When myopic defocus alternated with unrestricted vision, 6 hours per day were sufficient to induce nearly full compensation (2 hours vs. 6 hours: 4.4 D vs. 8.2 D; p < 0.0005). Choroids showed rapid increases in thickness to the daily episodes of myopic defocus; these resulted in "long-term" thickness changes in recovering eyes and eyes wearing lenses for 3 or 6 hours per day. The response to myopic defocus induced by prior form deprivation is more robust than the response induced by positive lenses, suggesting that the underlying mechanisms differ. Presumably, this difference is related to the size of the eye at the onset. Compensatory decreases in growth rate occur without full compensatory choroidal thickening.

75 FR 3964 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-25

... warranted. Respondents: Businesses or other for-profits. Estimated Total Burden Hours: 131,555 hours. OMB... electronically make FTDs and tax payments through EFTPS. Respondents: Businesses or other for-profits. Estimated... them. Respondents: Not-for-profit institutions. Estimated Total Burden Hours: 11,052,594 hours. OMB...

29 CFR 785.31 - Special situations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee at such courses outside of working hours would not be hours worked even if they are directly... Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS HOURS WORKED Application of Principles Lectures, Meetings and...

48 CFR 52.237-10 - Identification of Uncompensated Overtime.

Code of Federal Regulations, 2010 CFR

2010-10-01

... same level of detail as compensated hours, and the uncompensated overtime rate per hour, whether at the prime or subcontract level. This includes uncompensated overtime hours that are in indirect cost pools for personnel whose regular hours are normally charged direct. (c) The offeror's accounting practices...

75 FR 38854 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... compliance for these respondents is $621,270.00 per year (10,530 burden hours multiplied by $59/hour... Regulation ATS. There are currently 81 respondents. These respondents will spend approximately 10,530 hours per year (81 respondents at 130 burden hours/respondent) to comply with the recordkeeping requirements...

14 CFR Appendix A to Part 187 - Methodology for Computation of Fees for Certification Services Performed Outside the United States

Code of Federal Regulations, 2013 CFR

2013-01-01

... hours of a U.S. Federal Government employee. This result in the hourly government paid cost of an... average annual leave hours and 1,800 average annual hours available for work for computer manpower...

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...

Impact of Cold Ischemia Time in Kidney Transplants From Donation After Circulatory Death Donors.

PubMed

Kayler, Liise; Yu, Xia; Cortes, Carlos; Lubetzky, Michelle; Friedmann, Patricia

2017-07-01

Deceased-donor kidneys are exposed to ischemic events from donor instability during the process of donation after circulatory death (DCD). Clinicians may be reluctant to transplant DCD kidneys with prolonged cold ischemia time (CIT) for fear of an additional deleterious effect. We performed a retrospective cohort study examining US registry data between 1998 and 2013 of adult first-time kidney-only recipients of paired kidneys (derived from the same donor transplanted into different recipients) from DCD donors. On multivariable analysis, death-censored graft survival (DCGS) was comparable between recipients of kidneys with higher CIT relative to paired donor recipients with lower CIT when the CIT difference was 1 hour or longer (adjusted hazard ratio, [aHR], 1.02; 95% confidence interval [CI], 0.88-1.17; n = 6276), 5 hours or longer (aHR, 0.98; 95% CI, 0.80-1.19; n = 3130), 10 hours or longer (aHR, 1.15; 95% CI, 0.82-1.60; n = 1124) or 15 hours (aHR, 1.15; 95% CI, 0.66-1.99; n = 498). There was a higher rate of primary non function in the long CIT groups for delta 1 hour or longer (0.89% vs 1.63%; P = 0.006), 5 hours (1.09% vs 1.67%, P = 0.13); 10 hours (0.53% vs 1.78%; P = 0.03), and 15 hours (0.40% vs 1.61%; P = 0.18), respectively. Between each of the 4 delta CIT levels of shorter and longer CIT, there was a significantly and incrementally higher rate of delayed graft function in the long CIT groups for delta 1 hour or longer (37.3% vs 41.7%; P < 0.001), 5 hours (35.9% vs 42.7%; P < 0.001), 10 hours (29.4% vs 44.2%, P < 0.001), and 15 hours (29.6% vs 46.1%, P < 0.001), respectively. Overall patient survival was comparable with delta CITs of 1 hour or longer (aHR, 0.96; 95% CI, 0.84-1.08), 5 hours (aHR, 1.01; 95% CI, 0.85-1.20), and 15 hours (aHR, 1.27; 95% CI, 0.79-2.06) but not 10 hours (aHR, 1.47; 95% CI, 1.09-1.98). These results suggest that in the setting of a prior ischemic donor event, prolonged CIT has limited bearing on long-term outcomes.

Impact of Cold Ischemia Time in Kidney Transplants From Donation After Circulatory Death Donors

PubMed Central

Kayler, Liise; Yu, Xia; Cortes, Carlos; Lubetzky, Michelle; Friedmann, Patricia

2017-01-01

Background Deceased-donor kidneys are exposed to ischemic events from donor instability during the process of donation after circulatory death (DCD). Clinicians may be reluctant to transplant DCD kidneys with prolonged cold ischemia time (CIT) for fear of an additional deleterious effect. Methods We performed a retrospective cohort study examining US registry data between 1998 and 2013 of adult first-time kidney-only recipients of paired kidneys (derived from the same donor transplanted into different recipients) from DCD donors. Results On multivariable analysis, death-censored graft survival (DCGS) was comparable between recipients of kidneys with higher CIT relative to paired donor recipients with lower CIT when the CIT difference was 1 hour or longer (adjusted hazard ratio, [aHR], 1.02; 95% confidence interval [CI], 0.88-1.17; n = 6276), 5 hours or longer (aHR, 0.98; 95% CI, 0.80-1.19; n = 3130), 10 hours or longer (aHR, 1.15; 95% CI, 0.82-1.60; n = 1124) or 15 hours (aHR, 1.15; 95% CI, 0.66-1.99; n = 498). There was a higher rate of primary non function in the long CIT groups for delta 1 hour or longer (0.89% vs 1.63%; P = 0.006), 5 hours (1.09% vs 1.67%, P = 0.13); 10 hours (0.53% vs 1.78%; P = 0.03), and 15 hours (0.40% vs 1.61%; P = 0.18), respectively. Between each of the 4 delta CIT levels of shorter and longer CIT, there was a significantly and incrementally higher rate of delayed graft function in the long CIT groups for delta 1 hour or longer (37.3% vs 41.7%; P < 0.001), 5 hours (35.9% vs 42.7%; P < 0.001), 10 hours (29.4% vs 44.2%, P < 0.001), and 15 hours (29.6% vs 46.1%, P < 0.001), respectively. Overall patient survival was comparable with delta CITs of 1 hour or longer (aHR, 0.96; 95% CI, 0.84-1.08), 5 hours (aHR, 1.01; 95% CI, 0.85-1.20), and 15 hours (aHR, 1.27; 95% CI, 0.79-2.06) but not 10 hours (aHR, 1.47; 95% CI, 1.09-1.98). Conclusions These results suggest that in the setting of a prior ischemic donor event, prolonged CIT has limited bearing on long-term outcomes. PMID:28706980

Inventory of File gfs.t06z.pgrb2.1p00.f006

Science.gov Websites

fcst U-Component of Wind [m/s] 002 planetary boundary layer VGRD 6 hour fcst V-Component of Wind [m/s Wind Speed (Gust) [m/s] 005 10 mb HGT 6 hour fcst Geopotential Height [gpm] 006 10 mb TMP 6 hour fcst Temperature [K] 007 10 mb RH 6 hour fcst Relative Humidity [%] 008 10 mb UGRD 6 hour fcst U-Component of Wind

Inventory of File gfs.t06z.pgrb2.0p25.f006

Science.gov Websites

fcst U-Component of Wind [m/s] 002 planetary boundary layer VGRD 6 hour fcst V-Component of Wind [m/s Wind Speed (Gust) [m/s] 005 10 mb HGT 6 hour fcst Geopotential Height [gpm] 006 10 mb TMP 6 hour fcst Temperature [K] 007 10 mb RH 6 hour fcst Relative Humidity [%] 008 10 mb UGRD 6 hour fcst U-Component of Wind

Inventory of File sref_em.t09z.pgrb212.ctl.grib2

Science.gov Websites

Temperature [K] 002 10 m above ground UGRD 3 hour fcst U-Component of Wind [m/s] 003 10 m above ground VGRD 3 hour fcst V-Component of Wind [m/s] 004 mean sea level PRMSL 3 hour fcst Pressure Reduced to MSL [Pa mb HGT 3 hour fcst Geopotential Height [gpm] 012 250 mb UGRD 3 hour fcst U-Component of Wind [m/s

Inventory of File gfs.t06z.pgrb2.0p50.f006

Science.gov Websites

fcst U-Component of Wind [m/s] 002 planetary boundary layer VGRD 6 hour fcst V-Component of Wind [m/s Wind Speed (Gust) [m/s] 005 10 mb HGT 6 hour fcst Geopotential Height [gpm] 006 10 mb TMP 6 hour fcst Temperature [K] 007 10 mb RH 6 hour fcst Relative Humidity [%] 008 10 mb UGRD 6 hour fcst U-Component of Wind

Inventory of File gfs.t06z.pgrb2.2p50.f006

Science.gov Websites

fcst U-Component of Wind [m/s] 002 planetary boundary layer VGRD 6 hour fcst V-Component of Wind [m/s Wind Speed (Gust) [m/s] 005 10 mb HGT 6 hour fcst Geopotential Height [gpm] 006 10 mb TMP 6 hour fcst Temperature [K] 007 10 mb RH 6 hour fcst Relative Humidity [%] 008 10 mb UGRD 6 hour fcst U-Component of Wind

Effects of a night-team system on resident sleep and work hours.

PubMed

Chua, Kao-Ping; Gordon, Mary Beth; Sectish, Theodore; Landrigan, Christopher P

2011-12-01

In 2009, Children's Hospital Boston implemented a night-team system on general pediatric wards to reduce extended work shifts. Residents worked 5 consecutive nights for 1 week and worked day shifts for the remainder of the rotation. Of note, resident staffing at night decreased under this system. The objective of this study was to assess the effects of this system on resident sleep and work hours. We conducted a prospective cohort study in which residents on the night-team system logged their sleep and work hours on work days. These data were compared with similar data collected in 2004, when there was a traditional call system. In 2004 and 2009, mean shift length was 15.22 ± 6.86 and 12.92 ± 5.70 hours, respectively (P = .161). Daily work hours were 10.49 ± 6.85 and 8.79 ± 6.42 hours, respectively (P = .08). Nightly sleep time decreased from 6.72 ± 2.60 to 4.77 ± 2.46 hours (P < .001). Total sleep time decreased from 7.50 ± 3.13 to 5.47 ± 2.34 hours (P < .001). Implementation of a night-team system was unexpectedly associated with decreased sleep hours. As residency programs create work schedules that are compliant with the 2011 Accreditation Council for Graduate Medical Education duty-hour standards, resident sleep should be monitored carefully.

[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.

Association between long working hours and serum gamma-glutamyltransferase levels in female workers: data from the fifth Korean National Health and Nutrition Examination Survey (2010-2011).

PubMed

Park, Seung-Gwon; Lee, Yong-Jin; Ham, Jung-Oh; Jang, Eun-Chul; Kim, Seong-Woo; Park, Hyun

2014-01-01

The present study investigated the association between long working hours and serum gamma-glutamyltransferase (GGT) levels, a factor influencing the incidence of cardiovascular disease. Data from the fifth Korean National Health and Nutrition Examination Survey (2010-2011) were used to analyze 1,809 women. Subjects were divided into three groups based on the number of weekly working hours: ≤29, 30-51, and ≥52 hours per week. Complex samples logistic regression was performed after adjusting for general and occupational factors to determine the association between long working hours and high serum GGT levels. The prevalence of high serum GGT levels in groups with ≤29, 30-51, and ≥52 working hours per week was 22.0%, 16.9%, and 26.6%, respectively. Even after adjusting for general and occupational factors, those working 30-51 hours per week had the lowest prevalence of high serum GGT levels. Compared to those working 30-51 hours per week, the odds ratios (OR) of having high serum GGT levels in the groups with ≥52 and ≤29 working hours per week were 1.56 (95% confidence interval [CI], 1.10-2.23) and 1.53 (95% CI, 1.05-2.24), respectively. Long working hours were significantly associated with high serum GGT levels in Korean women.

When policy meets physiology: the challenge of reducing resident work hours.

PubMed

Lockley, Steven W; Landrigan, Christopher P; Barger, Laura K; Czeisler, Charles A

2006-08-01

Considerable controversy exists regarding optimal work hours for physicians and surgeons in training. In a series of studies, we assessed the effect of extended work hours on resident sleep and health as well as patient safety. In a validated nationwide survey, we found that residents who had worked 24 hours or longer were 2.3 times more likely to have a motor vehicle crash following that shift than when they worked < 24 hours, and that the monthly risk of a crash increased by 16.2% after each extended duration shift. We also found in a randomized trial that interns working a traditional on-call schedule slept 5.8 hours less per week, had twice as many attentional failures on duty overnight, and made 36% more serious medical errors and nearly six times more serious diagnostic errors than when working on a schedule that limited continuous duty to 16 hours. While numerous opinions have been published opposing reductions in extended work hours due to concerns regarding continuity of patient care, reduced educational opportunities, and traditionally-defined professionalism, there are remarkably few objective data in support of continuing to schedule medical trainees to work shifts > 24 hours. An evidence-based approach is needed to minimize the well-documented risk that current work hour practices confer on resident health and patient safety while optimizing education and continuity of care.

The Interventional Arm of the Flexibility In Duty-Hour Requirements for Surgical Trainees Trial: First-Year Data Show Superior Quality In-Training Initiative Outcomes.

PubMed

Mirmehdi, Issa; O'Neal, Cindy-Marie; Moon, Davis; MacNew, Heather; Senkowski, Christopher

With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules. Using National Surgical Quality Improvement Program Quality In-Training Initiative data along with duty-hour violations compared with old rules, it was hypothesized that quality of care would be improved and outcomes would be equivalent or better than the traditional duty-hour rules. It was also hypothesized that resident perception of compliance with duty hour would not change with implementation of new regulations based on FIRST trial. Flexible work hours were implemented on July 1, 2014. National Surgical Quality Improvement Program Quality In-Training Initiative information was reviewed from July 2014 to January 2015. Patient risk factors and outcomes were compared between institutional resident cases and the national cohort for comparison. Residents' duty-hour logs and violations during this period were compared to the 6-month period before the implementation of the FIRST trial. The annual Accreditation Council for Graduate Medical Education resident survey was used to assess the residents' perception of compliance with duty hours. With respect to the postoperative complications, the only statistically significant measures were higher prevalence of pneumonia (3.4% vs. 1.5%, p < 0.05) and lower prevalence of sepsis (0% vs. 1.5%, p < 0.05) among cases covered by residents with flexible duty hours. All other measures of postoperative surgical complications showed no difference. The total number of duty-hour violations decreased from 54 to 16. Had the institution not been part of the interventional arm of the FIRST trial, this number would have increased to 238. The residents' perception of compliance with 80-hour work week from the Accreditation Council for Graduate Medical Education survey improved from 68% to 91%. Residents with flexible work hours on the interventional arm of the FIRST trial at our institution took care of a significantly sicker cohort of patients as compared with the national dataset with equivalent outcomes. Flexible duty-hour policy under the FIRST trial has enabled the residents to have fewer work-hour violations while improving continuity of care to the patients. Additionally, the overall perception of resident compliance with the duty-hour requirements was improved. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Why the long hours? Job demands and social exchange dynamics.

PubMed

Genin, Emilie; Haines, Victor Y; Pelletier, David; Rousseau, Vincent; Marchand, Alain

2016-11-22

This study investigates the determinants of long working hours from the perspectives of the demand-control model [Karasek, 1979] and social exchange theory [Blau, 1964; Goulder, 1960]. These two theoretical perspectives are tested to understand why individuals work longer (or shorter) hours. The hypotheses are tested with a representative sample of 1,604 employed Canadians. In line with Karasek's model, the results support that high job demands are positively associated with longer work hours. The social exchange perspective would predict a positive association between skill discretion and work hours. This hypothesis was supported for individuals with a higher education degree. Finally, the results support a positive association between active jobs and longer work hours. Our research suggests that job demands and social exchange dynamics need to be considered together in the explanation of longer (or shorter) work hours.

Evaluation of Hexane Extract of Tuber of Root of Cyperus rotundus Linn (Cyperaceae) for Repellency against Mosquito Vectors

PubMed Central

Singh, S. P.; Raghavendra, K.; Dash, A. P.

2009-01-01

Hexane extract of tuber of plant Cyperus rotundus (Cyperaceae) was screened under laboratory conditions for repellent activity against mosquito vector Anopheles culicifacies Giles species A (Diptera: Culicidae), Anopheles stephensi Liston (Diptera: Culicidae), and Culex quinquefasciatus Say (Diptera: Culicidae). The Cyperus rotundus tuber extract was used to determine their effect on mosquito vector, and comparison with the DEET (NN Diethyl 1-3 methyl Benzamide, formerly known as diethyl 1-m-toluamide). The tuber extracts showed more effective at all the dose. Result obtained from the laboratory experiment showed that the tuber extracts are more effective for repellency of allthe mosquito vector even at low dose. Clear dose response relationships were established with the highest dose of 10% tuber extract evoking 100% repellency. Percent protection obtained against An. culicifacies Giles species A 100% repellency in 4 hours, 6 hours, An. stephensi 100% repellency in 6 hours and Cx. quinquefasciatus was 100% repellency in 6 hours at the 10% concentration. Against DEET- 2.5% An. culicifacies A 100% repellency in 1 hour, 2 hours, 6 hours, An. stephensi have shown 100% repellency in 6 hours, and Culex quinquefasciatus have shown 100% repellency in 1 hour, 2 hours, 6 hours. The consolidated data of the repellency observed in different species is given and it is evident that the over all repellency rates varied between 80 and 100% for different repellents concentrations (2.5%, 5%, and 10%). The extract can be applied as an effective personal protective measure against mosquito bites. PMID:20798887

The effect of working hours on outcome from major trauma.

PubMed

Guly, H R; Leighton, G; Woodford, M; Bouamra, O; Lecky, F

2006-04-01

To determine whether being admitted with major trauma to an emergency department outside rather than within working hours results in an adverse outcome. The data were collected from hospitals in England and Wales participating in the Trauma Audit and Research Network (TARN). Data from the TARN database were used. Admission time and discharge status were cross matched, and this was repeated while controlling for Injury Severity Score (ISS) values. Logistic regression was carried out, calculating the effects of Revised Trauma Score (RTS), ISS, age, and time of admission on outcome from major trauma. This allowed observed versus expected mortality rates (Ws) scores to be compared within and outside working hours. As much of the RTS data were missing, this was repeated using the Glasgow Coma Score instead of RTS. In total, 5.2% of people admitted "out of hours" died, compared with 5.3% of people within working hours, and 12.2% of people admitted outside working hours had an ISS score greater than 15, compared with 10.1% admitted within working hours. Outcome in cases with comparable ISS values were very similar (31.1% of cases with ISS >15 died out of hours, compared with 33.5% inside working hours.) The subgroup of data with missing RTS values had a significantly increased risk of death. Therefore, GCS was used to calculate severity adjusted odds of death instead of RTS. However, with either model, Ws scores were identical (both 0%) within and outside working hours. Out of hours admission does not in itself have an adverse effect on outcome from major trauma.

Type of homogenization and fat loss during continuous infusion of human milk.

PubMed

García-Lara, Nadia Raquel; Escuder-Vieco, Diana; Alonso Díaz, Clara; Vázquez Román, Sara; De la Cruz-Bértolo, Javier; Pallás-Alonso, Carmen Rosa

2014-11-01

Substantial fat loss may occur during continuous feeding of human milk (HM). A decrease of fat loss has been described following homogenization. Well-established methods of homogenization of HM for routine use in the neonatal intensive care unit (NICU) would be desirable. We compared the loss of fat based on the use of 3 different methods for homogenizing thawed HM during continuous feeding. Sixteen frozen donor HM samples were thawed, homogenized with ultrasound and separated into 3 aliquots ("baseline agitation," "hourly agitation," and "ultrasound"), and then frozen for 48 hours. Aliquots were thawed again and a baseline agitation was applied. Subsequently, aliquots baseline agitation and hourly agitation were drawn into a syringe, while ultrasound was applied to aliquot ultrasound before it was drawn into a syringe. The syringes were loaded into a pump (2 mL/h; 4 hours). At hourly intervals the hourly agitation infusion was stopped, the syringe was disconnected and gently shaken. During infusion, samples from the 3 groups were collected hourly for analysis of fat and caloric content. The 3 groups of homogenization showed similar fat content at the beginning of the infusion. For fat, mean (SD) hourly changes of -0.03 (0.01), -0.09 (0.01), and -0.09 (0.01) g/dL were observed for the hourly agitation, baseline agitation, and ultrasound groups, respectively. The decrease was smaller for the hourly agitation group (P < .001). When thawed HM is continuously infused, a smaller fat loss is observed when syringes are agitated hourly versus when ultrasound or a baseline homogenization is used. © The Author(s) 2014.

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.

Adenosine Phosphates in Germinating Radish (Raphanus sativus L.) Seeds 1

PubMed Central

Moreland, Donald E.; Hussey, Griscelda G.; Shriner, Carole R.; Farmer, Fred S.

1974-01-01

Changes in concentrations of adenosine phosphates (AMP, ADP, and ATP), oxygen utilization, and fresh weights were measured during the first 48 hours after imbibition of water by quiescent radish seeds (Raphanus sativus L.) at 22.5 C. The changes in ATP concentrations, oxygen utilization, and fresh weights followed a triphasic time course, characterized by a rapid initial increase, which extended from 0 to approximately 1.5 hours, a lag phase from 1.5 to 16 hours, and a sharp linear increase from 16 to 48 hours. In unimbibed seeds, the concentrations of ATP, ADP, and AMP were <0.1, 0.9, and 2.2 nmoles/seed, respectively. After imbibition of water by the quiescent seeds, for 1 hour, the ATP concentration had increased to 2.5, and ADP and AMP concentrations had decreased to 0.3 and 0.1 nmole/seed, respectively. These early changes occurred also in seeds maintained under anaerobic conditions (argon), or when treated with either 5 mm fluoroacetate, or 5 mm iodoacetate. The concentrations of ADP and AMP did not change significantly from 1 to 48 hours. The termination of the lag phase at 16 hours correlated with radicle emergence. Cell division in the radicles was initiated at approximately 28 hours. ATP concentrations in seeds maintained under argon or treated with fluoroacetate remained relatively constant from approximately 2 to 48 hours. In contrast, the ATP concentration of iodoacetate-treated seeds decreased curvilinearly from 4 to 48 hours. Oxidative phosphorylation was estimated to have contributed 15, 20, and 65% of the pool ATP at 1.5, 16, and 48 hours, respectively. PMID:16658928

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

Digital image analysis of striated skeletal muscle tissue injury during reperfusion after induced ischemia

NASA Astrophysics Data System (ADS)

Rosero Salazar, Doris Haydee; Salazar Monsalve, Liliana

2015-01-01

Conditions such as surgical procedures or vascular diseases produce arterial ischemia and reperfusion injuries, which generate changes in peripheral tissues and organs, for instance, in striated skeletal muscle. To determine such changes, we conducted an experimental method in which 42 male Wistar rat were selected, to be undergone to tourniquet application on the right forelimb and left hind limb, to induce ischemia during one and three hours, followed by reperfusion periods starting at one hour and it was prolonged up to 32 days. Extensor carpi radialis longus and soleus respectively, were obtained to be processed for histochemical and morphometric analysis. By means of image processing and detection of regions of interest, variations of areas occupied by muscle fibers and intramuscular extracellular matrix (IM-ECM) throughout reperfusion were observed. In extensor carpi radialis longus, results shown reduction in the area occupied by muscle fibers; this change is significant between one hour and three hours ischemia followed by 16 hours, 48 hours and 32 days reperfusión (p˂0.005). To compare only periods of reperfusión that continued to three hours ischemia, were found significant differences, as well. For area occupied by IM-ECM, were identified increments in extensor carpi radialis longus by three hours ischemia and eight to 16 days reperfusion; in soleus, was observed difference by one hour ischemia with 42 hours reperfusion, and three hours ischemia followed by four days reperfusion (p˂0.005). Skeletal muscle develops adaptive changes in longer reperfusion, to deal with induced injury. Descriptions beyond 32 days reperfusion, can determine recovering normal pattern.

What Is Known: Examining the Empirical Literature in Resident Work Hours Using 30 Influential Articles.

PubMed

Philibert, Ingrid

2016-12-01

Examining influential, highly cited articles can show the advancement of knowledge about the effect of resident physicians' long work hours, as well as the benefits and drawbacks of work hour limits. A narrative review of 30 articles, selected for their contribution to the literature, explored outcomes of interest in the research on work hours-including patient safety, learning, and resident well-being. Articles were selected from a comprehensive review. Citation volume, quality, and contribution to the evolving thinking on work hours and to the Accreditation Council for Graduate Medical Education standards were assessed. Duty hour limits are supported by the scientific literature, particularly limits on weekly hours and reducing the frequency of overnight call. The literature shows declining hours and call frequency over 4 decades of study, although the impact on patient safety, learning, and resident well-being is not clear. The review highlighted limitations of the scientific literature on resident hours, including small samples and reduced generalizability for intervention studies, and the inability to rule out confounders in large studies using administrative data. Key areas remain underinvestigated, and accepted methodology is challenged when assessing the impact of interventions on the multiple outcomes of interest. The influential literature, while showing the beneficial effect of work hour limits, does not answer all questions of interest in determining optimal limits on resident hours. Future research should use methods that permit a broader, collective examination of the multiple, often competing attributes of the learning environment that collectively promote patient safety and resident learning and well-being.

76 FR 28661 - Interim Final Determination To Defer Sanctions, Sacramento Metro 1-Hour Ozone Nonattainment Area...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... Determination To Defer Sanctions, Sacramento Metro 1-Hour Ozone Nonattainment Area, California AGENCY... Act (CAA) Section 185 fee program (Termination Determination) for the Sacramento Metro 1- hour Ozone nonattainment area (Sacramento Metro Area) to satisfy anti- backsliding requirements for the 1-hour Ozone...

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...

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...

78 FR 50432 - Agency Information Collection Activities: Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-19

... capabilities. The EMPG Work Plan narrative must demonstrate how proposed projects address gaps, deficiencies.... hourly respondent respondents respondent of responses (in hours) hours) wage rate cost State, Local or.... Hourly Wage Rate'' for each respondent includes a 1.4 multiplier to reflect a fully-loaded wage rate...

5 CFR 610.111 - Establishment of workweeks.

Code of Federal Regulations, 2010 CFR

2010-01-01

... administrative workweek. All work performed by an employee within the first 40 hours is considered regularly scheduled work for premium pay and hours of duty purposes. Any additional hours of officially ordered or... administrative workweek is the total number of regularly scheduled hours of duty a week. (2) When an employee has...

26 CFR 7.105-2 - Substantial gainful activity.

Code of Federal Regulations, 2010 CFR

2010-04-01

... this nature generally are performed for remuneration or profit. Some weeks the taxpayer works 10 hours, some weeks 40 hours, and over the year the taxpayer works an average of 20 hours per week. Even though... the duties performed and the average number of hours worked per week conclusively establish the...

75 FR 14253 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

...), Election to Amortize Start- Up Expenditures for Active Trade or Business. Abstract: The information is.... Respondents: Private sector: Businesses or other for-profits. Estimated Total Burden Hours: 40,750 hours. OMB.... Respondents: Private sector: Businesses or other for-profits. Estimated Total Burden Hours: 1 hour. OMB Number...

75 FR 54197 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-03

... these respondents is $621,270.00 per year (10,530 burden hours multiplied by $59/hour). Compliance with... ATS. There are currently 81 respondents. These respondents will spend approximately 10,530 hours per year (81 respondents at 130 burden hours/respondent) to comply with the recordkeeping requirements of...

50 CFR 260.79 - Travel and other expenses.

Code of Federal Regulations, 2013 CFR

2013-10-01

... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

50 CFR 260.79 - Travel and other expenses.

Code of Federal Regulations, 2014 CFR

2014-10-01

... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

50 CFR 260.79 - Travel and other expenses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

50 CFR 260.79 - Travel and other expenses.

Code of Federal Regulations, 2012 CFR

2012-10-01

... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

50 CFR 260.79 - Travel and other expenses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... based on an hourly rate, an additional hourly charge may be made for travel time including time spent waiting for transportation as well as time spent traveling, but not to exceed 8 hours of travel time for... charge may be made for travel time outside the employee's official work hours. ...

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...

40 CFR 69.41 - New exemptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operating specifications. At a minimum, the wind direction data will be monitored, collected and reported as 1-hour averages, starting on the hour. If the average wind direction for a given hour is from within the designated sector, the wind will be deemed to have flowed from within the sector for that hour...

40 CFR 69.41 - New exemptions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... operating specifications. At a minimum, the wind direction data will be monitored, collected and reported as 1-hour averages, starting on the hour. If the average wind direction for a given hour is from within the designated sector, the wind will be deemed to have flowed from within the sector for that hour...

75 FR 63514 - Agency Information Collection Activities: Submission to OMB for Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... be required to develop and submit a retained earnings accumulation plan. The rule generally requires... hours = 1,000 hours. Retained earnings accumulation Plans: 3 corporates x 50 hours = 150 hours. Notice... imposes new requirements concerning the use of nationally recognized statistical rating agencies, which...

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…

50 CFR 218.180 - Specified activity and specified geographical area and effective dates.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-1 RMS-ACL—up to 168 hours over the course of 5 years (an average of 33.5 hours per year); (x) BPAUV...); (vii) AN/WLD-1 RMS-ACL—up to 25 hours over the course of 5 years (an average of 5 hours per year...

50 CFR 218.180 - Specified activity and specified geographical area and effective dates.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-1 RMS-ACL—up to 168 hours over the course of 5 years (an average of 33.5 hours per year); (x) BPAUV...); (vii) AN/WLD-1 RMS-ACL—up to 25 hours over the course of 5 years (an average of 5 hours per year...

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...

78 FR 57132 - Endangered Species; File No. 16230

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-17

... for large mesh gillnets from one hour before sunset on Monday through Thursday and one hour after sunrise from Tuesday through Friday (i.e., fishing is prohibited from one hour after sunrise on Friday through one hour before sunset on Monday); (2) restrictions on the maximum net length per large mesh...

Holding equine oocytes in a commercial embryo-holding medium: New perspective on holding temperature and maturation time.

PubMed

Dini, Pouya; Bogado Pascottini, Osvaldo; Ducheyne, Kaatje; Hostens, Miel; Daels, Peter

2016-09-15

In the present study, we examined the effect of holding equine oocytes in Syngro embryo holding medium (EHM) overnight at either 4 °C, 17 °C, or 22 °C to 25 °C, on the time to maturation and developmental competence. We also examined the effect of placing denuded oocyte without extruded polar body back in maturation condition on subsequent maturation rate. In experiment 1, cumulus-oocyte complexes (COCs) were recovered postmortem and placed in EHM at 22 °C to 25 °C for 18 to 20 hours (OH) or placed directly in maturation (DM). The maturation rate was assessed after 22, 24, or 28 hours of culture. After denuding cumulus cells at 22 or 24 hours, oocytes without obvious polar body were placed back into culture and reassessed at subsequent time points. At 22 hours, a higher proportion of oocytes placed in OH achieved nuclear maturation than those placed in DM (63% and 37%, respectively, P = 0.008). At 24 and 28 hours, no significant differences in the % MII stage oocytes were observed between OH and DM. The nuclear maturation rate for OH oocytes was similar at 22, 24, and 28 hours, indicating that the maximum maturation rate was reached at an earlier time than that in DM. Oocytes fertilized by intracytoplasmic sperm injection resulted in a 7.1% and 6.3% blastocyst rate for OH and DM, respectively. Denuding oocytes after 22 hours or more of culture did not have an adverse effect on the final nuclear maturation rate. After 28 hours of culture, the same nuclear maturation rate (MII) was reached for nondenuded oocytes and oocytes denuded after 22 hours of 24 hours of culture. In experiment 2, COCs were held overnight at room temperature in EHM, then placed in maturation for 20, 22, and 28 hours. Nuclear maturation rate was significantly lower at 20 hours than 22 and 28 hours of culture and was similar at 22 and 28 hours, suggesting that at least 22 hours of culture is required to reach maximal maturation rate for stored oocytes (43%, 62%, and 65% at 20, 22, and 28 hours, respectively. P < 0.001). In experiment 3, COCs were either placed directly in culture or held at 22 °C to 25 °C, 17 °C, or 4 °C overnight. After 24 hours of culture, maturation rate was similar for all groups, suggesting that COCs can be stored in conventional 4 °C transport condition or 17 °C. In preliminary studies, COCs were held at 4 °C followed by 24 hours of culture, and mature oocytes were fertilized using intracytoplasmic sperm injection. Twenty-three injected oocytes yielded four blastocysts. In conclusion, we reported that oocytes can be placed in a commercial EHM and stored overnight without a detrimental effect on maturation rates or blastocyst development. Oocytes held in holding medium require less time to reach the MII stage than oocytes placed in culture directly. Removing the cumulus cells from oocytes that have been cultured for at least 22 hours does not seem to alter the final nuclear maturation rate. Finally, we observed no detrimental effect of storing oocytes at 4 °C for up to 18 hours, and oocytes appeared to maintain developmental competence and blastocyst potential. Copyright © 2016 Elsevier Inc. All rights reserved.

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

Inventory of File sref.t03z.pgrb197.spread_ds_3hrly.grib2

Science.gov Websites

3 hour fcst U-Component of Wind [m/s] std dev 002 10 m above ground VGRD 3 hour fcst V-Component of Wind [m/s] std dev 003 2 m above ground TMP 3 hour fcst Temperature [K] std dev 004 2 m above ground SPFH 3 hour fcst Specific Humidity [kg/kg] std dev 005 10 m above ground WIND 3 hour fcst Wind Speed [m

Inventory of File sref_nmb.t03z.pgrb212.ctl.grib2

Science.gov Websites

10 m above ground UGRD 3 hour fcst U-Component of Wind [m/s] ENS=low-res ctl 004 10 m above ground VGRD 3 hour fcst V-Component of Wind [m/s] ENS=low-res ctl 005 mean sea level PRMSL 3 hour fcst 250 mb UGRD 3 hour fcst U-Component of Wind [m/s] ENS=low-res ctl 014 500 mb UGRD 3 hour fcst U

Inventory of File sref.t03z.pgrb197.mean_ds_3hrly.grib

Science.gov Websites

3 hour fcst U-Component of Wind [m/s] wt ens-mean 002 10 m above ground VGRD 3 hour fcst V-Component of Wind [m/s] wt ens-mean 003 2 m above ground TMP 3 hour fcst Temperature [K] wt ens-mean 004 2 m above ground SPFH 3 hour fcst Specific Humidity [kg/kg] wt ens-mean 005 10 m above ground WIND 3 hour

Compared to Canadians, U.S. physicians spend nearly four times as much money interacting with payers.

PubMed

Zimmerman, Christina

2011-11-01

(1) In Canadian office practices, physi­cians spent 2.2 hours per week interacting with payers, nurses spent 2.5 hours, and clerical staff spent 15.9 hours. In U.S. practices, physicians spent 3.4 hours per week interacting with payers, nurses spent 20.6 hours, and clerical staff spent 53.1 hours. (2) Canadian physician practices spent $22,205 per physician per year on interactions with health plans. U.S. physician practices spent $82,975 per physician per year. (3) U.S. physician practices spend $60,770 per physician per year more (approximately four times as much) than their Canadian counterparts.

What do gastroenterology trainees want: recognition, remuneration or recreation?

PubMed

Harewood, G C; Pardi, D S; Hansel, S L; Corr, A E; Aslanian, H; Maple, J

2011-06-01

Occupational psychologists have identified three factors important in motivating physicians: financial reward, academic recognition, time off. To assess motivators among gastroenterology (GI) trainees. A questionnaire was distributed to GI trainees to assess their motivators: (1) work fewer hours for less lucrative rate, (2) reduction in salary/increase in hours for academic protected time, and (3) work longer hours for higher total salary, but less lucrative hourly rate. Overall, 61 trainees responded; 52% of trainees would work shorter hours for less lucrative rate; 60% would accept a disproportionate reduction in salary/increase in hours for academic protected time; 54% would work longer hours for more money but less lucrative rate. Most trainees (93%) accepted at least one scenario. Most GI trainees are willing to modify their job description to align with their personal values. Tailoring job descriptions according to these values can yield economic benefits to GI Divisions.

Influence of atropine therapy on fenthion-induced pancreatitis.

PubMed

Ela, Yuksel; Fidan, Huseyin; Sahin, Onder; Kilbas, Aynur; Bas, Orhan; Yavuz, Yucel; Kucuker, Hudaverdi; Altuntas, Irfan

2008-02-01

We searched the influence of dose and timing of atropine therapy in fenthion-induced pancreatitis model. All rats were intoxicated with fenthion except the control group. Two milligrams of atropine was administered for 24 hours in a high dose atropine group while a low dose atropine group received 100 micrograms of atropine for 24 hours. One group received 2 milligrams of atropine in the first four hours of intoxication while the other group received 2 milligrams of atropine in the last four hours before sacrifice. All rats were sacrificed 24 hours after intoxication. Pseudo-cholinesterase and lipase concentrations and histopathological markers of pancreatitis were studied. None of the models in this study completely prevented pancreatitis, however high dose atropine that is administered for 24 hours or the first four hours after intoxication prevented severe pancreatitis. Atropine administration influence on fenthion-induced pancreatitis should be studied for other organophosphates in animals and humans.

Dose-Response Relation between Work Hours and Cardiovascular Disease Risk: Findings from the Panel Study of Income Dynamics

PubMed Central

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

2015-01-01

Objectives To examine the presence of a dose-response relationship between work hours and incident cardiovascular disease (CVD) in a representative sample of U.S. workers. Methods Retrospective cohort study of 1,926 individuals from the Panel Study of Income Dynamics (1986–2011) employed for at least 10 years. Restricted cubic spline regression was used to estimate the dose-response relationship of work hours with CVD. Results A dose-response relationship was observed in which an average workweek of 46 hours or more for at least 10 years was associated with increased risk of CVD. Compared to working 45 hours per week, working an additional 10 hours per week or more for at least 10 years increased CVD risk by at least 16%. Conclusions Working more than 45 work hours per week for at least 10 years may be an independent risk factor for CVD. PMID:26949870

Thermoelectric generator testing and RTG degradation mechanisms evaluation. Progress report No. 33

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

Lockwood, A.; Stapfer, G.

1979-12-01

The n-type selenide legs after 10,600 hours continue to show agreement with the 3M Co. published data. In the ingradient testing after 11,378 hours the n-legs show comparable performance to the reported 3M data. The new design p-type legs were placed on test. The remaining MHW generator on test Q1-A has accumulated 19,567 hours and performance remains stable. Three 18 couple modules S/N-1, 2, and 3 previously tested at RCA were received for JPL test and evaluation. S/N-1 has 1700 hours testing at JPL with results indistinguishable from those at the end of RCA testing in 1977. The performances ofmore » LES 8/9 generators are following DEGRA predications after 31,824 hours. The performance of the Voyager 1 and 2 RTGs is reported after 19,577 hours and 20,122 hours of operation, respectively.« less

Psychological contracts: a new strategy for retaining reduced-hour physicians.

PubMed

Hartwell, Jennifer K

2010-01-01

As a retention strategy, healthcare organizations offer reduced-hour schedules to physicians seeking better work-family balance. However, this quantitative study of 94 full-time and reduced-hour female physicians in the Boston area found that working fewer hours helps physicians achieve better balance but does not improve their burnout or career satisfaction, or impact their intention to quit or leave the field of medicine. Instead, the findings demonstrate that psychological contract fulfillment, which reflects the subjective nature of the employment relationship, is more important than work hours, an objective job condition, in predicting intention to quit and these other outcomes. A fine-grained analysis is initiated uncovering the multidimensionality of the psychological contract construct. To integrate successful reduced-hour arrangements for physicians, medical managers are directed to the importance of understanding the composition of reduced-hour physicians' psychological contracts, specifically, their need to do challenging work, receive high levels of supervisor support, and promotion opportunities.

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...

75 FR 54778 - Approval and Promulgation of Air Quality Implementation Plans; Louisiana; Baton Rouge 8-Hour...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... Promulgation of Air Quality Implementation Plans; Louisiana; Baton Rouge 8-Hour Ozone Nonattainment Area; Determination of Attainment of the 8-Hour Ozone Standard AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY: The EPA has determined that the Baton Rouge (BR) moderate 8- hour ozone...

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...

29 CFR 779.18 - Regular rate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... premium rate paid for certain hours worked by the employee in any day or workweek because such hours are hours worked in excess of eight in a day or in excess of the maximum workweek applicable to such... the basic, normal, or regular workday (not exceeding 8 hours) or workweek (not exceeding the maximum...

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...

25 CFR 700.547 - Consuming intoxicants on Government premises or during duty hours.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Government premises or during duty hours. Consuming alcohol or non-prescription drugs on agency premises, or while driving or riding in a Government vehicle, or during working hours are prohibited conduct and... duty hours. 700.547 Section 700.547 Indians THE OFFICE OF NAVAJO AND HOPI INDIAN RELOCATION COMMISSION...

29 CFR 778.419 - Hourly workers employed at two or more jobs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS OVERTIME... Type of Work Performed in Overtime Hours (secs. 7(g) (1) and (2)) § 778.419 Hourly workers employed at... work, for which different straight time hourly rates are established, may agree with his employer in...

33 CFR 117.686 - Yazoo River.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) bridge shall open on signal if at least four hours notice is given. When a vessel has given notice and fails to arrive within the four hour period specified, the drawtender shall remain on duty for two additional hours and open the draw if the requesting vessel appears. After this time, an additional four hour...

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...

5 CFR 610.111 - Establishment of workweeks.

Code of Federal Regulations, 2011 CFR

2011-01-01

... administrative workweek. All work performed by an employee within the first 40 hours is considered regularly scheduled work for premium pay and hours of duty purposes. Any additional hours of officially ordered or... regularly scheduled work for premium pay and hours of duty purposes. (5 U.S.C. 5548 and 6101(c)) [33 FR...

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…

48 CFR 52.246-6 - Inspection-Time-and-Material and Labor-Hour.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-Material and Labor-Hour. 52.246-6 Section 52.246-6 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-6 Inspection—Time-and-Material and Labor-Hour. As prescribed in 46.306, insert the following clause: Inspection—Time-and-Material and Labor-Hour (MAY 2001) (a) Definitions. As used...

48 CFR 52.246-6 - Inspection-Time-and-Material and Labor-Hour.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-Material and Labor-Hour. 52.246-6 Section 52.246-6 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.246-6 Inspection—Time-and-Material and Labor-Hour. As prescribed in 46.306, insert the following clause: Inspection—Time-and-Material and Labor-Hour (MAY 2001) (a) Definitions. As used...

GPS-based Products - Naval Oceanography Portal

Science.gov Websites

more about how to use these products, click here. Rapids 24-hr sets of GPS satellite orbits, satellite every 24 hours. Ultras 48-hour sets (24 hours past, 24 hours predicted) of GPS satellite orbits , satellite clock solutions, and earth orientation parameters. Computed by USNO's IGS Analysis Center every

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...

37 CFR 201.3 - Fees for registration, recordation, and related services, special services, and services...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 201.3 Patents, Trademarks, and Copyrights U.S. COPYRIGHT OFFICE, LIBRARY OF CONGRESS COPYRIGHT... minimum) 200 (ii) Retrieval of digital records (per hour, half hour minimum, quarter hour increments) 200... copying, per hour 305 (13) Notice to libraries and archives 50 Each additional title 20 (14) Service...

50 CFR 21.61 - Population control of resident Canada geese.

Code of Federal Regulations, 2010 CFR

2010-10-01

... geese to extend to one-half hour after sunset, and removes daily bag limits for resident Canada geese... section may be implemented only between the hours of one-half hour before sunrise to one-half hour after... individuals participated in the program; (iii) The total number of resident Canada geese shot and retrieved...

50 CFR 21.61 - Population control of resident Canada geese.

Code of Federal Regulations, 2014 CFR

2014-10-01

... geese to extend to one-half hour after sunset, and removes daily bag limits for resident Canada geese... section may be implemented only between the hours of one-half hour before sunrise to one-half hour after... individuals participated in the program; (iii) The total number of resident Canada geese shot and retrieved...

50 CFR 21.61 - Population control of resident Canada geese.

Code of Federal Regulations, 2012 CFR

2012-10-01

... geese to extend to one-half hour after sunset, and removes daily bag limits for resident Canada geese... section may be implemented only between the hours of one-half hour before sunrise to one-half hour after... individuals participated in the program; (iii) The total number of resident Canada geese shot and retrieved...

50 CFR 21.61 - Population control of resident Canada geese.

Code of Federal Regulations, 2011 CFR

2011-10-01

... geese to extend to one-half hour after sunset, and removes daily bag limits for resident Canada geese... section may be implemented only between the hours of one-half hour before sunrise to one-half hour after... individuals participated in the program; (iii) The total number of resident Canada geese shot and retrieved...

50 CFR 21.61 - Population control of resident Canada geese.

Code of Federal Regulations, 2013 CFR

2013-10-01

... geese to extend to one-half hour after sunset, and removes daily bag limits for resident Canada geese... section may be implemented only between the hours of one-half hour before sunrise to one-half hour after... individuals participated in the program; (iii) The total number of resident Canada geese shot and retrieved...

78 FR 19576 - Proposed Collection; Comment Request for Information Collection Tools

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... government are working to ensure compliance with excise taxes on motor fuels. This joint effect has resulted... Respondent: 4 hours, 40 minutes. Estimated Annual Burden Hours for Respondents: 2,347,020. (2) Title: Support... Respondent: 34 hours, 19 minutes. Estimated Total Annual Reporting Burden hours: 549,120. (3) Title...

29 CFR 783.43 - Computation of seaman's minimum wage.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS... STANDARDS ACT TO EMPLOYEES EMPLOYED AS SEAMEN Computation of Wages and Hours § 783.43 Computation of seaman... all hours on duty in such period at the hourly rate prescribed for employees newly covered by the Act...

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...

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...

75 FR 37523 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-29

... before July 29, 2010 to be assured of consideration. Bureau of Public Debt (BPD) OMB Number: 1535-0121... Governments. Estimated Total Burden Hours: 247 hours. OMB Number: 1535-0131. Type of Review: Extension without.... Estimated Total Burden Hours: 2,050 hours. OMB Number: 1535-0094. Type of Review: Extension without change...

44 CFR 353.5 - Average cost per FEMA professional staff-hour.

Code of Federal Regulations, 2014 CFR

2014-10-01

... professional staff-hour. 353.5 Section 353.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... cost per FEMA professional staff-hour. Fees for FEMA services rendered will be calculated based upon the costs for such services using a professional staff rate per hour equivalent to the sum of the...

44 CFR 353.5 - Average cost per FEMA professional staff-hour.

Code of Federal Regulations, 2010 CFR

2010-10-01

... professional staff-hour. 353.5 Section 353.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... cost per FEMA professional staff-hour. Fees for FEMA services rendered will be calculated based upon the costs for such services using a professional staff rate per hour equivalent to the sum of the...

44 CFR 353.5 - Average cost per FEMA professional staff-hour.

Code of Federal Regulations, 2011 CFR

2011-10-01

... professional staff-hour. 353.5 Section 353.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... cost per FEMA professional staff-hour. Fees for FEMA services rendered will be calculated based upon the costs for such services using a professional staff rate per hour equivalent to the sum of the...

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...

Immunofluorescence localization of dissociation supernatant and extracellular matrix components in Lytechinus pictus sectioned embryos. M.S. Thesis

NASA Technical Reports Server (NTRS)

Garciaflack, Ana Leticia

1988-01-01

Indirect immunofluorescence was used to localize specific extracellular components in embryos of the sea urchin Lytechinus pictus. Hyalin and S2 (a group of components found in the disaggregation supernatant from Strongylocentrotus purpuratus blastulae) were uniformly present at all stages (unfertilized up to 32 hr) except hyalin could not be detected at the 12 hour early blastula stage. Laminin was found in 16 cell, 32 cell, 6 hour, 18 hour, 24 hour, and 32 hour stages, with especially bright fluorescence at 18 hours. Collagen I was present at all stages (freshly fertilized up to 32 hour) except little was detected at 12 hours. Fibronectin was uniformly present in blastocoelar fibers stained with anto-collagen I and anti-fibronectin. These results were compared with those for S. purpuratus to produce an overview of the localization of specific extracellular matrix components during development of two species of sea urchins. The results set the stage for future studies that will examine the function of these components at the various developmental stages.

Using lean methodology to decrease wasted RN time in seeking supplies in emergency departments.

PubMed

Richardson, David M; Rupp, Valerie A; Long, Kayla R; Urquhart, Megan C; Ricart, Erin; Newcomb, Lindsay R; Myers, Paul J; Kane, Bryan G

2014-11-01

Timely stocking of essential supplies in an emergency department (ED) is crucial to efficient and effective patient care. The objective of this study was to decrease wasted nursing time in obtaining needed supplies in an ED through the use of Lean process controls. As part of a Lean project, the team conducted a "before and after" prospective observation study of ED nurses seeking supplies. Nurses were observed for an entire shift for the time spent outside the patient room obtaining supplies at baseline and after implementation of a point-of-use storage system. Before implementation, nurses were leaving patient rooms a median of 11 times per 8-hour shift (interquartile range [IQR], 8 times per 8-hour shift) and 10 times per 12-hour shift (IQR, 23 times per 12-hour shift). After implementation of the new system, the numbers decreased to 2.5 per 8-hour shift (IQR, 2 per 8-hour shift) and 1 per 12-hour shift (IQR, 1 per 12-hour shift). A redesigned process including a standardized stocking system significantly decreases the number of searches by nurses for supplies.

Changes in the number of resident publications after inception of the 80-hour work week.

PubMed

Namdari, Surena; Baldwin, Keith D; Weinraub, Barbara; Mehta, Samir

2010-08-01

Since the inception of resident work-hour regulations, there has been considerable concern regarding the influence of decreased work hours on graduate medical education. In particular, it is unclear whether implementation of work-hour restrictions has influenced resident academic performance as defined by quantity of peer-reviewed publications while participating in graduate medical education. We determined the impact of work-hour changes on resident involvement in the number of published clinical studies, laboratory research, case reports, and review articles. We conducted a PubMed literature search of 139 consecutive orthopaedic surgery residents (789 total resident-years) at one institution from academic years 1995-1996 to 2008-2009. This represented a continuous timeline before and after implementation of work-hour restrictions. The number of resident publications before and after implementation of work-hour changes was compared. There was a greater probability of peer review authorship in any given resident-year after work-hour changes than before. Average publications per resident-year increased for total articles, clinical articles, case reports, and reviews. There was an increased rate of publications in which the resident was the first author. Since implementation of work-hour changes, total resident publications and publications per resident-year have increased.

A new method for assessing the risk of accident associated with darkness.

PubMed

Johansson, Osten; Wanvik, Per Ole; Elvik, Rune

2009-07-01

This paper presents a new method for assessing the risk of accidents associated with darkness. The method estimates the risk of accident associated with darkness in terms of an odds ratio, which is defined as follows: [(number of accidents in darkness in a given hour of the day)/(number of accidents in daylight in the same hour of the day)]/[(Number of accidents in a given comparison hour when the case hour is dark)/(Number of accidents in a given comparison hour when the case hour is in daylight)]. This estimate of the risk of accident associated with darkness does not require data on exposure, but relies on the count of accidents in the same pair of hours throughout the year. One of the hours is dark part of the year, but has daylight the rest of the year. The comparison hour, which has daylight the whole year, is used to control for seasonal variations. The aim of relying on the same pair of hours throughout the year is to minimise the influence of potentially confounding factors. Estimates of the risk of injury accidents associated with darkness are developed on the basis of accident data for Norway, Sweden and the Netherlands. It is found that the risk of an injury accident increases by nearly 30% in darkness in urban areas, by nearly 50% in rural areas, and by about 40% for urban and rural areas combined (adjusted estimate).

Effects of Accreditation Council for Graduate Medical Education work hour restrictions on medical student experience.

PubMed

Nixon, L James; Benson, Bradley J; Rogers, Tyson B; Sick, Brian T; Miller, Wesley J

2007-07-01

Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education. Our objective was to determine the effects of resident work hour restrictions on medical student education. We compared student responses pre work hour restrictions with those completed post work hour restrictions. Students on required Internal Medicine, Surgery, and Pediatric clerkships at the University of Minnesota. Two thousand eight hundred twenty-five student responses on end-of-clerkship surveys. Students reported 1.6 more hours per week of teaching by residents (95%CI 0.8-2.6) in the post work hours era. Students' ratings of the overall quality of their teaching on the ward did not change appreciably, 0.05 points' decline on a 5-point scale (P = .05). Like the residents, students worked fewer hours per week (avg. 1.5 hours less, 95%CI 0.4-2.6). There was no change in quality or quantity of attending teaching, students' relationships with their patients, or the overall value of the clerkships. Whereas resident duty hour restrictions at our institution have had minimal effect on students' ratings of the overall teaching quality, they do report being taught more by their residents. This may be a factor of decreased resident fatigue or an increased sense of well-being; but more study is needed to clarify the causes of our observations.

Effects of Accreditation Council for Graduate Medical Education Work Hour Restrictions on Medical Student Experience

PubMed Central

Benson, Bradley J.; Rogers, Tyson B.; Sick, Brian T.; Miller, Wesley J.

2007-01-01

Background Residents have a major role in teaching students, yet little has been written about the effects of resident work hour restrictions on medical student education. Objective Our objective was to determine the effects of resident work hour restrictions on medical student education. Design We compared student responses pre work hour restrictions with those completed post work hour restrictions. Participants Students on required Internal Medicine, Surgery, and Pediatric clerkships at the University of Minnesota. Measurements Two thousand eight hundred twenty-five student responses on end-of-clerkship surveys. Results Students reported 1.6 more hours per week of teaching by residents (95%CI 0.8–2.6) in the post work hours era. Students’ ratings of the overall quality of their teaching on the ward did not change appreciably, 0.05 points’ decline on a 5-point scale (P = .05). Like the residents, students worked fewer hours per week (avg. 1.5 hours less, 95%CI 0.4–2.6). There was no change in quality or quantity of attending teaching, students’ relationships with their patients, or the overall value of the clerkships. Conclusions Whereas resident duty hour restrictions at our institution have had minimal effect on students’ ratings of the overall teaching quality, they do report being taught more by their residents. This may be a factor of decreased resident fatigue or an increased sense of well-being; but more study is needed to clarify the causes of our observations. PMID:17450390

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.

Workplace status and risk of hypertension among hourly and salaried aluminum manufacturing employees

PubMed Central

Clougherty, Jane Ellen; Eisen, Ellen A; Slade, Martin D; Kawachi, Ichiro; Cullen, Mark R

2009-01-01

An inverse relationship between workplace status and morbidity is well established; higher job status has been associated with reduced risks of heart disease, hypertension, and injury. Most research on job status, however, has focused on salaried populations, and it remains unclear whether job status operates similarly among hourly workers. Our objectives were to examine whether hourly status itself influences risk of hypertension after adjustment for socioeconomic confounders, and to explore the role of fine-scale job grade on hypertension incidence within hourly and salaried groups. We examined data for 14,999 aluminum manufacturing employees in 11 plants across the U.S., using logistic regression with adjustment for age, sex, race/ ethnicity and other individual characteristics. Propensity score restriction was used to identify comparable groups of hourly and salaried employees, reducing confounding by socio-demographic characteristics. Job grade (coded 1 through 30, within hourly and salaried groups) was examined as a more refined measure of job status. Hourly status was associated with an increased risk of hypertension, after propensity restriction and adjustment for confounders. The observed effect of hourly status was stronger among women, although the propensity-restricted cohort was disproportionately male (96 %). Among salaried workers, higher job grade was not consistently associated with decreased risk; among hourly employees, however, there was a significant trend, with higher job grades more protective against hypertension. Increasing the stringency of hypertension case criteria also increased the risk of severe or persistent hypertension for hourly employees. PMID:19027215

Workplace status and risk of hypertension among hourly and salaried aluminum manufacturing employees.

PubMed

Clougherty, Jane Ellen; Eisen, Ellen A; Slade, Martin D; Kawachi, Ichiro; Cullen, Mark R

2009-01-01

An inverse relationship between workplace status and morbidity is well established; higher job status has been associated with reduced risks of heart disease, hypertension, and injury. Most research on job status, however, has focused on salaried populations, and it remains unclear whether job status operates similarly among hourly workers. Our objectives were to examine whether hourly status itself influences risk of hypertension after adjustment for socioeconomic confounders, and to explore the role of fine-scale job grade on hypertension incidence within hourly and salaried groups. We examined data for 14,999 aluminum manufacturing employees in 11 plants across the U.S., using logistic regression with adjustment for age, sex, race/ethnicity and other individual characteristics. Propensity score restriction was used to identify comparable groups of hourly and salaried employees, reducing confounding by sociodemographic characteristics. Job grade (coded 1 through 30, within hourly and salaried groups) was examined as a more refined measure of job status. Hourly status was associated with an increased risk of hypertension, after propensity restriction and adjustment for confounders. The observed effect of hourly status was stronger among women, although the propensity-restricted cohort was disproportionately male (96%). Among salaried workers, higher job grade was not consistently associated with decreased risk; among hourly employees, however, there was a significant trend, with higher job grades more protective against hypertension. Increasing the stringency of hypertension case criteria also increased the risk of severe or persistent hypertension for hourly employees.

The association between long working hours and health: a systematic review of epidemiological evidence.

PubMed

Bannai, Akira; Tamakoshi, Akiko

2014-01-01

Many studies have investigated the association between long working hours and health. By focusing on differences in the definition of long working hours and the influence of shift work, we attempt to explain why the results of these studies remain inconclusive. We defined long working hours as working time greater than around 40 hours per week or 8 hours per day. Since previous studies have indicated that shift work is detrimental to health, we minimized the influence of shift work in the studies. We also placed importance on the existence of reference groups since this made the results clearer. Based on these points, we analyzed previous studies to clarify the epidemiological evidence regarding the association between long working hours and health. We established inclusion criteria and carried out a systematic search for articles published in the Medline and PsycINFO databases between 1995-2012. We identified a total of 17 articles and 19 studies (12 prospective cohort and 7 cross-sectional studies). The outcomes were all-cause mortality, circulatory disease, diabetes mellitus, metabolic syndrome, depressive state, anxiety, other psychological disorders, sleep condition, cognitive function, and health-related behavior. Long working hours had significant adverse effects on most health outcomes. We concluded that working long hours is associated with depressive state, anxiety, sleep condition, and coronary heart disease. However, further studies that appropriately deal with the definition of long working hours and shift work are needed.

Stability of hematologic analytes in monkey, rabbit, rat, and mouse blood stored at 4°C in EDTA using the ADVIA 120 hematology analyzer.

PubMed

Ameri, Mehrdad; Schnaars, Henry A; Sibley, John R; Honor, David J

2011-06-01

The time from sampling to analysis can be delayed when blood samples are shipped to distant reference laboratories or when analysis cannot be readily performed. The objective of this study was to evaluate the stability of hematologic analytes in blood samples from monkeys, rabbits, rats, and mice when samples were stored for up to 72 hours at 4°C. Blood samples from 30 monkeys, 15 rabbits, 20 rats, and 30 mice were collected into EDTA-containing tubes and were initially analyzed within 1 hour of collection using the ADVIA 120 analyzer. The samples were then stored at 4°C and reanalyzed at 24, 48, and 72 hours after collection. Significant (P<.0003) changes in hematologic analytes and calculations included increased HCT and MCV and decreased MCHC and cell hemoglobin concentration mean (CHCM) at 72 hours and increased MPV at 24 hours in monkeys; increased MCV at 72 hours and MPV at 48 hours and decreased monocyte count at 24 hours in rabbits; increased MCV and decreased MCHC, CHCM, and monocyte count at 24 hours in rats; increased MCV, red cell distribution width, and MPV and decreased MCHC, CHCM, and monocyte count at 24 hours in mice. Although most of the changes in the hematologic analytes in blood from monkeys, rabbits, rats, and mice when samples were stored at 4°C were analytically acceptable and clinically negligible, the best practice in measuring hematologic analytes in these animals is timely processing of blood samples, preferably within 1 hour after collection. ©2011 American Society for Veterinary Clinical Pathology.

Total and segmental colon transit time in constipated children assessed by scintigraphy with 111In-DTPA given orally.

PubMed

Vattimo, A; Burroni, L; Bertelli, P; Messina, M; Meucci, D; Tota, G

1993-12-01

Serial colon scintigraphy using 111In-DTPA (2 MBq) given orally was performed in 39 children referred for constipation, and the total and segmental colon transit times were measured. The bowel movements during the study were recorded and the intervals between defecations (ID) were calculated. This method proved able to identify children with normal colon morphology (no. = 32) and those with dolichocolon (no. = 7). Normal children were not included for ethical reasons and we used the normal range determined by others using x-ray methods (29 +/- 4 hours). Total and segmental colon transit times were found to be prolonged in all children with dolichocolon (TC: 113.55 +/- 41.20 hours; RC: 39.85 +/- 26.39 hours; LC: 43.05 +/- 18.30 hours; RS: 30.66 +/- 26.89 hours). In the group of children with a normal colon shape, 13 presented total and segmental colon transit times within the referred normal value (TC: 27.79 +/- 4.10 hours; RC: 9.11 +/- 2.53 hours; LC: 9.80 +/- 3.50 hours; RS: 8.88 +/- 4.09 hours) and normal bowel function (ID: 23.37 +/- 5.93 hours). In the remaining children, 5 presented prolonged retention in the rectum (RS: 53.36 +/- 29.66 hours), and 14 a prolonged transit time in all segments. A good correlation was found between the transit time and bowel function. From the point of view of radiation dosimetry, the most heavily irradiated organs were the lower large intestine and the ovaries, and the level of radiation burden depended on the colon transit time. We can conclude that the described method results safe, accurate and fully diagnostic.

Growth and tuberization of potato (Solanum tuberosum L.) under continuous light

NASA Technical Reports Server (NTRS)

Wheeler, R. M.; Tibbitts, T. W.

1986-01-01

The growth and tuberization of potatoes (Solanum tuberosum L.) maintained for 6 weeks under four different regimes of continuous irradiance were compared to plants given 12 hours light and 12 hours dark. Treatments included: (a) continuous photosynthetic photon flux of 200 micromoles per square meter per second cool-white fluorescent (CWF); (b) continuous 400 micromoles per square meter per second CWF; (c) 12 hours 400 micromoles per square meter per second CWF plus 12 hours dim CWF at 5 micromoles per square meter per second; (d) 12 hours [400] micromoles per square meter per second CWF plus 12 hours dim incandescent (INC) at 5 micromoles per square meter per second and a control treatment of 12 hours light at 400 micromoles per square meter per second CWF and 12 hours dark. The study included five cultivars ranging from early- to late-season types: 'Norland,' 'Superior,''Norchip,' 'Russet Burbank,' and 'Kennebec,' Tuber development progressed well under continuous irradiation at 400 micromoles per square meter per second and under 12 hours irradiance and 12 hours dark, while tuber development was suppressed in all other light treatments. Continuous irradiation at 200 or 400 micromoles per square meter per second resulted in severe stunting and leaf malformation on 'Superior' and 'Kennebec' plants, but little or no injury and vigorous shoot growth in the other cultivars. No injury or stunting were apparent under 12-dim light or 12-dark treatments. Plants given 12 hours dim INC showed significantly greater stem elongation but less total biomass than plants in other treatments. The continuous light encouraged shoot growth over tuber growth but this trend was overridden by providing a high irradiance level. The variation among cultivars for tolerance to continuous lighting indicates that potato may be a useful species for photoinhibition studies.

Growth and Tuberization of Potato (Solanum tuberosum L.) under Continuous Light 1

PubMed Central

Wheeler, Raymond M.; Tibbitts, Theodore W.

1986-01-01

The growth and tuberization of potatoes (Solanum tuberosum L.) maintained for 6 weeks under four different regimes of continuous irradiance were compared to plants given 12 hours light and 12 hours dark. Treatments included: (a) continuous photosynthetic photon flux of 200 micromoles per square meter per second cool-white fluorescent (CWF); (b) continuous 400 micromoles per square meter per second CWF; (c) 12 hours 400 micromoles per square meter per second CWF plus 12 hours dim CWF at 5 micromoles per square meter per second; (d) 12 hours micromoles per square meter per second CWF plus 12 hours dim incandescent (INC) at 5 micromoles per square meter per second and a control treatment of 12 hours light at 400 micromoles per square meter per second CWF and 12 hours dark. The study included five cultivars ranging from early- to late-season types: `Norland,' `Superior,' `Norchip,' `Russet Burbank,' and `Kennebec.' Tuber development progressed well under continuous irradiation at 400 micromoles per square meter per second and under 12 hours irradiance and 12 hours dark, while tuber development was suppressed in all other light treatments. Continuous irradiation at 200 or 400 micromoles per square meter per second resulted in severe stunting and leaf malformation on `Superior' and `Kennebec' plants, but little or no injury and vigorous shoot growth in the other cultivars. No injury or stunting were apparent under 12-dim light or 12-dark treatments. Plants given 12 hours dim INC showed significantly greater stem elongation but less total biomass than plants in other treatments. The continuous light encouraged shoot growth over tuber growth but this trend was overridden by providing a high irradiance level. The variation among cultivars for tolerance to continuous lighting indicates that potato may be a useful species for photoinhibition studies. PMID:11539039

Circadian phase-shifting effects of a laboratory environment: a clinical trial with bright and dim light.

PubMed

Youngstedt, Shawn D; Kripke, Daniel F; Elliott, Jeffrey A; Rex, Katharine M

2005-09-09

Our aims were to examine the influence of different bright light schedules on mood, sleep, and circadian organization in older adults (n = 60, ages 60-79 years) with insomnia and/or depression, contrasting with responses of young, healthy controls (n = 30, ages 20-40 years). Volunteers were assessed for one week in their home environments. Urine was collected over two 24-hour periods to establish baseline acrophase of 6-sulphatoxymelatonin (aMT6s) excretion. Immediately following home recording, volunteers spent five nights and four days in the laboratory. Sleep periods were fixed at eight hours in darkness, consistent with the volunteers' usual sleep periods. Volunteers were randomly assigned to one of three light treatments (four hours per day) within the wake period: (A) two hours of 3,000 lux at 1-3 hours and 13-15 hours after arising; (B) four hours of 3,000 lux at 6-10 hours after arising; (C) four hours of dim placebo light at 6-10 hours after arising. Lighting was 50 lux during the remainder of wakefulness. The resulting aMT6s acrophase was determined during the final 30 hours in the laboratory. Neither mood nor total melatonin excretion differed significantly by treatment. For the three light treatments, significant and similar phase-response plots were found, indicating that the shift in aMT6s acrophase was dependent upon the circadian time of treatment. The changes in circadian timing were not significantly correlated to changes in sleep or mood. The trial failed to demonstrate photoperiodic effects. The results suggest that even low levels of illumination and/or fixed timing of behavior had significant phase-shifting effects.

Working hours and self-rated health over 7 years: gender differences in a Korean longitudinal study.

PubMed

Cho, Seong-Sik; Ki, Myung; Kim, Keun-Hoe; Ju, Young-Su; Paek, Domyung; Lee, Wonyun

2015-12-23

To investigate the association between long working hours and self-rated health (SRH), examining the roles of potential confounding and mediating factors, such as job characteristics. Data were pooled from seven waves (2005-2011) of the Korean Labour and Income Panel Study. A total of 1578 workers who consecutively participated in all seven study years were available for analysis. A generalized estimating equation for repeated measures with binary outcome was used to examine the association between working hours (five categories; 20-35, 36-40, 41-52, 53-68 and ≥ 69 h) and SRH (two categories; poor and good health), considering possible confounders and serial correlation. Associations between working hours and SRH were observed among women, but only for the category of the shortest working hours among men. The associations with the category of shortest working hours among men and women disappeared after adjustment for socioeconomic factors. Among women, though not men, working longer than standard hours (36-40 h) showed a linear association with poor health; OR = 1.41 (95% CI = 1.08-1.84) for 52-68 working hours and OR = 2.11 (95% CI = 1.42-3.12) for ≥ 69 working hours. This association persisted after serial adjustments. However, it was substantially attenuated with the addition of socioeconomic factors (e.g., OR = 1.66 (95% CI = 1.07-2.57)) but only slightly attenuated with further adjustment for behavioural factors (e.g., OR = 1.63 (95% CI = 1.05-2.53)). The associations with job satisfaction were significant for men and women. The worsening of SRH with increasing working hours only among women suggests that female workers are more vulnerable to long working hours because of family responsibilities in addition to their workload.

Associations of work hours with carotid intima-media thickness and ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Charles, Luenda E; Fekedulegn, Desta; Burchfiel, Cecil M; Fujishiro, Kaori; Landsbergis, Paul; Diez Roux, Ana V; Macdonald, Leslie; Foy, Capri G; Andrew, Michael E; Stukovsky, Karen H; Baron, Sherry

2012-10-01

Long working hours may be associated with cardiovascular disease (CVD). The objective was to investigate cross-sectional associations of work hours with carotid intima-media thickness (CIMT) and ankle-brachial index (ABI). Participants were 1694 women and 1868 men from the Multi-Ethnic Study of Atherosclerosis. CIMT and ABI were measured using standard protocols. Information on work hours was obtained from questionnaires. Mean values of CIMT and ABI were examined across five categories of hours worked per week (≤20, 21-39, 40, 41-50 and >50) using analysis of variance/analysis of covariance. p Values for trend were obtained from linear regression models. Mean age of participants was 56.9±8.4 years; 52.4% were men. Distinct patterns of association between work hours and the subclinical CVD biomarkers were found for women and men, although this heterogeneity by gender was not statistically significant. Among women only, work hours were positively associated with common (but not internal) CIMT (p=0.073) after full risk factor adjustment. Compared with women working 40 h, those working >50 h were more likely to have an ABI <1 (vs 1-1.4) (OR=1.85, 95% CI 1.01 to 3.38). In men, work hours and ABI were inversely associated (p=0.046). There was some evidence that the association between work hours and ABI was modified by occupational category (interaction p=0.061). Among persons classified as management/professionals, longer work hours was associated with lower ABI (p=0.015). No significant associations were observed among other occupational groups. Working longer hours may be associated with subclinical CVD. These associations should be investigated using longitudinal studies.

Development Study of Pedestrian Bridge at Gramedia Bookstore Jalan Raden Intan Bandar Lampung

NASA Astrophysics Data System (ADS)

Bernaditha, C. M.

2018-03-01

Bandar Lampung with high enough population densities has provides transportation facilities for pedestrian such as pedestrian bridge. This pedestrian bridges spread at Bandar Lampung’s traffic congested area, shopping centre nor education centre. Jl. Raden Intan as one of primary collector road with four lanes one direction at Bandar Lampung has high LHR (average daily traffic) movemenet pattern especially at morning, day and afternoon rush hour that make it difficult for pedestrian who want to cross the road. Therefore pedes trian bridge at this section Jl. Raden Intan highly needed especially at in front of Gramedia Bookstore with large amount of crossing pedestrian volume. From this research and analysis, found that number of LHR (average daily traffic) at Jl. Raden Intan shows large number traffic volume that is 4509 passenger car unit/hour at morning rush hour (07.00-08.30), with value of V/C Ratio or Degree of Saturation reach 0,92 (E category), while the amount of pedestrian who cross ahead from Gramedia Bookstore to Bank Muammalat is 29 people per 15 minutes. Other than that based on the calculation results of pedestrian volume and traffic volume at rush hour as follow: average pedestrian volume at rush hour is 146 people/hour between the range 100-1250 people/hour and traffic volume 7521 vehicles/hour over than 7000 vehicles/hour, and also the value PV2=1,682x1010 which is means the value of PV2 worth over 2x108, moreover the speed plan Jl. Raden Intan between 60-80 km/hour above 70 km/hour. Based on the calculation and analysis above, it can be concluded transportation facilities recommended for Jl. Raden Intan is pedestrian bridge.

Effect of the duration of food withholding prior to anesthesia on gastroesophageal reflux and regurgitation in healthy dogs undergoing elective orthopedic surgery.

PubMed

Viskjer, Sivert; Sjöström, Lennart

2017-02-01

OBJECTIVE To compare the incidence of and risk factors for gastroesophageal reflux (GER) and regurgitation associated with preanesthetic food withholding for periods of 18 hours (overnight) and 3 hours in healthy dogs undergoing elective orthopedic surgery. ANIMALS 82 healthy (American Society of Anesthesiologists physical status classification I or II) client-owned dogs. PROCEDURES Food was withheld for 18 hours (18-hour group [n = 41]) or each dog was allowed to consume half its daily ration of canned food approximately 3 hours (3-hour group [n = 41]) prior to induction of anesthesia. In each anesthetized dog, a pH catheter was introduced through the oropharynx into the distal portion of the esophagus; the pH was continuously recorded throughout the period of anesthesia. Gastroesophageal reflux was defined as pH < 4.0. RESULTS Gastroesophageal reflux was significantly associated with age, dorsal recumbency, and duration of preanesthetic food withholding. Regurgitation was significantly associated with duration of GER and duration of preanesthetic food withholding. During anesthesia, 25 (61%) dogs in the 3-hour group had GER and 12 (48%) of those dogs regurgitated gastric content; 18 (43.9%) dogs in the 18-hour group had GER and 2 (11.1%) of those dogs regurgitated gastric content. The mean lowest pH measured in the refluxate in the 3-hour group (2.3) was significantly greater than that in the 18-hour group (1.3). CONCLUSIONS AND CLINICAL RELEVANCE Among the study dogs undergoing orthopedic surgery, consumption of a light meal 3 hours prior to anesthesia was associated with significantly greater odds of reflux and regurgitation, compared with overnight food withholding.

Associations Between Sedentary Behaviors, Sleep Patterns, and BMI in Young Dancers Attending a Summer Intensive Dance Training Program.

PubMed

Stracciolini, Andrea; Stein, Cynthia J; Kinney, Susan; McCrystal, Tara; Pepin, Michael J; Meehan Iii, William P

2017-09-15

The purpose of this study was to investigate associations between sedentary behaviors, sleep hours, and body mass index (BMI) in 12- to 17-year-old dancers. This was a cross sectional survey in which bivariate correlation and simple linear regression were used to determine associations between self-reported components. One hundred fifteen dancers were queried, 91.3% of whom were female. The mean BMI was 19.6 ± 2.3 kg/m2. Two-thirds of dancers fell below the 50th percentile for age-adjusted BMI, and 30.4% fell below the 25th percentile. Better than 12% of dancers reported a history of anxiety, and 2.6% reported depression. Mean hours of sleep per night was 7.8 ± 0.9, with 58% of the dancers getting less than 8 hours of sleep per night. The mean total screen time for dancers was 3.4 ± 2.1 hours/day, which consisted of tablet and computer usage: 1.6 ± 1.1 hours/day; texting: 0.5 ± 1.1 hours/day; watching television: 1.2 ± 1.1 hours/day; and playing video games 1.2 ± 1.1 hours/ day. Total screen time was independently associated positively with BMI, explaining nearly 10% of the variability in BMI. Age, hours dancing per day, and hours of sleep per night were not independently associated with BMI. To summarize: screen time was associated with increased BMI in this young dancer cohort; the majority of dancers slept less than 8 hours per night; anticipatory guidance addressing media use and sleep hygiene in the adolescent dancer population is needed.

Daily variations in the thermoregulatory behaviors of naked neck broilers in an equatorial semi-arid environment.

PubMed

de Queiroz, João Paulo Araújo Fernandes; de Souza, João Batista Freire; de Lima, Hiagos Felipe Ferreira; de Oliveira Costa, Monik Kelly; de Macedo Costa, Leonardo Lelis; de Arruda, Alex Martins Varela

2014-08-01

The aim of this study was to evaluate the daily variations in the thermoregulatory behavior of 4- to 6-week-old naked neck broilers (Label Rouge) in an equatorial semi-arid environment. A total of 220 birds were monitored for 5 days starting at 0600 hours and ending at 1800 hours. The period of observation was divided into classes of hours (C H). The observed behaviors were as follows: feed and water intake, wing-spreading, sitting or lying, and beak-opening. A total of 14,300 behavioral data values were registered. In C H 2 (0900 hours to 1100 hours) and 3 (1200 hours to 1500 hours), the greatest average body surface temperature was recorded (34.67 ± 0.25 °C and 35.12 ± 0.22 °C, respectively). The C H had an effect on the exhibition of all behaviors with the exception of the water intake behavior. Feed intake was more frequent in C H 1 (0600 hours to 0800 hours) and 4 (1600 hours to 1800 hours). In C H 2 and 3, the highest frequency of sitting or lying behavior was observed. Beak-opening and wing-spreading behaviors occurred more frequently in C H 3 where the body surface temperature (35.12 ± 0.22 °C), radiant heat load (519.38 ± 2.22 W m(-2)), and enthalpy (82.74 ± 0.36 kJ kg(-1) of dry air) reached maximum recorded averages. Thus, it can be concluded that naked neck broilers adjust their behavior in response to daily variations in the thermal environment. Wing-spreading and beak-opening behaviors are important adaptive responses to the thermal challenges posed by the equatorial semi-arid environment.

The intervention research on treatment by Xianchen to rabbits model of chemotherapeutic phlebitis.

PubMed

Zhang, Jing; Shen, Juan; Yin, Weiwei; Wei, Xiaoyu; Wu, Ligao; Liu, Hao

2016-08-01

To develop a chemotherapeutics induced phlebitis and explore the effects of Xianchen on the phlebitis treatment. Forty-eight rabbits were divided into two series. Phlebitis model induced by vincristine was established at each series. The first series had 24 rabbits, which were divided into four groups (6 hours, 12 hours, 18 hours, 24 hours) after vincristine infusion. The grades of phlebitis through visual observation and histopathological examination were observed. The second series had also 24 rabbits. Interventions were performed 12 hours after vincristine infusion. These rabbits were randomly divided into four groups, according to treatment: Hirudoid (bid), Xianchen (daily), Xianchen (tid), Xianchen (five times a day). Four days after intervention, the venous injury through visual observation and histopathological examination were evaluated. Series 1: Phlebitis appeared 12 hours after infusion of vincristine through visual observation. There was a significant difference (p<0.05) between 6 hours and 24 hours, 6 hours and 18 hours through visual observation. However, the inflammation happened 6 hours after infusion, the loss of venous endothelial cells demonstrated differences among four groups through histopathological evaluation (p<0.05). There were significant differences (p<0.05) after 4 days among the intervention groups through visual observation, the effects of Xianchen group (five times a day) were better than Xianchen group (tid) (p<0.01). The treatment of edema demonstrated differences among groups through histopathological evaluation (p<0.05), Xianchen (five times a day) better relieved the degree of edema (p<0.05). The study showed that inflammatory reaction of phlebitis appeared early. Xianchen can treat vincristine induced phlebitis, as well as Hirudoid. It is particularly effective in the treatment of edema, and there is a remarkable dose-response relationship.

Pregnancy outcomes using stallion epididymal sperm stored at 5 °C for 24 or 48 hours before harvest.

PubMed

Stawicki, R J; McDonnell, S M; Giguère, S; Turner, R M

2016-03-01

The cryopreservation of epididymal sperm can be useful in a variety of circumstances for ensuring genetic preservation of a valued stallion. Although early studies have reported pregnancy rates significantly lower than those achieved with cryopreserved ejaculated sperm, two recent studies report over 60% one-cycle pregnancy rates with epididymal sperm stored for 24 hours at 5 °C before harvest and cryopreservation. The aims of this study were to: (1) attempt to replicate the one-cycle pregnancy rate of over 60% using epididymal sperm cooled and stored within the epididymis for 24 hours before harvest and cryopreservation and (2) evaluate pregnancy outcome with sperm cooled and stored within the epididymis for 48 hours before sperm harvest and cryopreservation. Testicles were obtained from 13 stallions undergoing routine castration. The epididymides were stored at 5 °C for either 24 or 48 hours before sperm harvest and cryopreservation in an egg yolk and dimethylformamide-based freezing extender. Thirteen mares were bred on one cycle with cryopreserved epididymal sperm stored for 24 hours before harvest, and 10 of those 13 mares were also bred on a previous or subsequent cycle with samples from the same stallion that had been stored for 48 hours before harvest. Pregnancy occurred in 7 of the 13 inseminations of sperm stored for 24 hours before harvest, and in 4 of the 10 inseminations of sperm stored for 48 hours before harvest. The pregnancy rate using epididymal sperm stored for 24 hours before harvest is consistent with that of previous reports. In addition, these results provide evidence that pregnancies can be achieved when the epididymides are cooled and stored for 48 hours before sperm harvest and cryopreservation. Copyright © 2016 Elsevier Inc. All rights reserved.

Gender, family status and physician labour supply.

PubMed

Wang, Chao; Sweetman, Arthur

2013-10-01

With the increasing participation of women in the physician workforce, it is important to understand the sources of differences between male and female physicians' market labour supply for developing effective human resource policies in the health care sector. Gendered associations between family status and physician labour supply are explored in the Canadian labour market, where physicians are paid according to a common fee schedule and have substantial discretion in setting their hours of work. Canadian 1991, 1996, 2001 and 2006 twenty percent census files with 22,407 physician observations are used for the analysis. Although both male and female physicians have statistically indistinguishable hours of market work when never married and without children, married male physicians have higher market hours, and their hours are unchanged or increased with parenthood. In contrast, female physicians have lower market hours when married, and much lower hours when a parent. Little change over time in these patterns is observed for males, but for females two offsetting trends are observed: the magnitude of the marriage-hours effect declined, whereas that for motherhood increased. Preferences and/or social norms induce substantially different labour market outcomes. In terms of work at home, the presence of children is associated with higher hours for male physicians, but for females the hours increase is at least twice as large. A male physician's spouse is much less likely to be employed, and if employed, has lower market hours in the presence of children. In contrast, a female physician's spouse is more likely to be employed if there are three or more children. Both male and female physicians have lower hours of work when married to another physician. Overall, there is no gender difference in physician market labour supply after controlling for family status and demographics. Copyright © 2013 Elsevier Ltd. All rights reserved.

Working hours and common mental disorders in English police officers.

PubMed

Houdmont, J; Randall, R

2016-12-01

There is a paucity of evidence on working hours and their psychological correlates in police officers of the federated ranks in England. An exploratory study to establish the extent to which a sample of English police officers worked long hours and the association between long working hours and common mental disorder (CMD). Officers of the federated ranks (constable, sergeant, inspector) from two English county forces completed a questionnaire to report their typical weekly working hours and symptoms of CMD. We also collected socio- and occupational-demographic data. We defined long working hours as ≥49 h in a typical week in accordance with 48-h weekly limit specified in the 1993 European Directive on the Organisation of Working Time. We established associations between long working hours and self-reported CMDs using binary logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potential confounding variables. Twenty-seven per cent (n = 327/1226) of respondents reported long working hours. The ORs for psychological distress (OR 2.05, 95% CI 1.57-2.68), emotional exhaustion (OR 1.99, 95% CI 1.52-2.59), and depersonalization (OR 1.30, 95% CI 1.00-1.71) were significantly increased for long working hours after adjustment for socio- and occupational-demographic characteristics. More than one quarter of sampled police officers reported working long hours and were significantly more likely to report CMD. National and longitudinal research is required to confirm these findings, which suggest management of working hours may effectively promote psychological well-being. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reliability of the nursing care hour measure: a descriptive study.

PubMed

Klaus, Susan F; Dunton, Nancy; Gajewski, Byron; Potter, Catima

2013-07-01

The nursing care hour has become an international standard unit of measure in research where nurse staffing is a key variable. Until now, there have been no studies verifying whether nursing care hours obtained from hospital data sources can be collected reliably. To examine the processes used by hospitals to generate nursing care hour data and to evaluate inter-rater reliability and guideline compliance with standards of the National Database of Nursing Quality Indicators(®) (NDNQI(®)) and the National Quality Forum. Two-phase descriptive study of all NDNQI hospitals that submitted data in third quarter of 2007. Data for phase I came from an online survey created by the authors to ascertain the processes used by hospitals to collect nursing care hours and their compliance with standardized data collection guidelines. In phase II, inter-rater reliability was measured using intra-class correlations between nursing care hours generated from clock hour files submitted to the study team by participants' payroll/accounting departments and aggregated data submitted previously. Phase I data were obtained from a total of 714 respondents. Nearly half (48%) of all sites use payroll records to obtain nursing care hour data and 70% use one of the standardized methods for converting the bi-weekly hours into months. Unit secretaries were reportedly included in NCH by 17.4% of respondents and only 26.2% of sites could accurately identify the point at which newly hired nurses should be included. The phase II findings (n=11) support the ability of two independent raters to obtain similar results when calculating total nursing care hours according to standard guidelines (ICC=0.76-0.99). Although barriers exist, this study found support for hospitals' abilities to collect reliable nursing care hour data. Copyright © 2012 Elsevier Ltd. All rights reserved.

The effect of pre-anaesthetic fasting time and type of food on gastric content volume and acidity in dogs.

PubMed

Savvas, Ioannis; Rallis, Timoleon; Raptopoulos, Dimitris

2009-11-01

To investigate the effect of pre-anaesthetic fasting time and variety of food on gastric content (GC) volume and pH in dogs. Randomized, cross-over, prospective experimental study. Fifteen mongrel dogs (nine females and six males 1-4 years old, weighing 10-24.5 kg). Each dog received the same seven treatments in random order: dry food 3 hours before anaesthesia (BA) (treatment 3D), canned food (half daily rate) 3 hours BA (treatment 3C), 0% fat cow milk 3 hours BA (treatment 3M), dry food 10 hours BA (treatment 10D), canned food 10 hours BA (treatment 10C), low fat canned food 10 hours BA (treatment 10F) and low protein canned food 10 hours BA (treatment 10P). All animals were pre-medicated with propionyl promazine and anaesthesia was induced with thiopental sodium and maintained with halothane. GC was aspirated using an orogastric catheter and its volume and pH were measured. Treatment 10F had significantly lower GC pH than all the 3-hour treatments. Treatments 10D and 10P had significantly lower pH than treatments 3D and 3C. Treatment 3M had significantly lower pH than the other 3-hour treatments. Treatment 3D had significantly greater gastric volume than treatments 3M, 10C, 10F and 10P. Canned food at half the daily rate administered 3 hours before anaesthesia did not increase significantly the GC volume compared to the other types of food used. The GC pH was also high. This type of food fed 3 hours before induction of anaesthesia may be of benefit in reduction of the incidence of gastro-oesophageal reflux during anaesthesia in dogs.

Pulmonary disposition and pharmacokinetics of minocycline in adult horses.

PubMed

Echeverria, Kate O; Lascola, Kara M; Giguère, Steeve; Foreman, Jonathan H; Austin, Scott A

2017-11-01

OBJECTIVE To determine pharmacokinetics and pulmonary disposition of minocycline in horses after IV and intragastric administration. ANIMALS 7 healthy adult horses. PROCEDURES For experiment 1 of the study, minocycline was administered IV (2.2 mg/kg) or intragastrically (4 mg/kg) to 6 horses by use of a randomized crossover design. Plasma samples were obtained before and 16 times within 36 hours after minocycline administration. Bronchoalveolar lavage (BAL) was performed 4 times within 24 hours after minocycline administration for collection of pulmonary epithelial lining fluid (PELF) and BAL cells. For experiment 2, minocycline was administered intragastrically (4 mg/kg, q 12 h, for 5 doses) to 6 horses. Plasma samples were obtained before and 20 times within 96 hours after minocycline administration. A BAL was performed 6 times within 72 hours after minocycline administration for collection of PELF samples and BAL cells. RESULTS Mean bioavailability of minocycline was 48% (range, 35% to 75%). At steady state, mean ± SD maximum concentration (Cmax) of minocycline in plasma was 2.3 ± 1.3 μg/mL, and terminal half-life was 11.8 ± 0.5 hours. Median time to Cmax (Tmax) was 1.3 hours (interquartile range [IQR], 1.0 to 1.5 hours). The Cmax and Tmax of minocycline in the PELF were 10.5 ± 12.8 μg/mL and 9.0 hours (IQR, 5.5 to 12.0 hours), respectively. The Cmax and Tmax for BAL cells were 0.24 ± 0.1 μg/mL and 6.0 hours (IQR, 0 to 6.0 hours), respectively. CONCLUSIONS AND CLINICAL RELEVANCE Minocycline was distributed into the PELF and BAL cells of adult horses.

Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis.

PubMed

Dorhout Mees, Sanne M; Algra, Ale; Wong, George K C; Poon, Wai S; Bradford, Celia M; Saver, Jeffrey L; Starkman, Sidney; Rinkel, Gabriel J E; van den Bergh, Walter M; van Kooten, F; Dirven, C M; van Gijn, J; Vermeulen, M; Rinkel, G J E; Boet, R; Chan, M T V; Gin, T; Ng, S C P; Zee, B C Y; Al-Shahi Salman, R; Boiten, J; Kuijsten, H; Lavados, P M; van Oostenbrugge, R J; Vandertop, W P; Finfer, S; O'Connor, A; Yarad, E; Firth, R; McCallister, R; Harrington, T; Steinfort, B; Faulder, K; Assaad, N; Morgan, M; Starkman, S; Eckstein, M; Stratton, S J; Pratt, F D; Hamilton, S; Conwit, R; Liebeskind, D S; Sung, G; Kramer, I; Moreau, G; Goldweber, R; Sanossian, N

2015-11-01

Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but individual trials had not enough power for such a subanalysis. We performed an individual patient data meta-analysis to study whether magnesium is effective when given within different time frames within 24 hours after the SAH. Patients were divided into categories according to the delay between symptom onset and start of the study medication: <6, 6 to 12, 12 to 24, and >24 hours. We calculated adjusted risk ratios with corresponding 95% confidence intervals for magnesium versus placebo treatment for poor outcome and DCI. We included 5 trials totaling 1981 patients; 83 patients started treatment<6 hours. For poor outcome, the adjusted risk ratios of magnesium treatment for start <6 hours were 1.44 (95% confidence interval, 0.83-2.51); for 6 to 12 hours 1.03 (0.65-1.63), for 12 to 24 hours 0.84 (0.65-1.09), and for >24 hours 1.06 (0.87-1.31), and for DCI, <6 hours 1.76 (0.68-4.58), for 6 to 12 hours 2.09 (0.99-4.39), for 12 to 24 hours 0.80 (0.56-1.16), and for >24 hours 1.08 (0.88-1.32). This meta-analysis suggests no beneficial effect of magnesium treatment on poor outcome or DCI when started early after SAH onset. Although the number of patients was small and a beneficial effect cannot be definitively excluded, we found no justification for a new trial with early magnesium treatment after SAH. © 2015 American Heart Association, Inc.

The desire and capability of Australian general practitioners to change their working hours.

PubMed

Norman, Richard; Hall, Jane P

2014-04-21

To explore factors associated with general practitioners' desire to work less and their success in making that change. Waves 3 and 4 (conducted in 2010 and 2011) of a national longitudinal survey of Australian doctors in clinical practice (Medicine in Australia: Balancing Employment and Life). Of the broader group of medical practitioners in the survey, there were 3664 and 3436 GP completers in Waves 3 and 4, respectively. The association between the desire to reduce hours and doctor, job and geographic characteristics; the association between predictors of the capability to reduce hours and these same doctor, job and geographic characteristics. Over 40% of GPs stated a preference to reduce their working hours. Characteristics that predicted this preference were being middle-aged, being female, working ≥ 40 hours per week (all P < 0.01), and being on call (P = 0.03). Factors associated with not wanting to reduce working hours were being in excellent health, being satisfied or very satisfied with work (both P < 0.01), and not being a partner in a practice (P < 0.01 for a number of alternative options [ie, associates, contractors and locums]). Of those who wanted to reduce working hours, 26.8% successfully managed to do so in the subsequent year (where reduction was defined as reducing hours by at least 5 per week). Predictors of successfully reducing hours were being younger, female and working ≥ 40 hours per week (all P < 0.01). A number of factors appear to determine both the desire of GPs to reduce hours and their subsequent success in doing so. Declining working hours have contributed to the perceived shortage in GPs. Therefore, designing policies that address not just the absolute number of medical graduates but also their subsequent level of work may alleviate some of the pressures on the Australian primary health care system.

THE SLEEP OF LONG-HAUL TRUCK DRIVERS

PubMed Central

Mitler, Merrill M.; Miller, James C.; Lipsitz, Jeffrey J.; Walsh, James K.; Wylie, C. Dennis

2008-01-01

Background Fatigue and sleep deprivation are important safety issues for long-haul truck drivers. Methods We conducted round-the-clock electrophysiologic and performance monitoring of four groups of 20 male truck drivers who were carrying revenue-producing loads. We compared four driving schedules, two in the United States (five 10-hour trips of day driving beginning about the same time each day or of night driving beginning about 2 hours earlier each day) and two in Canada (four 13-hour trips of late-night-to-morning driving beginning at about the same time each evening or of afternoon-to-night driving beginning 1 hour later each day). Results Drivers averaged 5.18 hours in bed per day and 4.78 hours of electrophysiologically verified sleep per day over the five-day study (range, 3.83 hours of sleep for those on the steady 13-hour night schedule to 5.38 hours of sleep for those on the steady 10-hour day schedule). These values compared with a mean (±SD) self-reported ideal amount of sleep of 7.1±1 hours a day. For 35 drivers (44 percent), naps augmented the sleep obtained by an average of 0.45±0.31 hour. No crashes or other vehicle mishaps occurred. Two drivers had undiagnosed sleep apnea, as detected by polysomnography. Two other drivers had one episode each of stage 1 sleep while driving, as detected by electroencephalography. Forty-five drivers (56 percent) had at least 1 six-minute interval of drowsiness while driving, as judged by analysis of video recordings of their faces; 1067 of the 1989 six-minute segments (54 percent) showing drowsy drivers involved just eight drivers. Conclusions Long-haul truck drivers in this study obtained less sleep than is required for alertness on the job. The greatest vulnerability to sleep or sleep-like states is in the late night and early morning. PMID:9287232

Daily temporal patterns of heroin and cocaine use and craving: relationship with business hours regardless of actual employment status.

PubMed

Phillips, Karran A; Epstein, David H; Preston, Kenzie L

2013-10-01

Real-time monitoring of behavior using Ecological Momentary Assessment (EMA) has provided detailed data about daily temporal patterns of craving and use in cigarette smokers. We have collected similar data from a sample of cocaine and heroin users. Here we analyzed it in the context of its relationship with a societal construct of daily temporal organization: 9-to-5 business hours. In a 28-week prospective study, 112 methadone-maintained polydrug-abusing individuals initiated an electronic-diary entry and provided data each time they used cocaine, heroin, or both during weeks 4 to 28. EMA data were collected for 10,781 person-days and included: 663 cocaine-craving events, 710 cocaine-use events, 288 heroin-craving events, 66 heroin-use events, 630 craving-both-drugs events, and 282 use-of-both-drugs events. At baseline, 34% of the participants reported full-time employment in the preceding 3-year period. Most participants' current employment status fluctuated throughout the study. In a generalized linear mixed model (SAS Proc Glimmix), cocaine use varied by time of day relative to business hours (p<0.0001) and there was a significant interaction between Day of the Week and Time Relative to Business Hours (p<0.002) regardless of current work status. Cocaine craving also varied by time of day relative to business hours (p<0.0001), however, there was no significant interaction between Day of the Week and Time Relative to Business Hours (p=.57). Heroin craving and use were mostly reported during business hours, but data were sparse. Cocaine craving is most frequent during business hours while cocaine use is more frequent after business hours. Cocaine use during business hours, but not craving, seems suppressed on most weekdays, but not weekends, suggesting that societal conventions reflected in business hours influence drug-use patterns even in individuals whose daily schedules are not necessarily dictated by employment during conventional business hours. Published by Elsevier Ltd.

Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey.

PubMed

Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

2015-01-01

Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09-1.70) for males and 1.38 (1.11-1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks' experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6-8 hours of nighttime sleep. In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion

PubMed Central

Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

2016-01-01

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. Commentary: A commentary on this article apears in this issue on page 1439. Citation: Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med 2016;12(11):1549–1561. PMID:27707447

Liquid-containing Refluxes and Acid Refluxes May Be Less Frequent in the Japanese Population Than in Other Populations: Normal Values of 24-hour Esophageal Impedance and pH Monitoring

PubMed Central

Kawamura, Osamu; Kohata, Yukie; Kawami, Noriyuki; Iida, Hiroshi; Kawada, Akiyo; Hosaka, Hiroko; Shimoyama, Yasuyuki; Kuribayashi, Shiko; Fujiwara, Yasuhiro; Iwakiri, Katsuhiko; Inamori, Masahiko; Kusano, Motoyasu; Hongo, Micho

2016-01-01

Background/Aims Twenty-four-hour esophageal impedance and pH monitoring allows detection of all types of reflux episodes and is considered the best technique for identifying gastroesophageal refluxes. However, normative data for the Japanese population are lacking. This multicenter study aimed to establish the normal range of 24-hour esophageal impedance and pH data both in the distal and the proximal esophagus in Japanese subjects. Methods Forty-two healthy volunteers (25 men and 17 women) with a mean ± standard deviation age of 33.3 ± 12.4 years (range: 22–72 years) underwent a combined 24-hour esophageal impedance and pH monitoring. According to the physical and pH properties, distal or proximal esophageal reflux events were categorized. Results Median 45 reflux events occurred in 24 hours, and the 95th percentile was 85 events. Unlike previous reports, liquid-containing reflux events are median 25/24 hours with the 95th percentile of 62/24 hours. Acidic reflux events were median 11/24 hours with the 95th percentile of 39/24 hours. Non-acidic gas reflux events were median 15/24 hours with the 95th percentile of 39/24 hours. Proximal reflux events accounted for 80% of the total reflux events and were mainly non-acidic gas refluxes. About 19% of liquid and mixed refluxes reached the proximal esophagus. Conclusions Unlike previous studies, liquid-containing and acidic reflux events may be less frequent in the Japanese population. Non-acidic gas reflux events may be frequent and a cause of frequent proximal reflux events. This study provides important normative data for 24-hour impedance and pH monitoring in both the distal and the proximal esophagus in the Japanese population. PMID:27247103

Development of accelerated net nitrate uptake. [Zea mays L

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

MacKown, C.T.; McClure, P.R.

1988-05-01

Upon initial nitrate exposure, net nitrate uptake rates in roots of a wide variety of plants accelerate within 6 to 8 hours to substantially greater rates. Effects of solution nitrate concentrations and short pulses of nitrate ({le}1 hour) upon nitrate-induced acceleration of nitrate uptake in maize (Zea mays L.) were determined. Root cultures of dark-grown seedlings, grown without nitrate, were exposed to 250 micromolar nitrate for 0.25 to 1 hour or to various solution nitrate concentration (10-250 micromolar) for 1 hour before returning them to a nitrate-free solution. Net nitrate uptake rates were assayed at various periods following nitrate exposuremore » and compared to rates of roots grown either in the absence of nitrate (CaSO{sub 4}-grown) or with continuous nitrate for at least 20 hours. Three hours after initial nitrate exposure, nitrate pulse treatments increased nitrate uptake rates three- to four-fold compared to the rates of CaSO{sub 4}-grown roots. When cycloheximide (5 micrograms per milliliter) was included during a 1-hour pulse with 250 micromolar nitrate, development of the accelerated nitrate uptake state was delayed. Otherwise, nitrate uptake rates reached maximum values within 6 hours before declining. Maximum rates, however, were significantly less than those of roots exposed continuously for 20, 32, or 44 hours. Pulsing for only 0.25 hour with 250 micromolar nitrate and for 1 hour with 10 micromolar caused acceleration of nitrate uptake, but the rates attained were either less than or not sustained for a duration comparable to those of roots pulsed for 1 hour with 250 micromolar nitrate. These results indicate that substantial development of nitrate-induced accelerated nitrate uptake state can be achieved by small endogenous accumulations of nitrate, which appear to moderate the activity or level of root nitrate uptake.« less

The urine output definition of acute kidney injury is too liberal

PubMed Central

2013-01-01

Introduction The urine output criterion of 0.5 ml/kg/hour for 6 hours for acute kidney injury (AKI) has not been prospectively validated. Urine output criteria for AKI (AKIUO) as predictors of in-hospital mortality or dialysis need were compared. Methods All admissions to a general ICU were prospectively screened for 12 months and hourly urine output analysed in collection intervals between 1 and 12 hours. Prediction of the composite of mortality or dialysis by urine output was analysed in increments of 0.1 ml/kg/hour from 0.1 to 1 ml/kg/hour and the optimal threshold for each collection interval determined. AKICr was defined as an increase in plasma creatinine ≥26.5 μmol/l within 48 hours or ≥50% from baseline. Results Of 725 admissions, 72% had either AKICr or AKIUO or both. AKIUO (33.7%) alone was more frequent than AKICr (11.0%) alone (P <0.0001). A 6-hour urine output collection threshold of 0.3 ml/kg/hour was associated with a stepped increase in in-hospital mortality or dialysis (from 10% above to 30% less than 0.3 ml/kg/hour). Hazard ratios for in-hospital mortality and 1-year mortality were 2.25 (1.40 to 3.61) and 2.15 (1.47 to 3.15) respectively after adjustment for age, body weight, severity of illness, fluid balance, and vasopressor use. In contrast, after adjustment AKIUO was not associated with in-hospital mortality or 1-year mortality. The optimal urine output threshold was linearly related to duration of urine collection (r2 = 0.93). Conclusions A 6-hour urine output threshold of 0.3 ml/kg/hour best associated with mortality and dialysis, and was independently predictive of both hospital mortality and 1-year mortality. This suggests that the current AKI urine output definition is too liberally defined. Shorter urine collection intervals may be used to define AKI using lower urine output thresholds. PMID:23787055

Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey

PubMed Central

Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

2015-01-01

Background Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Methods Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Results Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09–1.70) for males and 1.38 (1.11–1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks’ experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6–8 hours of nighttime sleep. Conclusion In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated. PMID:26080022

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

Surgeon distress as calibrated by hours worked and nights on call.

PubMed

Balch, Charles M; Shanafelt, Tait D; Dyrbye, Lotte; Sloan, Jeffrey A; Russell, Thomas R; Bechamps, Gerald J; Freischlag, Julie A

2010-11-01

The relationships of working hours and nights on call per week with various parameters of distress among practicing surgeons have not been previously examined in detail. More than 7,900 members of the American College of Surgeons responded to an anonymous, cross-sectional survey. The survey included self-assessment of their practice setting, a validated depression screening tool, and standardized assessments of burnout and quality of life. There was a clear gradient between hours and burnout, with the prevalence of burnout ranging from 30% for surgeons working <60 hours/week, 44% for 60 to 80 hours/week, and 50% for those working >80 hours/week (p < 0.001). When correlated with number of nights on call, burnout exhibited a threshold effect at ≥2 nights on call/week (≤1 nights on call/week, 30%; ≥2 nights on call/week, 44% to 46%; p < 0.0001). Screening positive for depression rate also correlated strongly with hours and nights on call (both p < 0.0001). Those who worked >80 hours/week reported a higher rate of medical errors compared with those who worked <60 hours/week (10.7% versus 6.9%; p < 0.001), and were twice as likely to attribute the error to burnout (20.1% versus 8.9%; p = 0.001). Not surprisingly, work and home conflicts were higher among surgeons who worked longer hours or had ≥2 nights on call. A significantly higher proportion of surgeons who worked >80 hours/week or had >2 nights on call/week would not become a surgeon again (p < 0.0001). Number of hours worked and nights on call per week appear to have a substantial impact on surgeons, both professionally and personally. These factors are strongly related to burnout, depression, career satisfaction, and work and home conflicts. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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.

Earlier Endpoints Are Required for Hemorrhagic Shock Trials among Severely Injured Patients

PubMed Central

Fox, Erin E.; Holcomb, John B.; Wade, Charles E.; Bulger, Eileen M.; Tilley, Barbara C.

2016-01-01

Background Choosing the appropriate endpoint for a trauma hemorrhage control trial can determine the likelihood of its success. Recent Phase 3 trials and observational studies have used 24-hour and/or 30-day all-cause mortality as the primary endpoint and some have not used exception from informed consent (EFIC), resulting in multiple failed trials. Five recent high-quality prospective studies among 4,064 hemorrhaging trauma patients provide new evidence to support earlier primary endpoints. Methods The goal of this project was to determine the optimal endpoint for hemorrhage control trials using existing literature and new analyses of previously published data. Results Recent studies among bleeding trauma patients show that hemorrhagic deaths occur rapidly, at a high rate, and in a consistent pattern. Early preventable deaths among trauma patients are largely due to hemorrhage and the median time to hemorrhagic death from admission is 2.0-2.6 hours. Approximately 85% of hemorrhagic deaths occur within 6 hours. The hourly mortality rate due to traumatic injury decreases rapidly after enrollment from 4.6% per hour at 1 hour post-enrollment to 1% per hour at 6 hours to <0.1% per hour by 9 hours and thereafter. Early primary endpoints (within 6 hours) have critically important benefits for hemorrhage control trials, including being congruent with the median time to hemorrhagic death, biologic plausibility, and enabling the use of all-cause mortality, which is definitive and objective. Conclusions Primary endpoints should be congruent with the timing of the disease process. Therefore, if a resuscitation/hemorrhage control intervention is under study, a primary endpoint of all-cause mortality evaluated within the first 6 hours is appropriate. Before choosing the timing of the primary endpoint for a large multicenter trial, we recommend performing a Phase 2 trial under EFIC to better understand the effects of the hemorrhage control intervention and distribution of time to death. When early primary endpoints are used, patients should be monitored for multiple subsequent secondary safety endpoints, including 24 hour and 30 day all-cause mortality as well as the customary safety endpoints. PMID:28207628

One-Hour Postload Hyperglycemia Confers Higher Risk of Hepatic Steatosis to HbA1c-Defined Prediabetic Subjects.

PubMed

Fiorentino, Teresa Vanessa; Andreozzi, Francesco; Mannino, Gaia Chiara; Pedace, Elisabetta; Perticone, Maria; Sciacqua, Angela; Perticone, Francesco; Sesti, Giorgio

2016-11-01

Individuals with glycated hemoglobin (HbA1c)-defined prediabetes (HbA1c value of 5.7-6.4%) and 1-hour plasma glucose ≥155 mg/dL during an oral glucose tolerance test have an increased risk of developing type 2 diabetes. To evaluate the degree to which HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL individually and jointly associate with hepatic steatosis and related biomarkers. A cross-sectional analysis was performed on 1108 White individuals. Ambulatory care. Anthropometric and metabolic characteristics including hepatic steatosis assessed by ultrasonography. Compared with the normal group (HbA1c <5.7%), HbA1c-defined prediabetic and diabetic individuals exhibit higher values of fasting, 1-hour, and 2-hour postload glucose; fasting and 2-hour postload insulin; triglycerides; uric acid; homeostasis model of assessment for insulin resistance; liver insulin resistance index; liver enzymes; and inflammatory biomarkers; and lower levels of high-density lipoprotein cholesterol and IGF-1. Prediabetic and diabetic subjects have increased risk of hepatic steatosis (1.5- and 2.46-fold, respectively). Stratifying participants according to HbA1c and 1-hour postload glucose, we found that individuals with HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL have significantly higher risk of hepatic steatosis as compared with individuals with HbA1c-defined prediabetes but 1-hour postload glucose <155 mg/dL. Individuals with HbA1c-defined prediabetes and 1-hour postload glucose ≥155 mg/dL exhibit higher values of liver enzymes; fasting, 1-hour, and 2-hour postload glucose; insulin; triglycerides; uric acid; and inflammatory biomarkers; and lower levels of high-density lipoprotein and IGF-1. These data suggest that a value of 1-hour postload glucose ≥155 mg/dL may be helpful to identify a subset of individuals within HbA1c-defined glycemic categories at higher risk of hepatic steatosis.

To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).

PubMed

Imtiyaz, Shagufta; Veqar, Zubia; Shareef, M Y

2014-01-01

To compare the effects of vibration therapy and massage in prevention of DOMS. Pre-test and Post-test Control-Group Design was used, 45 healthy female non athletic Subjects were recruited and randomly distributed to the three groups (15 subject in each group). After the subject's initial status was measured experimental groups received vibration therapy (50 Hz vibration for five minutes) or massage therapy (15 minutes) intervention and control group received no treatment, just prior to the eccentric exercise. Subjects were undergoing the following measurements to evaluate the changes in the muscle condition: muscle soreness (pain perception), Range of Motion (ROM), Maximum Isometric Force (MIF), Repetition maximum (RM), Lactate dehydrogenase (LDH) and Cretain Kinase (CK) level. All the parameters except LDH, CK and 1RM were measured before, immediately post intervention, immediately post exercise, 24 hours post exercise, 48 hours post exercise and 72 hours post exercise. LDH, CK and 1 RM were measured before and 48 hours post exercise. Muscle soreness was reported to be significantly less for experimental (vibration and massage) group (p=0.000) as compared to control group at 24, 48, and 72 hours of post-exercise. Experimental and control group did not show any significant difference in MIF immediate (p=0.2898), 24 hours (p=0.4173), 48 hours (p=0.752) and 72 hours (p=0.5297) of post-exercise. Range of motion demonstrated significant recovery in experimental groups in 48 hours (p=0.0016) and 72 hours (p=0.0463). Massage therapy showed significant recovery in 1RM (p=0.000) compared to control group and vibration therapy shows significantly less LDH level (p=0.000) 48 hours of post exercise compare to control group. CK at 48 hours of post exercise in vibration group (p=0.000) and massage group showed (p=0.002) significant difference as compared to control group. Vibration therapy and massage are equally effective in prevention of DOMS. Massage is effective in restoration of concentric strength (1 RM). Yet vibration therapy shows clinically early reduction of pain and is effective in decreasing the level of LDH in 48 hours post exercise periods.

Hours Lost to Planned and Unplanned Dental Visits Among US Adults.

PubMed

Kelekar, Uma; Naavaal, Shillpa

2018-01-11

Poor oral health is associated with lost hours at work or school, which may affect a person's productivity. The objective of our study was to estimate work or school hours lost to dental visits among adults aged 18 and older by the types of visits (emergency or unplanned; routine, planned, or orthodontic; or cosmetic) and to determine the factors associated with hours lost. We used the most recent Oral Health Supplement data, from the 2008 National Health Interview Survey (NHIS), to estimate the total hours lost at work or school for dental visits among adults in the United States. The associations of the hours lost in unplanned and planned dental visits with socioeconomic characteristics, oral health status, and affordability were calculated. We used χ 2 tests and logistic regression to determine associations at P < .05. An average of 320.8 million work or school hours were lost annually for dental care in the United States, of which 92.4 million hours were for emergency (unplanned) care (0.99 h/adult), 159.8 million for routine (planned) care or orthodontic care (1.71 h/adult), and 68.6 million for cosmetic care (0.73 h/adult). Adults with poor oral health were more likely to lose one or more hours in unplanned dental visits (OR = 5.60; 95% confidence interval [CI], 3.25-9.63) than those who reported very good oral health. Not being able to afford dental care was positively associated with more work hours lost in unplanned care (odds ratio [OR] = 2.56; 95% CI, 1.76-3.73). Compared with Hispanic adults, non-Hispanic white adults (OR = 2.09; 95% CI, 1.40-3.11) and non-Hispanic Asian adults and adults of other races/ethnicities (OR =1.91; 95% CI, 1.06-3.47) were more likely to lose any hours for planned care. Consistently, those with more than a high school education were more likely to lose any hours in planned care (OR = 1.39; 95% CI, 1.06-1.83) than those with a high school education or less. Dental problems result in hours lost from work and may adversely affect a person's productivity. There is disparity in lost hours at work by race/ethnicity and dental care affordability.

The Relation between Maternal Work Hours and Primary School Students' Affect in China: The Role of the Frequency of Mother-Child Communication (FMCC) and Maternal Education.

PubMed

Zhou, Huan; Lv, Bo; Guo, Xiaolin; Liu, Chunhui; Qi, Bing; Hu, Weiping; Liu, Zhaomin; Luo, Liang

2017-01-01

Background: Although substantial evidence suggests that maternal work hours may have a negative effect on children's cognitive development, the link between maternal work hours and children's affect remains unclear. Some studies have observed that non-daytime maternal work hours are associated with more emotional problems among children. However, few studies have focused on the effects of maternal work hours on workdays and non-workdays. Therefore, this study separately investigated the relation between maternal work hours on workdays and on non-workdays and explored the mediating role of the frequency of mother-child communication (FMCC) and the moderating role of maternal education. Method: Using cluster sampling, this study selected 879 students in grades 4-6 at two primary schools in the Hebei and Shandong provinces in China and their mothers as the study subjects. A multi-group structural equation model (SEM) was used to test the relations between maternal work hours, FMCC and children's affect and the moderating effect of maternal education. Results: (1) Non-college-educated mothers' work hours on workdays negatively predicted FMCC, but there was no such effect for college-educated mothers; (2) non-workday work hours of all employed mothers negatively predicted FMCC; (3) the FMCC of all employed mothers positively predicted children's positive affect; (4) the FMCC of college-educated mothers negatively predicted children's negative affect although there was no such relation for non-college-educated mothers; (5) there was a significant mediating effect of FMCC on the relation between maternal work hours and children's affect only for non-college-educated mothers; and (6) the workday work hours of non-college-educated mothers positively predicted children's negative affect, but this correlation was negative for college-educated mothers. Conclusion: Maternal work hours have a marginally significant negative effect on children's affect through FMCC only for non-college-educated mothers. Compared with non-college-educated mothers, college-educated mothers more easily compensate for the loss of communication opportunities caused by increased work hours on workdays, and children with college-educated mothers benefit more from this communication. However, compensating for the loss of communication opportunities caused by increased work hours on non-workdays is difficult for all employed mothers.

The Relation between Maternal Work Hours and Primary School Students’ Affect in China: The Role of the Frequency of Mother–Child Communication (FMCC) and Maternal Education

PubMed Central

Zhou, Huan; Lv, Bo; Guo, Xiaolin; Liu, Chunhui; Qi, Bing; Hu, Weiping; Liu, Zhaomin; Luo, Liang

2017-01-01

Background: Although substantial evidence suggests that maternal work hours may have a negative effect on children’s cognitive development, the link between maternal work hours and children’s affect remains unclear. Some studies have observed that non-daytime maternal work hours are associated with more emotional problems among children. However, few studies have focused on the effects of maternal work hours on workdays and non-workdays. Therefore, this study separately investigated the relation between maternal work hours on workdays and on non-workdays and explored the mediating role of the frequency of mother-child communication (FMCC) and the moderating role of maternal education. Method: Using cluster sampling, this study selected 879 students in grades 4–6 at two primary schools in the Hebei and Shandong provinces in China and their mothers as the study subjects. A multi-group structural equation model (SEM) was used to test the relations between maternal work hours, FMCC and children’s affect and the moderating effect of maternal education. Results: (1) Non-college-educated mothers’ work hours on workdays negatively predicted FMCC, but there was no such effect for college-educated mothers; (2) non-workday work hours of all employed mothers negatively predicted FMCC; (3) the FMCC of all employed mothers positively predicted children’s positive affect; (4) the FMCC of college-educated mothers negatively predicted children’s negative affect although there was no such relation for non-college-educated mothers; (5) there was a significant mediating effect of FMCC on the relation between maternal work hours and children’s affect only for non-college-educated mothers; and (6) the workday work hours of non-college-educated mothers positively predicted children’s negative affect, but this correlation was negative for college-educated mothers. Conclusion: Maternal work hours have a marginally significant negative effect on children’s affect through FMCC only for non-college-educated mothers. Compared with non-college-educated mothers, college-educated mothers more easily compensate for the loss of communication opportunities caused by increased work hours on workdays, and children with college-educated mothers benefit more from this communication. However, compensating for the loss of communication opportunities caused by increased work hours on non-workdays is difficult for all employed mothers. PMID:29075219

On the Integration of Wind and Solar Energy to Provide a Total Energy Supply in the U.S

NASA Astrophysics Data System (ADS)

Liebig, E. C.; Rhoades, A.; Sloggy, M.; Mills, D.; Archer, C. L.

2009-12-01

This study examines the feasibility of using renewable energy - mostly wind and solar radiation - as the primary sources of energy in the U.S., under the assumption that a nationwide electric transmission grid is in place. Previous studies have shown that solar output from California and Texas using energy storage is well correlated with the state energy load on an hour by hour basis throughout the year and with the US national load on a monthly basis. Other studies have shown that solar or wind alone can power the present US grid on average. This study explores scenarios for use of wind and solar energy together at the national scale on an hour by hour basis to determine if such a combination is a better match to national seasonal load scenarios than either of the two alone on an hour-by-hour basis. Actual hour by hour national load data from a particular year will be used as a basis, with some scenarios incorporating vehicle sector electrification and building heating and cooling using electric heat pumps. Hydro and geothermal generation can provide additional controllable output, when needed, to fulfill the hourly electricity and/or energy needs. Hourly wind speed data were calculated at the hub height of 80 m above the ground for the year 2006 at over 150 windy locations in the continental US using an extrapolation technique based on 10-m wind speed measurements and vertical sounding profiles. Using a 1.5 MW wind turbine as benchmark, the hourly wind power production nationwide was determined at all locations. Similarly, the hourly output from solar plants, with and without thermal storage, was calculated based on Ausra’s model assuming that the solar production would occur in the Southwest, the area with the greatest solar radiation density in the U.S. Hourly electricity demand for the year 2006 was obtained nationwide from a variety of sources, including the Federal Energy Regulation Commission. Hourly residential heating and cooking, industrial heat processing, and future electrified transportation loads were calculated from monthly energy consumption data from the Energy Information Administration. Using different scenarios of wind power penetration (10%, 20%, 30%, 50%, 80%, 100% of the average national electricity and/or energy demand), the remaining hourly electricity and/or energy load was covered by various combinations of solar, hydro, and geothermal generation. Statistics of the reliability of the various scenarios, as well as details on the area covered by wind and solar farms per each scenario, will be analyzed and presented.

Long-term wireless pH monitoring of the distal esophagus: prolonging the test beyond 48 hours is unnecessary and may be misleading.

PubMed

Capovilla, G; Salvador, R; Spadotto, L; Voltarel, G; Pesenti, E; Perazzolo, A; Nicoletti, L; Merigliano, S; Costantini, M

2017-10-01

Wireless pH monitoring of the esophagus has been widely used to detect GERD for more than a decade. It is generally well tolerated and accepted by patients, but it is still unclear whether prolonging a recording beyond the usual 48 hours can improve the test's diagnostic value. The aim of this study is to examine the diagnostic yield of 96-hour pH monitoring vis-à-vis 24- and 48-hour tests, and to ascertain whether any gain in diagnostic terms was of genuine clinical utility. Patients with suspected GERD underwent 4-day PPI-off wireless pH monitoring of the distal esophagus. The capsule was inserted under endoscopic control, 6 cm above the squamocolumnar junction. Average acid exposure time was calculated after 24, 48, and 96 hours of recording. Ninety-nine patients completed the 96 hour test, and formed the study sample. The wireless test method was used in 42 patients (42.4%) unable to tolerate the traditional pH-monitoring catheter, and in 57 (57.6%) with a previous negative pH study despite symptoms suggestive of GERD. On complete analysis, 47 patients (47.5%) had a pathological test result: 19 patients within the first 24 hours (19.2%, 24 hour group); another 16 after 48 hours (+16.2%, 48 hour group), and a further 12 (+12.1%, 96 hour group) only after 96 hours of monitoring. All 47 patients with an abnormal acid exposure were offered and accepted surgery (10 patients) or medical therapy (37 patients). Clinical follow-up was obtained in all patients with a positive Bravo test result after a median 67 months (IQR: 38-98) using a validated symptom questionnaire. A good outcome after fundoplication or medical therapy was achieved in 73.7% of patients in the 24 hour group, in 62.5% of those in the 48 hour group, and in only 25% of those in the 96 hour group, P = 0.02. Long-term wireless pH monitoring enables an increase in the diagnostic yield over traditional 24- and 48-hour pH studies, but prolonging the test may constitute an unwanted bias and prompt the recruitment of more complex patients, in whom the outcome of surgical or medical therapy may prove less than satisfactory. These findings should be taken into account when establishing the guidelines for assessing GERD with such long-term pH monitoring methods. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Split-time artificial insemination in beef cattle: I-Using estrous response to determine the optimal time(s) at which to administer GnRH in beef heifers and postpartum cows.

PubMed

Bishop, B E; Thomas, J M; Abel, J M; Poock, S E; Ellersieck, M R; Smith, M F; Patterson, D J

2016-09-01

Two experiments evaluated timing of GnRH administration in beef heifers and cows on the basis of estrous status during split-time artificial insemination (AI) after controlled internal drug release (CIDR) based protocols. In experiment 1, estrus was synchronized for 816 pubertal and prepubertal or peripubertal heifers using the 14-day CIDR-PGF2α (PG) protocol, and in experiment 2, estrus was synchronized for 622 lactating cows using the 7-day CO-Synch + CIDR protocol. For both experiments, estrus detection aids (Estrotect) were applied at PG, with estrus recorded at 66 and 90 hours after PG. Treatments were balanced across locations for heifers using reproductive tract score and weight; whereas for cows, treatments were assigned and balanced to treatment according to age, body condition score, and days postpartum. Timing of AI for heifers and cows was on the basis of estrus expression 66 hours after PG. Females in each treatment that exhibited estrus before 66 hours were inseminated at 66 hours, whereas AI was delayed 24 hours until 90 hours after PG for females failing to exhibit estrus before 66 hours. Females in treatment one received GnRH 66 hours after PG irrespective of estrus expression; however, in treatment 2, GnRH was administered coincident with delayed AI only to females not detected in estrus at 66 hours after PG. Among heifers, there was no effect of treatment on overall estrous response (P = 0.49) or AI pregnancy rate (P = 0.54). Pregnancy rate for heifers inseminated at 66 hours was not influenced by GnRH (P = 0.65), and there were no differences between treatments in estrous response during the 24 hours delay period (P = 0.22). Cows in treatment 2 had a greater (P = 0.04) estrous response during the 24-hour delay period resulting in a greater overall estrous response (P = 0.04), but this did not affect AI pregnancy rate at 90 hours (P = 0.51) or total AI pregnancy rate (P = 0.89). Pregnancy rate resulting from AI for cows inseminated at 66 hours was not influenced by GnRH (P = 0.50). In summary, when split-time AI was used with the 14-day CIDR-PG protocol in heifers or the 7-day CO-Synch + CIDR protocol in cows, administration of GnRH at AI to females that exhibited estrus before 66 hours after PG was not necessary. Furthermore, among heifers for which AI was delayed on the basis of failure to exhibit estrus before 66 hours after PG, timing of GnRH (66 vs. 90 hours after PG) was more flexible. Delayed administration of GnRH to 90 hours after PG coincident with AI for cows that failed to exhibit estrus before 66 hours improved overall estrous response; however, in this study, a corresponding increase in pregnancy rate resulting from AI was not observed. Copyright © 2016 Elsevier Inc. All rights reserved.

26 CFR 31.3221-3 - Supplemental tax.

Code of Federal Regulations, 2011 CFR

2011-04-01

... include regular time worked; overtime; time paid for vacations and holidays; time allowed for meals; away... that includes paid holidays, vacations, and sick time, the number of work-hours for one month is 174..., vacations, or sick time. During May, B worked 6 hours on 4 days, 7 hours on 6 days, 8 hours on 6 days, and 9...

29 CFR 4.175 - Meeting requirements for health, welfare, and/or pension benefits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... payments are due for all hours paid for, including paid vacation, sick leave, and holiday hours, up to a... two weeks on vacation and received 80 hours of vacation pay, the employee must also receive payment for the 80 hours of health and welfare and/or pension benefits which accrue during the vacation period...

75 FR 57220 - Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... Rule To Implement the 1997 8-Hour Ozone National Ambient Air Quality Standard: New Source Review Anti-Backsliding Provisions for Former 1-Hour Ozone Standard--Public Hearing Notice AGENCY: Environmental... be held for the proposed ``Rule to Implement the 1997 8-Hour Ozone National Ambient Air Quality...

40 CFR 49.137 - Rule for air pollution episodes.

Code of Federal Regulations, 2010 CFR

2010-07-01

... continue or reoccur over the next 24 hours. (A) Particulate matter (PM10): 350 micrograms per cubic meter, 24-hour average; (B) Carbon monoxide (CO): 17 milligrams per cubic meter (15 ppm), 8-hour average; (C) Sulfur dioxide (SO2): 800 micrograms per cubic meter (0.3 ppm), 24-hour average; (D) Ozone (O3): 400...

29 CFR 4.181 - Overtime pay provisions of other Acts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 4.180. (b) Contract Work Hours and Safety Standards Act. (1) The Contract Work Hours and Safety... the work performed for the employer is subject to such Act and if, in such workweek, the total hours... not less than 11/2 times their regular rate of pay for all hours worked in excess of the applicable...

29 CFR 778.315 - Payment for all hours worked in overtime workweek is required.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OVERTIME COMPENSATION Special Problems Effect of Failure to Count Or Pay for Certain Working Hours § 778... 29 Labor 3 2010-07-01 2010-07-01 false Payment for all hours worked in overtime workweek is required. 778.315 Section 778.315 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION...

47 CFR 80.108 - Transmission of traffic lists by coast stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... working hours of the coast station. (2) In the case of radiotelephony, at least one hour and not more than four hours during the working hours of the coast station. (b) The announcement must be as brief as... traffic on hand. These traffic lists will be transmitted on the station's normal working frequencies at...

29 CFR 778.317 - Agreements not to pay for certain nonovertime hours.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COMPENSATION Special Problems Effect of Failure to Count Or Pay for Certain Working Hours § 778.317 Agreements... 29 Labor 3 2010-07-01 2010-07-01 false Agreements not to pay for certain nonovertime hours. 778.317 Section 778.317 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT...

Time for Children, One's Spouse and Oneself among Parents Who Work Nonstandard Hours

ERIC Educational Resources Information Center

Wight, Vanessa R.; Raley, Sara B.; Bianchi, Suzanne M.

2008-01-01

Using data from the 2003 and 2004 American Time Use Surveys, this article examines nonstandard work hours and their relationship to parents' family, leisure and personal care time--informing the discussion of the costs and benefits of working nonstandard hours. The results suggest that parents who work nonstandard evening hours spend less time in…

Flexible Work Hours and Other Job Factors in Parental Time with Children

ERIC Educational Resources Information Center

Baxter, Jennifer

2011-01-01

Flexible working hours are typically seen to be advantageous to working parents, as the flexible hours more easily allow responsibilities of care and employment be balanced. But do flexible work hours actually mean that parents can spend more time with their children? This article explores this for parents of young children in Australia. The…

48 CFR 22.403-3 - Contract Work Hours and Safety Standards Act.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Contract Work Hours and... Standards for Contracts Involving Construction 22.403-3 Contract Work Hours and Safety Standards Act. The Contract Work Hours and Safety Standards Act (40 U.S.C. 3701 et seq.) requires that certain contracts (see...

29 CFR 5.8 - Liquidated damages under the Contract Work Hours and Safety Standards Act.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 1 2011-07-01 2011-07-01 false Liquidated damages under the Contract Work Hours and Safety... APPLICABLE TO NONCONSTRUCTION CONTRACTS SUBJECT TO THE CONTRACT WORK HOURS AND SAFETY STANDARDS ACT) Davis-Bacon and Related Acts Provisions and Procedures § 5.8 Liquidated damages under the Contract Work Hours...

77 FR 24347 - Airworthiness Directives; Bombardier, Inc. Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

..., dated February 9, 2011, estimates 4 work-hours for replacing the printed wiring assemblies in the GCU...) inspection on some airplanes, we have added an additional work-hour, for a total estimate of 6 work-hours... that it will take about 6 work-hours per product to comply with the basic requirements of this AD. The...

29 CFR 5.8 - Liquidated damages under the Contract Work Hours and Safety Standards Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Liquidated damages under the Contract Work Hours and Safety... APPLICABLE TO NONCONSTRUCTION CONTRACTS SUBJECT TO THE CONTRACT WORK HOURS AND SAFETY STANDARDS ACT) Davis-Bacon and Related Acts Provisions and Procedures § 5.8 Liquidated damages under the Contract Work Hours...

77 FR 8297 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... account for an 1800-hour work year and multiplied by 2.93 to account for bonuses, firm size, employee... for each of approximately 2400 purchasers annually (at an estimated $67 per hour),\\1\\ for a total annual burden of 120 hours (at a total annual cost of $8,040). \\1\\ $67/hour figure for a Compliance Clerk...

42 CFR 23.21 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... meet the needs of patients treated and to assure continuity of care. The 40 hours per week must be performed in no less than 4 days per week with no more than 12 hours of work being performed in any 24-hour... clinical practice means the provision of ambulatory clinical services for a minimum of 40 hours per week...

28 CFR Appendix A to Part 70 - Contract Provisions

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department. 4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333)—Where applicable, all... standard work week of forty hours. Work in excess of the standard work week is permissible provided that... all hours worked in excess of forty hours in the work week. Section 107 of the Act is applicable to...

38 CFR Appendix A to Part 49 - Contract Provisions

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal awarding agency. 4. Contract Work Hours and Safety Standards Act (40 U.S.C. 327-333)—Where... the basis of a standard work week of 40 hours. Work in excess of the standard work week is permissible... hours worked in excess of 40 hours in the work week. Section 107 of the Act is applicable to...

48 CFR 52.243-3 - Changes-Time-and-Materials or Labor-Hours.

Code of Federal Regulations, 2010 CFR

2010-10-01

... performed. (2) Time of performance (i.e., hours of the day, days of the week, etc.). (3) Place of... or Labor-Hours. 52.243-3 Section 52.243-3 Federal Acquisition Regulations System FEDERAL ACQUISITION... Clauses 52.243-3 Changes—Time-and-Materials or Labor-Hours. As prescribed in 43.205(c), insert the...

29 CFR 5.15 - Limitations, variations, tolerances, and exemptions under the Contract Work Hours and Safety...

Code of Federal Regulations, 2010 CFR

2010-07-01

... the Contract Work Hours and Safety Standards Act. 5.15 Section 5.15 Labor Office of the Secretary of... WORK HOURS AND SAFETY STANDARDS ACT) Davis-Bacon and Related Acts Provisions and Procedures § 5.15 Limitations, variations, tolerances, and exemptions under the Contract Work Hours and Safety Standards Act. (a...

29 CFR 778.306 - Salary reductions in short workweeks.

Code of Federal Regulations, 2010 CFR

2010-07-01

... employee is hired at a fixed salary of $200 for a 40-hour week, his hourly rate is $5. When he works only...” from the salary for hours not worked in short weeks will be considered strong, if not conclusive....306 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR...

48 CFR 514.270-7 - Guidelines for using the price list method.

Code of Federal Regulations, 2010 CFR

2010-10-01

... work anticipated to be performed during normal working hours. (3) List the unit prices for work to be performed during both normal working hours and outside of normal working hours. (4) Define “normal” in terms of hours and days of the week. (5) Advise bidders of the previous year's total expenditures or...

49 CFR 398.6 - Hours of service of drivers; maximum driving time.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Hours of service of drivers; maximum driving time... REGULATIONS TRANSPORTATION OF MIGRANT WORKERS § 398.6 Hours of service of drivers; maximum driving time. No... or operate for more than 10 hours in the aggregate (excluding rest stops and stops for meals) in any...

49 CFR 398.6 - Hours of service of drivers; maximum driving time.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Hours of service of drivers; maximum driving time... REGULATIONS TRANSPORTATION OF MIGRANT WORKERS § 398.6 Hours of service of drivers; maximum driving time. No... or operate for more than 10 hours in the aggregate (excluding rest stops and stops for meals) in any...

76 FR 53485 - Notice of Availability of the Supplement to the Draft Environmental Impact Statement for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-26

... available at the following offices during regular business hours: Columbine Field Office, 367 Pearl St... business hours. The FIRS is available 24 hours a day, 7 days a week, to leave a message or question with the above individual. You will receive a reply during normal business hours. SUPPLEMENTARY INFORMATION...

48 CFR 52.232-7 - Payments under Time-and-Materials and Labor-Hour Contracts.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-Materials and Labor-Hour Contracts. 52.232-7 Section 52.232-7 Federal Acquisition Regulations System FEDERAL... Provisions and Clauses 52.232-7 Payments under Time-and-Materials and Labor-Hour Contracts. As prescribed in 32.111(a)(7), insert the following clause: Payments Under Time-and-Materials and Labor-Hour Contracts...

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...

29 CFR 778.321 - Decrease in hours without decreasing pay-general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... COMPENSATION Special Problems Reduction in Workweek Schedule with No Change in Pay § 778.321 Decrease in hours without decreasing pay—general. Since the regular rate of pay is the average hourly rate at which an... 29 Labor 3 2010-07-01 2010-07-01 false Decrease in hours without decreasing pay-general. 778.321...

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 778.321 - Decrease in hours without decreasing pay-general.

Code of Federal Regulations, 2011 CFR

2011-07-01

... COMPENSATION Special Problems Reduction in Workweek Schedule with No Change in Pay § 778.321 Decrease in hours without decreasing pay—general. Since the regular rate of pay is the average hourly rate at which an... 29 Labor 3 2011-07-01 2011-07-01 false Decrease in hours without decreasing pay-general. 778.321...

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...

49 CFR 192.381 - Service lines: Excess flow valve performance standards.

Code of Federal Regulations, 2011 CFR

2011-10-01

... hour (0.57 cubic meters per hour); or (B) For an excess flow valve designed to prevent equalization of pressure across the valve, to no more than 0.4 cubic feet per hour (.01 cubic meters per hour); and (4) Not... the manufacturer according to an industry specification, or the manufacturer's written specification...

49 CFR 192.381 - Service lines: Excess flow valve performance standards.

Code of Federal Regulations, 2013 CFR

2013-10-01

... hour (0.57 cubic meters per hour); or (B) For an excess flow valve designed to prevent equalization of pressure across the valve, to no more than 0.4 cubic feet per hour (.01 cubic meters per hour); and (4) Not... the manufacturer according to an industry specification, or the manufacturer's written specification...

49 CFR 192.381 - Service lines: Excess flow valve performance standards.

Code of Federal Regulations, 2012 CFR

2012-10-01

... hour (0.57 cubic meters per hour); or (B) For an excess flow valve designed to prevent equalization of pressure across the valve, to no more than 0.4 cubic feet per hour (.01 cubic meters per hour); and (4) Not... the manufacturer according to an industry specification, or the manufacturer's written specification...

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...

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...

5 CFR 551.423 - Time spent in training or attending a lecture, meeting, or conference.

Code of Federal Regulations, 2010 CFR

2010-01-01

... working hours shall be considered hours of work. (2) Time spent in training outside regular working hours... performance of the duties and responsibilities of his or her current position. (3) Time spent in... training under the Veterans Recruitment Act (5 CFR part 307) outside regular working hours shall not be...

76 FR 13626 - Agency Information Collection Activities; Proposed Collection; Comment Request; Comparing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-14

... consumers make informed dietary choices. To help design and refine the questionnaire, we plan to conduct... members of the online consumer panels to have 180 of them complete a 15-minute (0.25 hour) pretest. The total for the pretest activities is 77 hours (32 hours + 45 hours). For the survey, we estimate that 19...

5 CFR 531.607 - Computing hourly, daily, weekly, and biweekly locality rates.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Computing hourly, daily, weekly, and... Computing hourly, daily, weekly, and biweekly locality rates. (a) Apply the following methods to convert an... firefighter whose pay is computed under 5 U.S.C. 5545b, a firefighter hourly locality rate is computed using a...

49 CFR 192.381 - Service lines: Excess flow valve performance standards.

Code of Federal Regulations, 2010 CFR

2010-10-01

... hour (0.57 cubic meters per hour); or (B) For an excess flow valve designed to prevent equalization of pressure across the valve, to no more than 0.4 cubic feet per hour (.01 cubic meters per hour); and (4) Not... the manufacturer according to an industry specification, or the manufacturer's written specification...

Acquisition of Formulaic Sequences in Intensive and Regular EFL Programmes

ERIC Educational Resources Information Center

Serrano, Raquel; Stengers, Helene; Housen, Alex

2015-01-01

This paper aims to analyse the role of time concentration of instructional hours on the acquisition of formulaic sequences in English as a foreign language (EFL). Two programme types that offer the same amount of hours of instruction are considered: intensive (110 hours/1 month) and regular (110 hours/7 months). The EFL learners under study are…

77 FR 31684 - Hours of Service of Drivers: RockTenn, Exemption Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-29

... 14th hour of coming on duty. This exemption will allow these individuals to occasionally work up to 16 consecutive hours and be allowed to return to work with less than the mandatory 10 consecutive hours off duty... public road--Compress Street--an average of forty times per day to travel between its manufacturing...

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...