Duty hours and incidents in flight among commercial airline pilots.

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O'Hagan, Anna Donnla; Issartel, Johann; Fletcher, Richard; Warrington, Giles

2016-01-01

Working long duty hours has often been associated with increased risk of incidents and accidents in transport industries. Despite this, information regarding the intermediate relationship between duty hours and incident risk is limited. This study aimed to test a work hours/incident model to identify the interplay of factors contributing to incidents within the aviation industry. Nine hundred and fifty-four European-registered commercial airline pilots completed a 30-item survey investigating self-report attitudes and experiences of fatigue. Path analysis was used to test the proposed model. The fit indices indicated this to be a good fit model (χ(2) = 11.066, df = 5, p = 0.05; Comparative Fit Index = 0.991; Normed Fit Index = 0.984; Tucker-Lewis Index = 0.962; Root Mean Square of Approximation = 0.036). Highly significant relationships were identified between duty hours and sleep disturbance (r = 0.18, p hours through to self-reported incidents in flight was identified. Further investigation employing both objective and subjective measures of sleep and fatigue is needed.

Hospitalized Patients' Perceptions of Resident Fatigue, Duty Hours, and Continuity of Care.

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Drolet, Brian C; Hyman, Charles H; Ghaderi, Kimeya F; Rodriguez-Srednicki, Joshua; Thompson, Jordan M; Fischer, Staci A

2014-12-01

Physicians' perceptions of duty hour regulations have been closely examined, yet patient opinions have been largely unstudied to date. We studied patient perceptions of residency duty hours, fatigue, and continuity of care following implementation of the Accreditation Council for Graduate Medical Education 2011 Common Program Requirements. A cross-sectional survey was administered between June and August 2013 to inpatients at a large academic medical center and an affiliated community hospital. Adult inpatients on teaching medical and surgical services were eligible for inclusion in the study. Survey response rate was 71.3% (513 of 720). Most respondents (57.1%, 293 of 513) believed residents should not be assigned to shifts longer than 12 hours, and nearly half (49.7%, 255 of 513) wanted to be notified if a resident caring for them had worked longer than 12 hours. Most patients (63.2%, 324 of 513) believed medical errors commonly occurred because of fatigue, and fewer (37.4%, 192 of 513; odds ratio, 0.56; P care. Given the choice between a familiar physician who "may be tired from a long shift" or a "fresh" physician who had received sign-out, more patients chose the fresh but unfamiliar physician (57.1% [293 of 513] versus 42.7% [219 of 513], P care.

Resident operative experience in general surgery, plastic surgery, and urology 5 years after implementation of the ACGME duty hour policy.

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Simien, Christopher; Holt, Kathleen D; Richter, Thomas H; Whalen, Thomas V; Coburn, Michael; Havlik, Robert J; Miller, Rebecca S

2010-08-01

Resident duty hour restrictions were implemented in 2002-2003. This study examines changes in resident surgical experience since these restrictions were put into place. Operative log data for 3 specialties were examined: general surgery, urology, and plastic surgery. The academic year immediately preceding the duty hour restrictions, 2002-2003, was used as a baseline for comparison to subsequent academic years. Operative log data for graduating residents through 2007-2008 were the primary focus of the analysis. Examination of associated variables that may moderate the relationship between fewer duty hours and surgical volume was also included. Plastic surgery showed no changes in operative volume following duty hour restrictions. Operative volume increased in urology programs. General surgery showed a decrease in volume in some operative categories but an increase in others. Specifically the procedures in vascular, plastic, and thoracic areas showed a consistent decrease. There was no increase in the percentage of programs' graduates falling below minimum requirements. Procedures in pancreas, endocrine, and laparoscopic areas demonstrated an increase in volume. Graduates in larger surgical programs performed fewer procedures than graduates in smaller programs; this was not the case for urology or plastic surgery programs. The reduction of duty hours has not resulted in an across the board decrease in operative volume. Factors other than duty hour reforms may be responsible for some of the observed findings.

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

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

2017-07-18

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

The Media Response to the ACGME's 2017 Relaxed Resident Duty-Hour Restrictions.

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Zhang, Zi; Krauthamer, Alan V; Rosenkrantz, Andrew B

2018-03-01

In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement. Articles' stance was categorized as favorable, unfavorable, or neutral. Additional article characteristics were explored. Article sources were 58% national, 22% local, and 20% medical news. Article stance was most commonly unfavorable for national news sources (48%), compared with neutral for local (62%) and medical (72%) news sources. Most common reasons for unfavorable stance were sleep deprivation (n = 11), medical errors (n = 11), residents' health (n = 9), risk for car accidents (n = 9), a patriarchal hazing system (n = 6), and work-life balance (n = 5). Most common reasons for favorable stance were impact on resident education (n = 7) and continuity of care (n = 7). Supporting data were cited by 38% of unfavorable and 100% of favorable articles. Unfavorable articles most commonly quoted physicians affiliated with resident advocacy groups; favorable articles most commonly quoted physicians affiliated with the ACGME. The relaxed duty-hour restrictions received an overall unfavorable media response, particularly in nonmedical news sources, driven by concerns regarding sleep-deprived doctors. Favorable articles ubiquitously cited data supporting the safety of relaxed duty hour restrictions. Further research is warranted to better understand the impact of relaxed resident duty-hour limits on sleep deprivation, residents' health and education, and the quality of patient care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training.

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Bilimoria, Karl Y; Chung, Jeanette W; Hedges, Larry V; Dahlke, Allison R; Love, Remi; Cohen, Mark E; Hoyt, David B; Yang, Anthony D; Tarpley, John L; Mellinger, John D; Mahvi, David M; Kelz, Rachel R; Ko, Clifford Y; Odell, David D; Stulberg, Jonah J; Lewis, Frank R

2016-02-25

Concerns persist regarding the effect of current surgical resident duty-hour policies on patient outcomes, resident education, and resident well-being. We conducted a national, cluster-randomized, pragmatic, noninferiority trial involving 117 general surgery residency programs in the United States (2014-2015 academic year). Programs were randomly assigned to current Accreditation Council for Graduate Medical Education (ACGME) duty-hour policies (standard-policy group) or more flexible policies that waived rules on maximum shift lengths and time off between shifts (flexible-policy group). Outcomes included the 30-day rate of postoperative death or serious complications (primary outcome), other postoperative complications, and resident perceptions and satisfaction regarding their well-being, education, and patient care. In an analysis of data from 138,691 patients, flexible, less-restrictive duty-hour policies were not associated with an increased rate of death or serious complications (9.1% in the flexible-policy group and 9.0% in the standard-policy group, P=0.92; unadjusted odds ratio for the flexible-policy group, 0.96; 92% confidence interval, 0.87 to 1.06; P=0.44; noninferiority criteria satisfied) or of any secondary postoperative outcomes studied. Among 4330 residents, those in programs assigned to flexible policies did not report significantly greater dissatisfaction with overall education quality (11.0% in the flexible-policy group and 10.7% in the standard-policy group, P=0.86) or well-being (14.9% and 12.0%, respectively; P=0.10). Residents under flexible policies were less likely than those under standard policies to perceive negative effects of duty-hour policies on multiple aspects of patient safety, continuity of care, professionalism, and resident education but were more likely to perceive negative effects on personal activities. There were no significant differences between study groups in resident-reported perception of the effect of fatigue on

Views of surgery program directors on the current ACGME and proposed IOM duty-hour standards.

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Willis, Ross E; Coverdill, James E; Mellinger, John D; Collins, J Craig; Potts, John R; Dent, Daniel L

2009-01-01

The purpose of this study was to survey the experiences of surgery program directors with the current Accreditation Council for Graduate Medical Education (ACGME) duty-hour standards and views of the Institute of Medicine (IOM) proposed duty-hour recommendations. A total of 118 program directors (47.6% of all surgery programs in the US) responded to the survey. Results showed that the current duty-hour standards have hindered clinical education opportunities by reducing or eliminating rotations on many services, didactic teaching conferences, and clinical bedside teaching opportunities. Additionally, patient safety has been compromised by frequent hand offs of care. Most IOM recommendations were perceived as extremely difficult or impossible to implement, with the exception of the moonlighting recommendation. The results indicated that adopting the IOM recommendations is not feasible given current workforce limitations, and most program directors supported maintaining the current duty-hour standards until such time as there is evidence-based outcomes research to direct change. The conclusion was that the current ACGME duty-hour standards have reduced teaching opportunities and narrowed the scope of training.

Teaching hospital financial status and patient outcomes following ACGME duty hour reform.

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Navathe, Amol S; Silber, Jeffrey H; Small, Dylan S; Rosen, Amy K; Romano, Patrick S; Even-Shoshan, Orit; Wang, Yanli; Zhu, Jingsan; Halenar, Michael J; Volpp, Kevin G

2013-04-01

To examine whether hospital financial health was associated with differential changes in outcomes after implementation of 2003 ACGME duty hour regulations. Observational study of 3,614,174 Medicare patients admitted to 869 teaching hospitals from July 1, 2000 to June 30, 2005. Interrupted time series analysis using logistic regression to adjust for patient comorbidities, secular trends, and hospital site. Outcomes included 30-day mortality, AHRQ Patient Safety Indicators (PSIs), failure-to-rescue (FTR) rates, and prolonged length of stay (PLOS). All eight analyses measuring the impact of duty hour reform on mortality by hospital financial health quartile, in postreform year 1 ("Post 1") or year 2 ("Post 2") versus the prereform period, were insignificant: Post 1 OR range 1.00-1.02 and Post 2 OR range 0.99-1.02. For PSIs, all six tests showed clinically insignificant effect sizes. The FTR rate analysis demonstrated nonsignificance in both postreform years (OR 1.00 for both). The PLOS outcomes varied significantly only for the combined surgical sample in Post 2, but this effect was very small, OR 1.03 (95% CI 1.02, 1.04). The impact of 2003 ACGME duty hour reform on patient outcomes did not differ by hospital financial health. This finding is somewhat reassuring, given additional financial pressure on teaching hospitals from 2011 duty hour regulations. © Health Research and Educational Trust.

Association of the 2011 ACGME resident duty hour reform with general surgery patient outcomes and with resident examination performance.

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Rajaram, Ravi; Chung, Jeanette W; Jones, Andrew T; Cohen, Mark E; Dahlke, Allison R; Ko, Clifford Y; Tarpley, John L; Lewis, Frank R; Hoyt, David B; Bilimoria, Karl Y

2014-12-10

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P adverse outcome. Mean (SD) in-training examination scores did not significantly change from 2010 to 2013 for first-year residents (499.7 [ 85.2] to 500.5 [84.2], P = .99), for residents from other postgraduate years, or for first-time examinees taking the written or oral board

Psychiatric Emergency Services - Can Duty-Hour Changes Help Residents and Patients?

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Brainch, Navjot; Schule, Patrick; Laurel, Faith; Bodic, Maria; Jacob, Theresa

2018-04-14

Limitations on resident duty hours have been widely introduced with the intention of decreasing resident fatigue and improving patient outcomes. While there is evidence of improvement in resident well-being and education following such initiatives, they have inadvertently resulted in increased number of hand-offs between clinicians leading to potential errors in patient care. Current literature emphasizes need for more specialty/setting-specific scheduling, while considering residents' opinions when implementing duty-hour reforms. There are no reports examining the impact of duty-hour changes on residents or patients in psychiatric emergency service (PES) settings. Our purpose was to assess the impact of a recent scheduling change and decrease in overall duty hours, on resident well-being and sense of burnout, while also evaluating changes to patient wait-time and length of stay (LOS) in PES. Residents completed Maslach Burnout Inventory and anonymous surveys focusing on: fatigue, sleep, life outside work for shifts - regular (8 am-8 pm) and swing shifts (12 pm-10 pm). Data from the electronic medical records were collected for 6 months pre- and post-schedule change (January 2016-February 2017), for LOS and patient wait-time. Residents' preference for shifts was split. However, 86% reported getting enough sleep during swing shifts, while 83% reported lack of sleep during regular shifts. The average patient wait-time and LOS significantly decreased from 169 to 147 and 690 to 515 min, respectively. The change to swing shifts significantly impacts LOS and patient wait-time. The short shifts demonstrated an improvement in well-being for residents, but were not the singular factor for overall resident satisfaction.

Patient Perceptions of Whom is Most Involved in Their Care with Successive Duty Hour Limits.

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Arora, Vineet M; Prochaska, Micah T; Farnan, Jeanne M; Meltzer, David O

2015-09-01

Although direct patient care is necessary for experiential learning during residency, inpatient perceptions of the roles of resident and attending physicians in their care may have changed with residency duty hours. We aimed to assess if patients' perceptions of who is most involved in their care changed with residency duty hours. This was a prospective observational study over 12 years at a single institution. Participants were 22,408 inpatients admitted to the general medicine teaching service from 2001 to 2013, who completed a 1-month follow-up phone interview. Percentage of inpatients who reported an attending, resident, or intern as most involved in their care by duty hour period (pre-2003, post-2003-pre-2011, post-2011). With successive duty hour limits, the percentage of patients who reported the attending as most involved in their care increased (pre-2003 20 %, post-2003-pre-2011 29 %, post-2011 37 %, p care (pre-2003 20 %, post-2003-pre-2011 17 %, post-2011 12 %, p duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care. Given the importance of experiential learning to the formation of clinical judgment for independent practice, further study on the implications of these trends for resident education and patient safety is warranted.

Impact of the 2011 ACGME resident duty hour reform on hospital patient experience and processes-of-care.

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Rajaram, Ravi; Saadat, Lily; Chung, Jeanette; Dahlke, Allison; Yang, Anthony D; Odell, David D; Bilimoria, Karl Y

2016-12-01

In 2011, the Accreditation Council for Graduate Medical Education (ACGME) expanded restrictions on resident duty hours. While studies have shown no association between these restrictions and improved outcomes, process-of-care and patient experience measures may be more sensitive to resident performance, and thus may be impacted by duty hour policies. The objective of this study was to evaluate the association between the 2011 resident duty hour reform and measures of processes-of-care and patient experience. Hospital Consumer Assessment of Healthcare Providers and Systems survey data and process-of-care scores were obtained from the Centers for Medicare and Medicaid Services Hospital Compare website for 1 year prior to (1 July 2010 to 30 June 2011) and 1 year after (1 July 2011 to 30 June 2012) duty hour reform implementation. Using a difference-in-differences model, non-teaching and teaching hospitals were compared before and after the 2011 reform to test the association of this policy with changes in process-of-care and patient experience measure scores. Duty hour reform was not associated with a change in the five patient experience measures evaluated, including patients rating a hospital 9 or 10 (coefficient -0.003, 95% CI -0.79 to 0.79) or stating they would 'definitely recommend' a hospital (coefficient -0.28, 95% CI -1.01 to 0.44). For all 10 process-of-care measures examined, such as antibiotic timing (coefficient -0.462, 95% CI -1.502 to 0.579) and discontinuation (0.188, 95% CI -0.529 to 0.904), duty hour reform was not associated with a change in scores. The 2011 ACGME duty hour reform was not associated with improvements in process-of-care and patient experience measures. These data should be considered when considering reform of resident duty hour policies. 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/.

Duty hours and pregnancy outcome among residents in obstetrics and gynecology.

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Gabbe, Steven G; Morgan, Maria A; Power, Michael L; Schulkin, Jay; Williams, Sterling B

2003-11-01

To assess the present status of resident duty hours in obstetrics and gynecology, identify existing policies concerning work schedules during pregnancy, and evaluate pregnancy outcome in female house officers. A questionnaire-based study was administered to residents taking the 2001 Council on Residency Education in Obstetrics and Gynecology examination. More than 90% of the residents reported that their institution had a maternity leave policy. The leave was usually 4-8 weeks long and was paid. Nearly 95% of residents reported that they had to take over the work of residents on maternity leave. Most women residents worked more than 80 hours weekly throughout pregnancy, and few took time off before delivery. Most pregnancies occurred during the fourth year of training and did not seem to be adversely affected by the long work hours. This study, performed before the institution of the new Accreditation Council for Graduate Medical Education resident duty hour policies, demonstrated that, although women house officers continued to work more than 80 hours per week during pregnancy, most had a good pregnancy outcome. Nevertheless, there was a higher frequency of preterm labor, preeclampsia, and fetal growth restriction in female residents than in spouses or partners of male residents.

Medical education and the ACGME duty hour requirements: assessing the effect of a day float system on educational activities.

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Roey, Steve

2006-01-01

In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted new resident work hour mandates, which are being shown to improve resident well-being and patient safety. However, there are limited data on the impact these new mandates may have on educational activities. To assess the impact on educational activities of a day float system created to meet ACGME work hour mandates. The inpatient ward coverage was changed by adding a day float team responsible for new patient admissions in the morning, with the on-call teams starting later and being responsible for new patient admissions thereafter. I surveyed the residents to assess the impact of this new system on educational activities-resident autonomy, attending teaching, conference attendance, resident teaching, self-directed learning, and ability to complete patient care responsibilities. There was no adverse effect of the day float system on educational activities. House staff reported increased autonomy, enhanced teaching from attending physicians, and improved ability to complete patient care responsibilities. Additionally, house staff demonstrated improved compliance with the ACGME mandates. The implementation of a novel day float system for the inpatient medicine ward service improved compliance with ACGME work duty requirements and did not adversely impact educational activities of the residency training program.

Electrofishing power requirements in relation to duty cycle

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Miranda, L.E.; Dolan, C.R.

2004-01-01

Under controlled laboratory conditions we measured the electrical peak power required to immobilize (i.e., narcotize or tetanize) fish of various species and sizes with duty cycles (i.e., percentage of time a field is energized) ranging from 1.5% to 100%. Electrofishing effectiveness was closely associated with duty cycle. Duty cycles of 10-50% required the least peak power to immobilize fish; peak power requirements increased gradually above 50% duty cycle and sharply below 10%. Small duty cycles can increase field strength by making possible higher instantaneous peak voltages that allow the threshold power needed to immobilize fish to radiate farther away from the electrodes. Therefore, operating within the 10-50% range of duty cycles would allow a larger radius of immobilization action than operating with higher duty cycles. This 10-50% range of duty cycles also coincided with some of the highest margins of difference between the electrical power required to narcotize and that required to tetanize fish. This observation is worthy of note because proper use of duty cycle could help reduce the mortality associated with tetany documented by some authors. Although electrofishing with intermediate duty cycles can potentially increase effectiveness of electrofishing, our results suggest that immobilization response is not fully accounted for by duty cycle because of a potential interaction between pulse frequency and duration that requires further investigation.

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

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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.

Duty hour restrictions and surgical complications for head and neck key indicator procedures.

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Smith, Aaron; Jain, Nikhita; Wan, Jim; Wang, Lei; Sebelik, Merry

2017-08-01

Graduate medical education has traditionally required long work hours, allowing trainees little time for adequate rest. Based on concerns over performance deterioration with sleep deprivation and its effect on patient outcomes, duty hour restrictions have been mandated. We sought to characterize complications from otolaryngology key indicator procedures performed before and after duty hour reform. Retrospective cross-sectional analysis of National Inpatient Sample (NIS). The NIS was queried for procedure codes associated with head and neck key indicator groupings for the years 2000-2002 (45,363 procedures) and 2006-2008 (51,144 procedures). Hospitals were divided into three groups: nonteaching hospitals (NTH), teaching hospitals without otolaryngology programs (TH), and teaching hospitals with otolaryngology programs (TH-OTO). Surgical complication rates, length of stay, and mortality rates were analyzed using logistic and linear regression. The number of procedures increased (12.7%), with TH-OTO contributing more in postrestriction years (21% to 30%). Overall complication rates between the two periods revealed no difference, regardless of hospital setting. Subset analysis showed some variation within each complication within each grouping. Length of stay increased at TH-OTO (2.75 to 2.78 days) and decreased at NTH (2.28 to 2.24 days) and TH (2.39 to 2.36 days). Mortality did not increase among the three hospital types (NTH, P key indicator procedures. Moreover, concerns about reduced surgical case numbers appear unfounded, especially for otolaryngology programs. 2c Laryngoscope, 127:1797-1803, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Limitation of duty hour regulations for pediatric resident wellness

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Nomura, Osamu; Mishina, Hiroki; Kobayashi, Yoshinori; Ishiguro, Akira; Sakai, Hirokazu; Kato, Hiroyuki

2016-01-01

Abstract Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents. A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-se...

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

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Moeller, Andrew; Webber, Jordan; Epstein, Ian

2016-07-13

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

Morbidity, mortality, and health care costs for patients undergoing spine surgery following the ACGME resident duty-hour reform: Clinical article.

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Babu, Ranjith; Thomas, Steven; Hazzard, Matthew A; Lokhnygina, Yuliya V; Friedman, Allan H; Gottfried, Oren N; Isaacs, Robert E; Boakye, Maxwell; Patil, Chirag G; Bagley, Carlos A; Haglund, Michael M; Lad, Shivanand P

2014-10-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented resident duty-hour restrictions on July 1, 2003, in concern for patient and resident safety. Whereas studies have shown that duty-hour restrictions have increased resident quality of life, there have been mixed results with respect to patient outcomes. In this study, the authors have evaluated the effect of duty-hour restrictions on morbidity, mortality, length of stay (LOS), and charges in patients who underwent spine surgery. The Nationwide Inpatient Sample was used to evaluate the effect of duty-hour restrictions on complications, mortality, LOS, and charges by comparing the prereform (2000-2002) and postreform (2005-2008) periods. Outcomes were compared between nonteaching and teaching hospitals using a difference-in-differences (DID) method. Results A total of 693,058 patients were included in the study. The overall complication rate was 8.6%, with patients in the postreform era having a significantly higher rate than those in the pre-duty-hour restriction era (8.7% vs. 8.4%, p duty-hour reform era. The DID analysis to compare the magnitude in change between teaching and nonteaching institutions revealed that teaching institutions to had a significantly greater increase in complications during the postreform era (p = 0.0002). The overall mortality rate was 0.37%, with no significant difference between the pre- and post-duty-hour eras (0.39% vs. 0.36%, p = 0.12). However, the mortality rate significantly decreased in nonteaching hospitals in the postreform era (0.30% vs. 0.23%, p = 0.0008), while remaining the same in teaching institutions (0.46% vs. 0.46%, p = 0.75). The DID analysis to compare the changes in mortality between groups revealed that the difference between the effects approached significance (p = 0.069). The mean LOS for all patients was 4.2 days, with hospital stay decreasing in nonteaching hospitals (3.7 vs. 3.5 days, p duty-hour reform era, increasing from $40,000 in

Quantitative and qualitative perceptions of the 2011 residency duty hour restrictions: a multicenter, multispecialty cross-sectional study.

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Tierney, William S; Elkin, Rachel L; Nielsen, Craig D

2015-03-25

July 2011 saw the implementation of the newest duty hour restrictions, further limiting the working hours of first year residents and necessitating a variety of adaptations on the part of residency programs. The present study sought to characterize the perceived impact of these restrictions on residency program personnel using a multi-specialty and multi-site approach. We developed and administered a survey to internal medicine and general surgery residency programs at three academic medical centers within an urban region. The survey combined quantitative and qualitative components to gain a broader understanding of the impact of the newest regulations. Quantitative responses were compared between Internal Medicine and General Surgery programs with Student t-tests. Other comparisons were performed using ANOVA or Kruskal-Wallis testing as appropriate. For all comparisons, the threshold for significance was set at 0.01. Two independent reviewers coded all qualitative data and assigned one or more themes based on content. Descriptive statistics were calculated and the diversity of themes identified. No between-group comparisons were conducted with the qualitative data. We found significant differences in the overall perceptions of duty hour restrictions across specialty (internal medicine more positive than general surgery) and across position (first year residents more positive than senior residents and faculty). Notably, individuals who trained at osteopathic medical schools reported significantly more negative views of the duty hour restrictions than those who had trained at allopathic or international medical schools, suggesting an influence of undergraduate medical training. The complementary qualitative data offered insights into the perceived strengths and weaknesses of the duty hour restrictions, as well as actionable suggestions that could help to improve residency program function. This study characterizes responses to the new duty hour restrictions from a

Impact of resident duty hour limits on safety in the intensive care unit: a national survey of pediatric and neonatal intensivists.

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Typpo, Katri V; Tcharmtchi, M Hossein; Thomas, Eric J; Kelly, P Adam; Castillo, Leticia D; Singh, Hardeep

2012-09-01

Resident duty-hour regulations potentially shift the workload from resident to attending physicians. We sought to understand how current or future regulatory changes might impact safety in academic pediatric and neonatal intensive care units. Web-based survey. U.S. academic pediatric and neonatal intensive care units. Attending pediatric and neonatal intensivists. We evaluated perceptions on four intensive care unit safety-related risk measures potentially affected by current duty-hour regulations: 1) attending physician and resident fatigue; 2) attending physician workload; 3) errors (self-reported rates by attending physicians or perceived resident error rates); and 4) safety culture. We also evaluated perceptions of how these risks would change with further duty-hour restrictions. We administered our survey between February and April 2010 to 688 eligible physicians, of whom 360 (52.3%) responded. Most believed that resident error rates were unchanged or worse (91.9%) and safety culture was unchanged or worse (84.4%) with current duty-hour regulations. Of respondents, 61.9% believed their own work-hours providing direct patient care increased and 55.8% believed they were more fatigued while providing direct patient care. Most (85.3%) perceived no increase in their own error rates currently, but in the scenario of further reduction in resident duty-hours, over half (53.3%) believed that safety culture would worsen and a significant proportion (40.3%) believed that their own error rates would increase. Pediatric intensivists do not perceive improved patient safety from current resident duty-hour restrictions. Policies to further restrict resident duty-hours should consider unintended consequences of worsening certain aspects of intensive care unit safety.

Making sense: duty hours, work flow, and waste in graduate medical education.

Science.gov (United States)

Bush, Roger W; Philibert, Ingrid

2009-12-01

Parsimony, and not industry, is the immediate cause of the increase of capital. Industry, indeed, provides the subject which parsimony accumulates. But whatever industry might acquire, if parsimony did not save and store up, the capital would never be the greater.Adam Smith, The Wealth of Nations, book 2, chapter 31In 2003, the Accreditation Council for Graduate Medical Education implemented resident duty hour limits that included a weekly limit and limits on continuous hours. Recent recommendations for added reductions in resident duty hours have produced concern about concomitant reductions in future graduates' preparedness for independent practice. The current debate about resident hours largely does not consider whether all hours residents spend in the educational and clinical-care environment contribute meaningfully either to residents' learning or to effective patient care. This may distract the community from waste in the current clinical-education model. We propose that use of "lean production" and quality improvement methods may assist teaching institutions in attaining a deeper understanding of work flow and waste. These methods can be used to assign value to patient- and learner-centered activities and outputs and to optimize the competing and synergistic aspects of all desired outcomes to produce the care the Institute of Medicine recommends: safe, effective, efficient, patient-centered, timely, and equitable. Finally, engagement of senior clinical faculty in determining the culture of the care and education system will contribute to an advanced social-learning and care network.

Pilot trial of IOM duty hour recommendations in neurology residency programs: unintended consequences.

Science.gov (United States)

Schuh, L A; Khan, M A; Harle, H; Southerland, A M; Hicks, W J; Falchook, A; Schultz, L; Finney, G R

2011-08-30

To study the potential effect of the 2008 Institute of Medicine (IOM) work duty hour (WDH) recommendations on neurology residency programs. This study evaluated resident sleepiness, personal study hours, quality of life, and satisfaction and faculty satisfaction during a control month using the Accreditation Council for Graduate Medical Education WDH requirements and during an intervention month using the IOM WDH recommendations. Resident participation in both schedules was mandatory, but both resident and faculty participation in the outcome measures was voluntary. Thirty-four residents (11 postgraduate year [PGY]-4, 9 PGY-3, and 14 PGY-2) participated. End-of-work shift sleepiness, mean weekly sleep hours, personal study hours, and hours spent in lectures did not differ between the control and intervention months. Resident quality of life measured by the Maslach Burnout Inventory declined for 1 subscore in the intervention month (p = 0.03). Resident education satisfaction declined during the intervention month for issues related to continuity of care, patient hand-offs, and knowledge of their patients. Faculty satisfaction declined during the intervention month, without a decline in quality of life. The results from 3 residency programs suggest that the IOM WDH recommendations may negatively affect neurology resident education. This study was limited by the short duration of implementation, negative bias against the IOM recommendations, and inability to blind faculty. Additional study of the IOM WDH recommendations is warranted before widespread implementation.

Assessing the Effects of the 2003 Resident Duty Hours Reform on Internal Medicine Board Scores

Science.gov (United States)

Romano, Patrick S.; Itani, Kamal M.F.; Rosen, Amy K.; Small, Dylan; Lipner, Rebecca S.; Bosk, Charles L.; Wang, Yanli; Halenar, Michael J.; Korovaichuk, Sophia; Even-Shoshan, Orit; Volpp, Kevin G.

2014-01-01

Purpose To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were −5.43 (−7.63, −3.23), −3.44 (−5.65, −1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations. PMID:24556772

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

Science.gov (United States)

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  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.

The impact of the implementation of work hour requirements on residents' career satisfaction, attitudes and emotions.

Science.gov (United States)

Choi, Dongseok; Dickey, Jamie; Wessel, Kristen; Girard, Donald E

2006-10-17

To assess the impact of work hours' limitations required by the Accreditation Council for Graduate Medical Education (ACGME) on residents' career satisfaction, emotions and attitudes. A validated survey instrument was used to assess residents' levels of career satisfaction, emotions and attitudes before and after the ACGME duty hour requirements were implemented. The "pre" implementation survey was distributed in December 2002 and the "post" implementation one in December 2004. Only the latter included work-hour related questions. The response rates were 56% for the 2002 and 72% for the 2004 surveys respectively. Although career satisfaction remained unchanged, numerous changes occurred in both emotions and attitudes. Compared to those residents who did not violate work-hour requirements, those who did were significantly more negative in attitudes and emotions. With the implementation of the ACGME work hour limitations, the training experience became more negative for those residents who violated the work hour limits and had a small positive impact on those who did not violate them. Graduate medical education leaders must innovate to make the experiences for selected residents improved and still maintain compliance with the work hour requirements.

The effect of duty hour regulation on resident surgical case volume in otolaryngology.

Science.gov (United States)

Curtis, Stuart H; Miller, Robert H; Weng, Cindy; Gurgel, Richard K

2014-10-01

Evaluate the effect of duty hour regulation on graduating otolaryngology resident surgical case volume and analyze trends in surgical case volume for Accreditation Council for Graduate Medical Education (ACGME) key indicator cases from 1996 to 2011. Time-trend analysis of surgical case volume. Nationwide sample of otolaryngology residency programs. Operative logs from the American Board of Otolaryngology and ACGME for otolaryngology residents graduating in the years 1996 to 2011. Key indicator volumes and grouped domain volumes before and after resident duty hour regulations (2003) were calculated and compared. Independent t test was performed to evaluate overall difference in operative volume. Wilcoxon rank sum test evaluated differences between procedures per time period. Linear regression evaluated trend. The average total number of key indicator cases per graduating resident was 440.8 in 1996-2003 compared to 500.4 cases in 2004-2011, and overall average per number of key indicators was 31.5 and 36.2, respectively (P = .067). Four key indicator cases showed statistically significant (P otolaryngology residents. The overall trend in operative volume is increasing for several specific key indicators. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

A Reduced Duty Hours Model for Senior Internal Medicine Residents: A Qualitative Analysis of Residents' Experiences and Perceptions.

Science.gov (United States)

Mathew, Rebecca; Gundy, Serena; Ulic, Diana; Haider, Shariq; Wasi, Parveen

2016-09-01

To assess senior internal medicine residents' experience of the implementation of a reduced duty hours model with night float, the transition from the prior 26-hour call system, and the new model's effects on resident quality of life and perceived patient safety in the emergency department and clinical teaching unit at McMaster University. Qualitative data were collected during May 2013-July 2014, through resident focus groups held prior to implementation of a reduced duty hours model and 10 to 12 months postimplementation. Data analysis was guided by a constructivist grounded theory based in a relativist paradigm. Transcripts were coded; codes were collapsed into themes. Thematic analysis revealed five themes. Residents described reduced fatigue in the early morning, counterbalanced with worsened long-term fatigue on night float blocks; anticipation of negative impacts of the loss of distributed on-call experience and on-call shift volume; an urgency to sleep postcall in anticipation of consecutive night float shifts accompanied by conflicting role demands to stay postcall for care continuity; increased handover frequency accompanied by inaccurate/incomplete communication of patients' issues; and improvement in the senior resident experience on the clinical teaching unit, with increased ownership over patient care and improved relationships with junior housestaff. A reduced duty hours model with night float has potential to improve residents' perceived fatigue on call and care continuity on the clinical teaching unit. This must be weighed against increased handover frequency and loss of the postcall day, which may negatively affect patient care and resident quality of life.

Effect of 16-hour duty periods on patient care and resident education.

Science.gov (United States)

McCoy, Christopher P; Halvorsen, Andrew J; Loftus, Conor G; McDonald, Furman S; Oxentenko, Amy S

2011-03-01

To measure the effect of duty periods no longer than 16 hours on patient care and resident education. As part of our Educational Innovations Project, we piloted a novel resident schedule for an inpatient service that eliminated shifts longer than 16 hours without increased staffing or decreased patient admissions on 2 gastroenterology services from August 29 to November 27, 2009. Patient care variables were obtained through medical record review. Resident well-being and educational variables were collected by weekly surveys, end of rotation evaluations, and an electronic card-swipe system. Patient care metrics, including 30-day mortality, 30-day readmission rate, and length of stay, were unchanged for the 196 patient care episodes in the 5-week intervention month compared with the 274 episodes in the 8 weeks of control months. However, residents felt less prepared to manage cross-cover of patients (P = .006). There was a nonsignificant trend toward decreased perception of quality of education and balance of personal and professional life during the intervention month. Residents reported working fewer weekly hours overall during the intervention (64.3 vs 68.9 hours; P = .40), but they had significantly more episodes with fewer than 10 hours off between shifts (24 vs 2 episodes; P = .004). Inpatient hospital services can be staffed with residents working shifts less than 16 hours without additional residents. However, cross-cover of care, quality of education, and time off between shifts may be adversely affected.

The effect of the Accreditation Council for Graduate Medical Education Duty Hours Policy on plastic surgery resident education and patient care: an outcomes study.

Science.gov (United States)

Basu, Chandrasekhar Bob; Chen, Li-Mei; Hollier, Larry H; Shenaq, Saleh M

2004-12-01

The Accreditation Council for Graduate Medical Education (ACGME) Work-Hours Duty Policy became effective on July 1, 2003, mandating the reduction of resident duty work hours. The Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program instituted a resident duty work-hours policy on July 1, 2002 (1 year ahead of the national mandate). Outcomes data are needed to facilitate continuous improvements in plastic surgical residency training while maintaining high-quality patient care. To assess the effect of this policy intervention on plastic surgery resident education as measured through the six core competencies and patient/resident safety, the investigators surveyed all categorical plastic surgery residents 6 months after implementation of the policy. This work represents the first empiric study investigating the effect of duty hours reduction on plastic surgery training and education. The categorical plastic surgery residents at the Baylor College of Medicine Multi-Institutional Integrated Plastic Surgery Program completed a 68-item survey on a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). Residents were asked to rate multiple parameters based on the ACGME six core competencies, including statements on patient care and clinical/operative duties, resident education, resident quality of life, and resident perceptions on this policy. All surveys were completed anonymously. The sample size was n = 12 (program year 3 through program year 6), with a 100 percent response rate. Univariate and bivariate statistical analysis was conducted with SPSS version 10.0 statistical software. Specifically, interquartile deviations were used to find consensus among resident responses to each statement. Descriptive statistics indicated higher percentages of agreement on a majority of statements in three categories, including patient care and clinical/operative duties, academic duties, and resident quality of life. Using interquartile

Surgical training, duty-hour restrictions, and implications for meeting the Accreditation Council for Graduate Medical Education core competencies: views of surgical interns compared with program directors.

Science.gov (United States)

Antiel, Ryan M; Van Arendonk, Kyle J; Reed, Darcy A; Terhune, Kyla P; Tarpley, John L; Porterfield, John R; Hall, Daniel E; Joyce, David L; Wightman, Sean C; Horvath, Karen D; Heller, Stephanie F; Farley, David R

2012-06-01

To describe the perspectives of surgical interns regarding the implications of the new Accreditation Council for Graduate Medical Education (ACGME) duty-hour regulations for their training. We compared responses of interns and surgery program directors on a survey about the proposed ACGME mandates. Eleven general surgery residency programs. Two hundred fifteen interns who were administered the survey during the summer of 2011 and a previously surveyed national sample of 134 surgery program directors. Perceptions of the implications of the new duty-hour restrictions on various aspects of surgical training, including the 6 ACGME core competencies of graduate medical education, measured using 3-point scales (increase, no change, or decrease). Of 215 eligible surgical interns, 179 (83.3%) completed the survey. Most interns believed that the new duty-hour regulations will decrease continuity with patients (80.3%), time spent operating (67.4%), and coordination of patient care (57.6%), while approximately half believed that the changes will decrease their acquisition of medical knowledge (48.0%), development of surgical skills (52.8%), and overall educational experience (51.1%). Most believed that the changes will improve or will not alter other aspects of training, and 61.5% believed that the new standards will decrease resident fatigue. Surgical interns were significantly less pessimistic than surgery program directors regarding the implications of the new duty-hour restrictions on all aspects of surgical training (P training under the new paradigm of duty-hour restrictions have significant concerns about the effect of these regulations on the quality of their training.

Effects of duty hour restrictions on core competencies, education, quality of life, and burnout among general surgery interns.

Science.gov (United States)

Antiel, Ryan M; Reed, Darcy A; Van Arendonk, Kyle J; Wightman, Sean C; Hall, Daniel E; Porterfield, John R; Horvath, Karen D; Terhune, Kyla P; Tarpley, John L; Farley, David R

2013-05-01

To measure the implications of the new Accreditation Council for Graduate Medical Education duty hour regulations for education, well-being, and burnout. Longitudinal study. Eleven university-based general surgery residency programs from July 2011 to May 2012. Two hundred thirteen surgical interns. Perceptions of the impact of the new duty hours on various aspects of surgical training, including the 6 Accreditation Council for Graduate Medical Education core competencies, were measured on 3-point scales. Quality of life, burnout, balance between personal and professional life, and career satisfaction were measured using validated instruments. Half of all interns felt that the duty hour changes have decreased the coordination of patient care (53%), their ability to achieve continuity with hospitalized patients (70%), and their time spent in the operating room (57%). Less than half (44%) of interns believed that the new standards have decreased resident fatigue. In longitudinal analysis, residents' beliefs had significantly changed in 2 categories: less likely to believe that practice-based learning and improvement had improved and more likely to report no change to resident fatigue (P life. Compared with the normal US population, 50 interns (32%) were 0.5 SD less than the mean on the 8-item Short Form Health Survey mental quality of life score. Approximately one-third of interns demonstrated weekly symptoms of emotional exhaustion (28%) or depersonalization (28%) or reported that their personal-professional balance was either "very poor" or "not great" (32%). Although many interns (67%) reported that they daily or weekly reflect on their satisfaction from being a surgeon, 1 in 7 considered giving up their career as a surgeon on at least a weekly basis. The first cohort of surgical interns to train under the new regulations report decreased continuity with patients, coordination of patient care, and time spent in the operating room. Furthermore, suboptimal quality of

Association of Otolaryngology Resident Duty Hour Restrictions With Procedure-Specific Outcomes in Head and Neck Endocrine Surgery

Science.gov (United States)

Smith, Aaron; Braden, Lauren; Wan, Jim

2017-01-01

Importance Graduate medical education has undergone a transformation from traditional long work hours to a restricted plan to allow adequate rest for residents. The initial goal of this restriction is to improve patient outcomes. Objective To determine whether duty hour restrictions had any impact on surgery-specific outcomes by analyzing complications following thyroid and parathyroid procedures performed before and after duty hour reform. Design, Setting, and Participants Retrospective cross-sectional analysis of the National Inpatient Sample (NIS).The NIS was queried for procedure codes associated with thyroid and parathyroid procedures for the years 2000 to 2002 and 2006 to 2008. Hospitals were divided based on teaching status into 3 groups: nonteaching hospitals (NTHs), teaching hospitals without otolaryngology programs (THs), and teaching hospitals with otolaryngology programs (THs-OTO). Main Outcomes and Measures Procedure-specific complication rates, length of stay, and mortality rates were collected. SAS statistical software (version 9.4) was used for analysis with adjustment using Charlson comorbidity index. Results Total numbers of head and neck endocrine procedures were 34 685 and 39 770 (a 14.7% increase), for 2000 to 2002 and 2006 to 2008, respectively. THs-OTO contributed a greater share of procedures in 2006 to 2008 (from 18% to 25%). With the earlier period serving as the reference, length of stay remained constant (2.1 days); however, total hospital charges increased (from $12 978 to $23 708; P otolaryngology programs. PMID:28196195

Light duty utility arm software requirements specification

International Nuclear Information System (INIS)

Kiebel, G.R.

1995-01-01

This document defines the software requirements for the integrated control and data acquisition system of the Light Duty Utility Arm (LDUA) System. It is intended to be used to guide the design of the application software, to be a basis for assessing the application software design, and to establish what is to be tested in the finished application software product

14 CFR 91.1057 - Flight, duty and rest time requirements: All crewmembers.

Science.gov (United States)

2010-01-01

... RULES Fractional Ownership Operations Program Management § 91.1057 Flight, duty and rest time... cabin-safety-related responsibilities. Multi-time zone flight means an easterly or westerly flight or... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight, duty and rest time requirements...

A Narrative Review of High-Quality Literature on the Effects of Resident Duty Hours Reforms.

Science.gov (United States)

Lin, Henry; Lin, Emery; Auditore, Stephanie; Fanning, Jon

2016-01-01

To summarize current high-quality studies evaluating the effect and efficacy of resident duty hours reforms (DHRs) on patient safety and resident education and well-being. The authors searched PubMed and Medline in August 2012 and again in May 2013 for literature (1987-2013) about the effects of DHRs. They assessed the quality of articles using the Medical Education Research Study Quality Instrument (MERSQI) scoring system. They considered randomized controlled trials (RCTs), partial RCTs, and all studies with a MERSQI score ≥ 14 to be "high-quality" methodology studies. A total of 72 high-quality studies met inclusion criteria. Most studies showed no change or slight improvement in mortality and complication rates after DHRs. Resident well-being was generally improved, but there was a perceived negative impact on education (knowledge acquisition, skills, and cognitive performance) following DHRs. Eleven high-quality studies assessed the impact of DHR interventions; all reported a neutral to positive impact. Seven high-quality studies assessed costs associated with DHRs and demonstrated an increase in hospital costs. The results of most studies that allow enough time for DHR interventions to take effect suggest a benefit to patient safety and resident well-being, but the effect on the quality of training remains unknown. Additional methodologically sound studies on the impact of DHRs are necessary. Priorities for future research include approaches to optimizing education and clinical proficiency and studies on the effect of intervention strategies on both education and patient safety. Such studies will provide additional information to help improve duty hours policies.

The Accreditation Council for Graduate Medical Education resident duty hour new standards: history, changes, and impact on staffing of intensive care units.

Science.gov (United States)

Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M

2011-11-01

The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.

Limitation of duty hour regulations for pediatric resident wellness: A mixed methods study in Japan.

Science.gov (United States)

Nomura, Osamu; Mishina, Hiroki; Kobayashi, Yoshinori; Ishiguro, Akira; Sakai, Hirokazu; Kato, Hiroyuki

2016-09-01

Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents.A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system. A follow-up focus-group interview with 4 residents was conducted to explore the factors that may trigger or prevent depression and burnout.Mean working hours significantly decreased from 75.2 hours to 64.9 hours per week. Prevalence of depressive symptoms remained similar before and after implementation of the shift system. Emotional exhaustion and depersonalization from the burnout scale were markedly associated with depression. High workload, stress intolerance, interpersonal difficulties, and generation gaps regarding work-life balance could cause burnout. Stress tolerance, workload monitoring and balancing, appropriate supervision, and peer support could prevent burnout.Although the overnight call shift system was effective in reducing working hours, its effectiveness in managing mental health issues among pediatric residents remains unclear. Resident wellness programs represent an additional strategy and they should be aimed at fostering peer support and improvement of resident-faculty interactions. Such an approach could be beneficial to the relationship between physicians of different generations with conflicting belief structures.

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

Science.gov (United States)

Desai, Sanjay V; Feldman, Leonard; Brown, Lorrel; Dezube, Rebecca; Yeh, Hsin-Chieh; Punjabi, Naresh; Afshar, Kia; Grunwald, Michael R; Harrington, Colleen; Naik, Rakhi; Cofrancesco, Joseph

2013-04-22

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation

Return to Flying Duties Following Centrifuge or Vibration Exposures

Science.gov (United States)

Scheuring, Richard A.; Clarke, Jonathan; Jones, Jeffrey A.

2009-01-01

Introduction: In an effort to determine the human performance limits for vibration in spacecraft being developed by NASA, astronauts were evaluated during a simulated launch profile in a centrifuge/vibration environment and separate vibration-only simulation. Current USAF and Army standards for return to flight following centrifuge exposures require 12-24 hours to pass before a crewmember may return to flying duties. There are no standards on vibration exposures and return to flying duties. Based on direct observation and provocative neurological testing of the astronauts, a new standard for return to flying duties following centrifuge and/or vibration exposures was established. Methods: 13 astronaut participants were exposed to simulated launch profiles in a + 3.5 Gx bias centrifuge/vibration environment and separately on a vibration table at the NASA-Ames Research Center. Each subject had complete neurological evaluations pre- and post-exposure for the centrifuge/vibration runs with the NASA neurological function rating scale (NFRS). Subjects who participated in the vibration-only exposures had video oculography performed with provocative maneuvers in addition to the NFRS. NFRS evaluations occurred immediately following each exposure and at 1 hour post-run. Astronauts who remained symptomatic at 1 hour had repeat NFRS performed at 1 hour intervals until the crewmember was asymptomatic. Results: Astronauts in the centrifuge/vibration study averaged a 3-5 point increase in NFRS scores immediately following exposure but returned to baseline 3 hours post-run. Subjects exposed to the vibration-only simulation had a 1-3 point increase following exposure and returned to baseline within 1-2 hours. Pre- and post- vibration exposure video oculography did not reveal any persistent ocular findings with provocative testing 1 hour post-exposure. Discussion: Based on direct observations and objective measurement of neurological function in astronauts following simulated launch

Effects of resident duty hour reform on surgical and procedural patient safety indicators among hospitalized Veterans Health Administration and Medicare patients.

Science.gov (United States)

Rosen, Amy K; Loveland, Susan A; Romano, Patrick S; Itani, Kamal M F; Silber, Jeffrey H; Even-Shoshan, Orit O; Halenar, Michael J; Teng, Yun; Zhu, Jingsan; Volpp, Kevin G

2009-07-01

Improving patient safety was a strong motivation behind duty hour regulations implemented by Accreditation Council for Graduate Medical Education on July 1, 2003. We investigated whether rates of patient safety indicators (PSIs) changed after these reforms. Observational study of patients admitted to Veterans Health Administration (VA) (N = 826,047) and Medicare (N = 13,367,273) acute-care hospitals from July 1, 2000 to June 30, 2005. We examined changes in patient safety events in more versus less teaching-intensive hospitals before (2000-2003) and after (2003-2005) duty hour reform, using conditional logistic regression, adjusting for patient age, gender, comorbidities, secular trends, baseline severity, and hospital site. Ten PSIs were aggregated into 3 composite measures based on factor analyses: "Continuity of Care," "Technical Care," and "Other" composites. Continuity of Care composite rates showed no significant changes postreform in hospitals of different teaching intensity in either VA or Medicare. In the VA, there were no significant changes postreform for the technical care composite. In Medicare, the odds of a Technical Care PSI event in more versus less teaching-intensive hospitals in postreform year 1 were 1.12 (95% CI; 1.01-1.25); there were no significant relative changes in postreform year 2. Other composite rates increased in VA in postreform year 2 in more versus less teaching-intensive hospitals (odds ratio, 1.63; 95% CI; 1.10-2.41), but not in Medicare in either postreform year. Duty hour reform had no systematic impact on PSI rates. In the few cases where there were statistically significant increases in the relative odds of developing a PSI, the magnitude of the absolute increases were too small to be clinically meaningful.

Training on the clock: family medicine residency directors' responses to resident duty hours reform.

Science.gov (United States)

Peterson, Lars E; Johnson, Hillary; Pugno, Perry A; Bazemore, Andrew; Phillips, Robert L

2006-12-01

The Accreditation Council for Graduate Medical Education's 2003 restrictions on resident duty hours (RDH) raised concerns among educators about potential negative impacts on residents' training. In the early wake of these restrictions, little is known about how RDH reform impacts training in primary care. The authors surveyed family medicine (FM) residency program directors (PDs) for their perceptions of the impact of RDH regulations on training in primary care. All PDs of 472 FM residency programs were asked via list-serve to complete an anonymous Internet-based survey in the fall of 2004. The survey solicited PDs' opinions about changes in staff and in residents' training experiences with respect to implementation of RDH regulations. Descriptive and qualitative analyses were conducted. There were 369 partial and 328 complete responses, for a response rate of 69% (328/472). Effects of the RDH regulations are varied. Fifty percent of FMPDs report increased patient-care duties for attendings, whereas 42% report no increase. Nearly 80% of programs hired no additional staff. Sixty percent of programs eliminated postcall clinics, and nearly 40% implemented a night-float system. Administrative hassles and losses of professionalism, educational opportunity, and continuity of care were common concerns, but a sizeable minority feel that residents will be better off under the new regulations. Many FMPDs cited increased faculty burden and the risk of lower-quality educational experiences for their trainees. Innovations for increasing the effectiveness of teaching may ultimately compensate for lost educational time. If not, alternatives such as extending the length of residency must be considered.

An observational pre-post study of re-structuring Medicine inpatient teaching service: Improved continuity of care within constraint of 2011 duty hours.

Science.gov (United States)

Cheung, Joseph Y; Mueller, Daniel; Blum, Marissa; Ravreby, Hannah; Williams, Paul; Moyer, Darilyn; Caroline, Malka; Zack, Chad; Fisher, Susan G; Feldman, Arthur M

2015-09-01

Implementation of more stringent regulations on duty hours and supervision by the Accreditation Council for Graduate Medical Education in July 2011 makes it challenging to design inpatient Medicine teaching service that complies with the duty hour restrictions while optimizing continuity of patient care. To prospectively compare two inpatient Medicine teaching service structures with respect to residents' impression of continuity of patient care (primary outcome), time available for teaching, resident satisfaction and length-of-stay (secondary endpoints). Observational pre-post study. Surveys were conducted both before and after Conventional Medicine teaching service was changed to a novel model (MegaTeam). Academic General Medicine inpatient teaching service. Surveys before and after MegaTeam implementation were completed by 68.5% and 72.2% of internal medicine residents, respectively. Comparing conventional with MegaTeam, the % of residents who agreed or strongly agreed that the (i) ability to care for majority of patients from admission to discharge increased from 29.7% to 86.6% (pcare, decreases number of handoffs, provides adequate supervision and teaching of interns and medical students, increases resident overall satisfaction and decreases length-of-stay. Copyright © 2015 Elsevier Inc. All rights reserved.

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

Directory of Open Access Journals (Sweden)

Hirai Aizan

2010-03-01

Full Text Available Abstract Background Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals. Methods A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%. Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables. Results Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men. Conclusion Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study.

Science.gov (United States)

Wada, Koji; Yoshikawa, Toru; Goto, Takahisa; Hirai, Aizan; Matsushima, Eisuke; Nakashima, Yoshifumi; Akaho, Rie; Kido, Michiko; Hosaka, Takashi

2010-03-12

Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals. A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables. Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men. Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.

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

Science.gov (United States)

2012-05-29

... place of business. Its shipping and receiving departments are on opposite sides of the paper mill... mandatory 10 hours off-duty requirement, RockTenn schedules these drivers' shifts to start later than other... approval of their request would be for the convenience of the applicant, with no assurance of safety...

19 CFR 101.6 - Hours of business.

Science.gov (United States)

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...

Work hours restrictions as an ethical dilemma for residents: a descriptive survey of violation types and frequency.

Science.gov (United States)

Carpenter, Robert O; Spooner, John; Arbogast, Patrick G; Tarpley, John L; Griffin, Marie R; Lomis, Kimberly D

2006-01-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented requirements regarding allowable duty hours for resident training in the United States in July 2003. In a previous pilot study at Vanderbilt University Medical Center, a significant number of residents reported violation of requirements. In addition, almost half of those individuals admitted under-reporting their hours worked. The authors' goal was to further delineate the type and frequency of violations and under-reporting. A survey tool was designed to assess specific types of violations as well as factors that influence the number of hours residents worked and reported. Approval was obtained from the Vanderbilt Institutional Review Board and Office of Graduate Medical Education before enrollment of subjects. The program directors of Pediatrics, Internal Medicine, Medicine-Pediatrics, and General Surgery supported the participation of their residents. A voluntary anonymous survey of these residents was conducted 1 year after the pilot study. Of 263 eligible residents, 175 were surveyed. Of 175 residents, 125 (71%) residents responded. Eighty-five percent of residents reported violation of duty-hour requirements within the preceding 3 months. Residents reported violation of specific requirements as follows: 1 day off in 7, 28%; 80-hour weekly average, 65%; and "24+6" consecutive hours, 85%. Residents were asked to estimate the number of hours by which they exceeded requirements. Hours over the 80-hour weekly requirement were reported as follows: 1 hour, 12%; 2 hours, 15%; 3 hours, 21%; 4 hours, 5%; 5 hours, 14%; and 6 or more hours, 33%. Hours over the "24+6" requirement were reported as follows: 1 hour, 30%; 2 hours, 42%; 3 hours, 18%; 4 hours, 7%; 5 hours, 1%; and 6 or more hours, 2%. Forty-eight percent of respondents admitted under-reporting violations to their program director. Eighty-five percent of residents reported at least 1 violation, and 48% admitted under

Duty Rosters and Workloads of Obstetricians in Germany: Results of a Germany-wide Survey.

Science.gov (United States)

Neimann, Johannes; Knabl, Julia; Puppe, Julian; Bayer, Christian Michael; Gass, Paul; Gabriel, Lena; Seelbach-Goebel, Birgit; Lermann, Johannes; Schott, Sarah

2017-08-01

Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany. This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care. The survey consisted of an anonymized 95-item questionnaire which collected data on different types of duty roster systems and the workload of obstetricians in Germany for the period from 17.02.2015 to 16.05.2015. Out of a total of 2770 physicians who were contacted, 437 (16%) completed the questionnaire. Across all forms of care, the care provided outside normal working hours usually (75%) consisted of a combination of regular working times and on-call duty or even consisted entirely of standby duty. Level I perinatal centers were most likely 20% (n = 88) to have a shift system in place. Working a shift system was significantly more common in care facilities which had previously carried out a job analysis. The number of physicians in hospitals who are present during the night shift was higher in facilities with higher numbers of births and in facilities which offered higher levels of care. In addition to regularly working overtime and the fact that often not all the hours worked were recorded, it was notable that the systems used to compile duty rosters often did not comply with legal regulations or with collectively agreed working hours nor were they compatible with the staff planning requirements. The results of this study show that the conditions of work, the working times, and the organization of working times in obstetric departments are in need of improvement. Recording the actual times worked together with an

Development of Electronic Medical Record-Based "Rounds Report" Results in Improved Resident Efficiency, More Time for Direct Patient Care and Education, and Less Resident Duty Hour Violations.

Science.gov (United States)

Ham, Phillip B; Anderton, Toby; Gallaher, Ryan; Hyrman, Mike; Simmerman, Erika; Ramanathan, Annamalai; Fallaw, David; Holsten, Steven; Howell, Charles Gordon

2016-09-01

Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations. Hospital wide, 17,200 RRs were generated in the 1-month study. Twenty-three surgery residents participated. Time spent preparing for rounds decreased per floor patient (15.6 ± 3.0 vs 6.0 ± 1.2, P care unit patient (19.9 ± 2.9 vs 7.5 ± 1.2 P care increased from 45.1 ± 5.6 to 54.0 ± 5.7 per cent (P = 0.0044). Educational activity time increased from 35.2 ± 5.4 to 54.7 ± 7.1 minutes per resident per day (P = 0.0004). Reported duty hour violations decreased 58 per cent (P care at academic medical centers.

Impact of new duty-hour rules on residency training.

Science.gov (United States)

Duran-Nelson, Alisa; Van Camp, Joan; Ling, Louis

2010-11-01

On the surface, changing the rules related to the number of hours residents work per day and per week sounds like a good idea. Theoretically, residents who work fewer hours would be less tired and provide better patient care. But even small changes in residency training programs have implications for the quality of the educational experience and the cost of training, as well as patient care. This article highlights the challenges that two Minnesota residency programs are facing as they adapt to the new rules around residents' work hours.

78 FR 41852 - Hours of Service for Commercial Motor Vehicle Drivers; Regulatory Guidance Concerning Off-Duty Time

Science.gov (United States)

2013-07-12

... provided: 1. The driver is relieved of all duty and responsibility for the care and custody of the vehicle... Service for Commercial Motor Vehicle Drivers; Regulatory Guidance Concerning Off-Duty Time AGENCY: Federal... motor vehicle (CMV) driver to record meal and other routine stops made during a work shift as off-duty...

Associations of excessive sleepiness on duty with sleeping hours and number of days of overnight work among medical residents in Japan.

Science.gov (United States)

Wada, Koji; Sakata, Yumi; Theriault, Gilles; Narai, Rie; Yoshino, Yae; Tanaka, Katsutoshi; Aizawa, Yoshiharu

2007-11-01

Despite long-standing concerns regarding the effects of working hours on the performance and health of medical residents, and the patients' safety, prior studies have not shown an association of excessive sleepiness with the number of sleeping hours and days of overnight work among medical residents. In August 2005, a questionnaire was mailed to 227 eligible participants at 16 teaching hospitals. The total number of sleeping hours in the last 30 d was estimated from the average number of sleeping hours during regular days and during days with overnight work, and the number of days of overnight work. Multiple logistic regression analysis was used to adjust for potentially associated variables. A total of 149 men and 47 women participated in this study. The participation rate was 86.3%. Among the participants, 55 (28.1%) suffered from excessive sleepiness. Excessive sleepiness was associated with sleeping for less than 150 h in the last 30 d (corrected odds ratio [cOR]=1.57; 95% confidence interval [CI], 1.02-2.16). The number of days of overnight work in the last 30 d showed no association with excessive sleepiness. Excessive sleepiness was also associated with smoking (cOR, 1.65; 95%CI, 1.01-2.32). Medical residents who slept for less than 150 h in the last 30 d and smoked had a significantly higher risk of excessive sleepiness on duty.

5 CFR 610.404 - Requirement for time-accounting method.

Science.gov (United States)

2010-01-01

... REGULATIONS HOURS OF DUTY Flexible and Compressed Work Schedules § 610.404 Requirement for time-accounting method. An agency that authorizes a flexible work schedule or a compressed work schedule under this...

Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.

Science.gov (United States)

Jena, Anupam B; Schoemaker, Lena; Bhattacharya, Jay

2014-10-01

In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency. We found that the duty-hour reforms did not adversely affect hospital mortality and length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during their own residency. However, assessment of the impact of the duty-hour reforms on other clinical outcomes is needed. Project HOPE—The People-to-People Health Foundation, Inc.

Comparative study of alertness and performance on 8-hour and 12-hour evening and night shifts for nuclear power plant operators

International Nuclear Information System (INIS)

Baker, T.L.

1990-01-01

Twenty males aged 25-40 years, many with extensive shiftwork and/or power plant operations experience, volunteered for a laboratory study to compare 8-hour and 12-hour shift schedules. Experiments were conducted in workplace simulation laboratories of the Human Alertness Research Center (HARC) at the Institute for Circadian Physiology in Boston, MA. This unique facility includes a simulated control room with process control simulator, control panels, and self-contained residential apartments where subjects sleep and spend off-duty hours. The design of the study is described. Subjects learn the operation of the process control simulator in multiple practice sessions prior to the experiment. They also practice computer-based performance tests, learn work shift protocols and assignments, and procedures for keeping subjective rating scales for alertness, mood and performance. By the time the first experimental shift begins, all subjects are prepared to perform their simulated work shift duties. These duties include monitoring of four video display terminals for silent (visual cues only) and auditory (visual and auditory) alarms, acknowledging the alarms with computer controls, and keeping log records of alarm activity. The process control simulator simultaneously keeps records of subject performance of these tasks by recording storing all times of alarm activity and alarm acknowledgement by the subject

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

Science.gov (United States)

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.

19 CFR 19.36 - Requirements for duty-free store operations.

Science.gov (United States)

2010-04-01

... under the sales ticket procedure in § 144.37(h) of this chapter may be delivered only to individuals... restrictions on the sale of conditionally duty-free merchandise to any one individual to personal-use... consumption and brought into a duty-free store (Class 9 warehouse) for display and sale or for delivery to...

Understanding the Multidimensional Effects of Resident Duty Hours Restrictions: A Thematic Analysis of Published Viewpoints in Surgery.

Science.gov (United States)

Devitt, Katharine S; Kim, Michael J; Gotlib Conn, Lesley; Wright, Frances C; Moulton, Carol-Anne; Keshet, Itay; Ahmed, Najma

2018-02-01

Individuals representing various surgical disciplines have expressed concerns with the impact of resident duty hours (RDH) restrictions on resident education and patient outcomes. This thematic review of published viewpoints aimed to describe the effects of these restrictions in surgery. The authors conducted a qualitative systematic review of non-research-based literature published between 2003 and 2015. Articles were included if they focused on the RDH restrictions in surgery and resident wellness, health promotion, resident safety, resident education and/or training, patient safety, medical errors, and/or heterogeneity regarding training or disciplines. A thematic analysis approach guided data extraction. Contextual data were abstracted from the included articles to aid in framing the identified themes. Of 1,482 identified articles, 214 were included in the review. Most were from authors in the United States (144; 67%) and focused on the 80-hour workweek (164; 77%). The emerging themes were organized into three overarching categories: (1) impact of the RDH restrictions, (2) surgery has its own unique culture, and (3) strategies going forward. Published opinions suggested that RDH restrictions alone are insufficient to achieve the desired outcomes and that careful consideration of the surgical training model is needed to maintain the integrity of educational outcomes. Opinions from the surgical community highlight the complexity of issues surrounding the RDH restrictions and suggest that recent changes are not achieving all the desired outcomes and have resulted in unintended outcomes. From the perceptions of the various stakeholders in surgical education studied, areas for new policies were identified.

Medium- and Heavy-Duty Vehicle Duty Cycles for Electric Powertrains

Energy Technology Data Exchange (ETDEWEB)

Kelly, Kenneth; Bennion, Kevin; Miller, Eric; Prohaska, Bob

2016-03-02

NREL's Fleet Test and Evaluation group has extensive in-use vehicle data demonstrating the importance of understanding the vocational duty cycle for appropriate sizing of electric vehicle (EV) and power electronics components for medium- and heavy-duty EV applications. This presentation includes an overview of recent EV fleet evaluation projects that have valuable in-use data that can be leveraged for sub-system research, analysis, and validation. Peak power and power distribution data from in-field EVs are presented for four different vocations, including class 3 delivery vans, class 6 delivery trucks, class 8 transit buses, and class 8 port drayage trucks, demonstrating the impacts of duty cycle on performance requirements.

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

Science.gov (United States)

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

Moving beyond Debate: Support for CACREP's Standard Requiring 60 Credit Hours for School Counseling Programs

Science.gov (United States)

Merlin, Clare; Pagano, Timothy; George, Amanda; Zanone, Cassandra; Newman, Benjamin

2017-01-01

The Council for Accreditation of Counseling and Related Educational Programs (CACREP) recently released its 2016 standards. Included in these standards is a requirement for school counseling master's programs to have a minimum of 60 credit hours by the year 2020. This credit hour requirement is an increase from the previous 48-hour requirement and…

40 CFR 51.914 - What new source review requirements apply for 8-hour ozone nonattainment areas?

Science.gov (United States)

2010-07-01

... apply for 8-hour ozone nonattainment areas? 51.914 Section 51.914 Protection of Environment... Standard § 51.914 What new source review requirements apply for 8-hour ozone nonattainment areas? The requirements for new source review for the 8-hour ozone standard are located in § 51.165 of this part. [70 FR...

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

Science.gov (United States)

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...

75 FR 7426 - Tier 2 Light-Duty Vehicle and Light-Duty Truck Emission Standards and Gasoline Sulfur Control...

Science.gov (United States)

2010-02-19

... 2060-AI23; 2060-AQ12 Tier 2 Light-Duty Vehicle and Light-Duty Truck Emission Standards and Gasoline.... The rulemaking also required oil refiners to limit the sulfur content of the gasoline they produce. Sulfur in gasoline has a detrimental impact on catalyst performance and the sulfur requirements have...

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

Science.gov (United States)

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 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.

46 CFR 111.25-15 - Duty cycle.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Duty cycle. 111.25-15 Section 111.25-15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) ELECTRICAL ENGINEERING ELECTRIC SYSTEMS-GENERAL REQUIREMENTS Motors § 111.25-15 Duty cycle. Each motor must be rated for continuous duty, except a motor for an...

Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: systematic review.

Science.gov (United States)

Moonesinghe, S R; Lowery, J; Shahi, N; Millen, A; Beard, J D

2011-03-22

To determine whether a reduction in working hours of doctors in postgraduate medical training has had an effect on objective measures of medical education and clinical outcome. Systematic review. Medline, Embase, ISI Web of Science, Google Scholar, ERIC, and SIGLE were searched without language restriction for articles published between 1990 and December 2010. Reference lists and citations of selected articles. Studies that assessed the impact of a change in duty hours using any objective measure of outcome related to postgraduate medical training, patient safety, or clinical outcome. Any study design was eligible for inclusion. 72 studies were eligible for inclusion: 38 reporting training outcomes, 31 reporting outcomes in patients, and three reporting both. A reduction in working hours from greater than 80 hours a week (in accordance with US recommendations) does not seem to have adversely affected patient safety and has had limited effect on postgraduate training. Reports on the impact of European legislation limiting working hours to less than 56 or 48 a week are of poor quality and have conflicting results, meaning that firm conclusions cannot be made. Reducing working hours to less than 80 a week has not adversely affected outcomes in patient or postgraduate training in the US. The impact of reducing hours to less than 56 or 48 a week in the UK has not yet been sufficiently evaluated in high quality studies. Further work is required, particularly in the European Union, using large multicentre evaluations of the impact of duty hours' legislation on objective educational and clinical outcomes.

The eighty-hour workweek: surgical attendings' perspectives.

Science.gov (United States)

Griner, Devan; Menon, Rema P; Kotwall, Cyrus A; Clancy, Thomas V; Hope, William W

2010-01-01

The year 2008 was a sentinel year in resident education; this was the first graduating general surgery class trained entirely under the 80-hour workweek. The purpose of this study was to evaluate attending surgeon perceptions of surgical resident attitudes and performance before and after duty-hour restrictions. An electronic survey was sent to all surgical teaching institutions in North Carolina. Both surgeon and hospital characteristics were documented. The survey consisted of questions designed to assess residents' attitudes/performance before and after the implementation of the work-hour restriction. In all, 77 surveys were returned (33% response rate). The survey demonstrated that 92% of educators who responded to the survey recognized a difference between the restricted residents (RRs) and the nonrestricted residents (NRRs), and most respondents (67%) attributed this to both the work-hour restrictions and the work ethic of current residents. Most attending surgeons reported no difference between the RRs and the NRRs in most categories; however, they identified a negative change in the areas of work ethic, technical skills development, decision-making/critical-thinking skills, and patient ownership among the RR group. Most surgeons expressed less trust (55%) with patient care and less confidence (68%) in residents' ability to operate independently in the RR group. Eighty-nine percent indicated that additional decreases in work hours would continue to hamper the mission of timely and comprehensive resident education. The perception of surgical educators was that RRs are clearly different from the NRRs and that the primary difference is in work ethic and duty-hour restrictions. Although similar in most attributes, RRs are perceived as having a lower baseline work ethic and a less developed technical skill set, decision-making ability, and sense of patient ownership. Subsequent study is needed to evaluate these concerns. Copyright 2010 Association of Program

Duty hours for post-graduate resident doctors need for change

Directory of Open Access Journals (Sweden)

Sushil Kumar

2013-01-01

Full Text Available Post Graduate training involves Patient care, education and administrative activities. But in today's modern life, the patient doctor ratio is so high that it leads to long working hours among PG residents which leads to fatigue & stress, which ultimately affects the care-giver as well as the patients. A survey was done among 20 PG residents to analyse performance, behavior, attitude and practices in patient care by PG Residents and to understand the affliction of their personal life. It was found that the PG Residents are working for an average time of 110 hrs/week ranging from 80–132 hours/week. It was also found to affect their performance, self-care, needle stick injuries & personal life.

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

Science.gov (United States)

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

1998-04-01

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

Battery Dimensioning and Life Cycle Costs Analysis for a Heavy-Duty Truck Considering the Requirements of Long-Haul Transportation

OpenAIRE

Mareev, Ivan; Becker, Jan Nicolas; Sauer, Dirk Uwe

2018-01-01

The use of heavy-duty battery electric trucks for long-haul transportation is challenging because of the required high energy amounts and thus the high capacity of traction batteries. Furthermore a high capacity battery implies high initial costs for the electric vehicle. This study investigates the required battery capacity for battery electric trucks considering the requirements of long-haul transportation in Germany and compares the life cycle costs of battery electric trucks and conventio...

Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

International Nuclear Information System (INIS)

Illing, R.O.; Ingham Clark, C.L.; Allum, C.

2010-01-01

Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

Energy Technology Data Exchange (ETDEWEB)

Illing, R.O., E-mail: rowland@doctors.org.u [University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU (United Kingdom); Ingham Clark, C.L.; Allum, C. [Whittington Hospital NHS Trust, London (United Kingdom)

2010-04-15

Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

The 150 Credit-Hour Requirement and CPA Examination Pass Rates--A Four Year Study

Science.gov (United States)

Briggs, Gary P.; He, Lerong

2012-01-01

Debate concerning the minimum educational requirements of certified public accountant (CPA) candidates in the USA has been taking place for decades. This paper compares the sectional pass rates of CPA candidates from jurisdictions requiring 150 credit hours of college study with the pass rates of candidates from jurisdictions not requiring 150…

78 FR 76757 - Regulatory Guidance on Hours of Service of Drivers Rest Break Requirement; Drivers Who Become...

Science.gov (United States)

2013-12-19

... limitations for unforeseen reasons, is the driver in violation of the Sec. 395.3 rest break provision if more... unforeseen reasons, is not in violation of the Sec. 395.3 rest-break requirements if 8 or more hours have... Regulatory Guidance on Hours of Service of Drivers Rest Break Requirement; Drivers Who Become Ineligible for...

Performance concerns for high duty fuel cycle

International Nuclear Information System (INIS)

Esposito, V.J.; Gutierrez, J.E.

1999-01-01

One of the goals of the nuclear industry is to achieve economic performance such that nuclear power plants are competitive in a de-regulated market. The manner in which nuclear fuel is designed and operated lies at the heart of economic viability. In this sense reliability, operating flexibility and low costs are the three major requirements of the NPP today. The translation of these three requirements to the design is part of our work. The challenge today is to produce a fuel design which will operate with long operating cycles, high discharge burnup, power up-rating and while still maintaining all design and safety margins. European Fuel Group (EFG) understands that to achieve the required performance high duty/energy fuel designs are needed. The concerns for high duty design includes, among other items, core design methods, advanced Safety Analysis methodologies, performance models, advanced material and operational strategies. The operational aspects require the trade-off and evaluation of various parameters including coolant chemistry control, material corrosion, boiling duty, boron level impacts, etc. In this environment MAEF is the design that EFG is now offering based on ZIRLO alloy and a robust skeleton. This new design is able to achieve 70 GWd/tU and Lead Test Programs are being executed to demonstrate this capability. A number of performance issues which have been a concern with current designs have been resolved such as cladding corrosion and incomplete RCCA insertion (IRI). As the core duty becomes more aggressive other new issues need to be addressed such as Axial Offset Anomaly. These new issues are being addressed by combination of the new design in concert with advanced methodologies to meet the demanding needs of NPP. The ability and strategy to meet high duty core requirements, flexibility of operation and maintain acceptable balance of all technical issues is the discussion in this paper. (authors)

29 CFR 2580.412-8 - The nature of the duties or activities to which the bonding requirement relates.

Science.gov (United States)

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false The nature of the duties or activities to which the bonding requirement relates. 2580.412-8 Section 2580.412-8 Labor Regulations Relating to Labor (Continued) EMPLOYEE... INCOME SECURITY ACT OF 1974 TEMPORARY BONDING RULES Scope and Form of the Bond § 2580.412-8 The nature of...

30 CFR 772.13 - Coal exploration compliance duties.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal exploration compliance duties. 772.13... INTERIOR SURFACE COAL MINING AND RECLAMATION OPERATIONS PERMITS AND COAL EXPLORATION SYSTEMS UNDER REGULATORY PROGRAMS REQUIREMENTS FOR COAL EXPLORATION § 772.13 Coal exploration compliance duties. (a) All...

48 CFR 52.216-30 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition without...

Science.gov (United States)

2010-10-01

...-Hour Proposal Requirements-Non-Commercial Item Acquisition without Adequate Price Competition. 52.216... Price Competition. As prescribed in 16.601(e)(2), insert the following provision: Time-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition Without Adequate Price Competition (FEB...

The role of the nonphysician educator in general surgery residency training: from outcome project and duty-hours restrictions to the next accreditation system and milestones.

Science.gov (United States)

Tarpley, Margaret J; Davidson, Mario A; Tarpley, John L

2014-01-01

In 2002 and 2003 the ACGME Outcome Project (assessing residents based on competencies) and duty-hours restrictions were implemented. One strategy for assisting PDs in the increased workload was to hire nonphysician educators with training and experience in curriculum design, teaching techniques, adult learning theories, and research methods. This study sought to document prevalence and responsibilities of nonphysician educators. IRB approval was received for a two-part study. All 247 general surgery PDs were e-mailed the question, "Do you have a nonphysician educator as a member of your surgery education office?" Those who replied "yes" or volunteered "not currently but in the past" were e-mailed a link to an electronic survey concerning the role of the nonphysician educator. Residency training programs in general surgery. General surgery program directors. Of the 126 PDs who responded to the initial query, 37 said "yes" and 4 replied "not currently but in the past". Thirty-two PDs of the initial 41 respondents completed the survey. Significant findings included: 65% were hired in the last 6 years; faculty rank is held by 69%; and curriculum development was the most common responsibility but teaching, research, and administrative duties were often listed. PDs perceived that faculty, residents, and medical students had mostly positive attitudes towards nonphysician educators. The overall results seem to support the notion that nonphysician educators serve as vital members of the team. Copyright © 2014 Association of Program Directors in Surgery. All rights reserved.

76 FR 54537 - Swap Data Repositories: Registration Standards, Duties and Core Principles

Science.gov (United States)

2011-09-01

... Part 49 Swap Data Repositories: Registration Standards, Duties and Core Principles; Final Rule #0;#0...: Registration Standards, Duties and Core Principles AGENCY: Commodity Futures Trading Commission. ACTION: Final... registration requirements, statutory duties, core principles and certain compliance obligations for registered...

Fleet average NOx emission performance of 2004 model year light-duty vehicles, light-duty trucks and medium-duty passenger vehicles

International Nuclear Information System (INIS)

2006-05-01

The On-Road Vehicle and Engine Emission Regulations came into effect on January 1, 2004. The regulations introduced more stringent national emission standards for on-road vehicles and engines, and also required that companies submit reports containing information concerning the company's fleets. This report presented a summary of the regulatory requirements relating to nitric oxide (NO x ) fleet average emissions for light-duty vehicles, light-duty trucks, and medium-duty passenger vehicles under the new regulations. The effectiveness of the Canadian fleet average NO x emission program at achieving environmental performance objectives was also evaluated. A summary of the fleet average NO x emission performance of individual companies was presented, as well as the overall Canadian fleet average of the 2004 model year based on data submitted by companies in their end of model year reports. A total of 21 companies submitted reports covering 2004 model year vehicles in 10 test groups, comprising 1,350,719 vehicles of the 2004 model year manufactured or imported for the purpose of sale in Canada. The average NO x value for the entire Canadian LDV/LDT fleet was 0.2016463 grams per mile. The average NO x values for the entire Canadian HLDT/MDPV fleet was 0.321976 grams per mile. It was concluded that the NO x values for both fleets were consistent with the environmental performance objectives of the regulations for the 2004 model year. 9 tabs

A workplace modified duty program for employees in an oncology center.

Science.gov (United States)

Soteriades, Elpidoforos S

2017-01-01

Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department. Employees' participation in the program was 3%. A total of 12 employees participated (6 each year). The participants were all women and the mean participation period was 21.6 days (range 10 - 65 days). The two most frequent reasons for a modified duty assignment were pregnancy and back pain. Employees were assigned either on limited duties or on a combination of limited duties and reduced work hours. Employees reported being very satisfied with their participation based on a follow-up narrative oral assessment. The small participation rate does not allow for advanced statistical analyses. Further studies from larger organizations are urgently needed to evaluate the effectiveness of modified duty programs. The development of a legal framework for such modified duty programs in Cyprus as well as internationally may promote their implementation in order to facilitate the effective management of temporary partial job disability for the benefit of both employees and businesses.

77 FR 28763 - Flightcrew Member Duty and Rest Requirements; Correction

Science.gov (United States)

2012-05-16

...;Prices of new books are listed in the first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0... duty with the intention of conducting a flight, a series of flights, or positioning or ferrying flights, and ends when the aircraft is parked after the last flight and there is no intention for further...

Evaluation of duty cycles for heavy-duty urban vehicles : final report of IEA AMF Annex 29

Energy Technology Data Exchange (ETDEWEB)

Nylund, N.O.; Erkkila, K. [VTT Technical Research Centre of Finland, Espoo (Finland); Clark, N. [West Virginia Univ., Morgantown, WV (United States); Rideout, G. [Environment Canada, Ottawa, ON (Canada). Environmental Technology Centre, Emissions Research and Measurement Div

2007-07-01

Heavy-duty vehicles in Europe and North America will require incylinder measures or exhaust gas after-treatment technology to control emissions and meet ever stringent emission requirements. Alternatively, manufacturers can choose clean burning alternative fuels such as natural gas. Although there are no international standards for heavy-duty vehicle chassis dynamometer testing at present, the IEA Implementing Agreements offer excellent platforms for international collaborative research. Harmonization of test methods for vehicles and fuels is one important task. This paper reported on the work of 3 laboratories that have produced emission results for complete heavy-duty vehicles. VTT Technical Research of Finland, Environment Canada and West Virginia University measured standard size urban buses driving various duty cycles on chassis dynamometers. The number of transient test cycles per laboratory varied from 6 to 16. European and North American diesel and natural gas vehicles were included in the vehicle matrix. The objective was to demonstrate how the driving cycle affects the emission performance of conventional and advanced urban buses. Several driving cycles were run on urban buses to better understand the characteristics of different duty cycles; produce a key for cross-interpretation of emission results generated with different cycles; and study the interaction between vehicle, exhaust after-treatment and fuel technologies and test procedures. Fuel consumption and exhaust emissions were measured. The results varied significantly not only by test cycle, but also by vehicle technology. In general, vehicles emissions were directly proportioned to the amount of fuel consumed, with the exception of NOx-emissions from SCR-vehicles. There was a clear difference in the emission profiles of European and North American vehicles. In Europe, fuel efficiency was emphasized, while in North America, more focus was given to regulated exhaust emissions, especially low

48 CFR 252.216-7002 - Alternate A, Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition...

Science.gov (United States)

2010-10-01

...-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate Price Competition... Requirements—Non-Commercial Item Acquisition With Adequate Price Competition. As prescribed in 216.601(e...-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price...

48 CFR 52.216-29 - Time-and-Materials/Labor-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate...

Science.gov (United States)

2010-10-01

...-Hour Proposal Requirements-Non-Commercial Item Acquisition With Adequate Price Competition. 52.216-29... Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price Competition (FEB 2007) (a) The... Time-and-Materials/Labor-Hour Proposal Requirements—Non-Commercial Item Acquisition With Adequate Price...

Antinatalism, Asymmetry, and an Ethic of Prima Facie Duties ...

African Journals Online (AJOL)

Benatar's central argument for antinatalism develops an asymmetry between the pain and pleasure in a potential life. I am going to present an alternative route to the antinatalist conclusion. I argue that duties require victims and that as a result there is no duty to create the pleasures contained within a prospective life but a ...

15 CFR 303.5 - Application for annual allocations of duty-exemptions and duty-refunds.

Science.gov (United States)

2010-01-01

... and control of the company and to the satisfaction of eligibility requirements of duty-free treatment... watch assembly operation. (8) All records pertaining to health insurance, life insurance and pension benefits for each employee; and (9) If HTSUS tariffs on watches and watch movements are reduced, records of...

Kant on euthanasia and the duty to die: clearing the air.

Science.gov (United States)

Cholbi, Michael

2015-08-01

Thanks to recent scholarship, Kant is no longer seen as the dogmatic opponent of suicide that he appears to be at first glance. However, some interpreters have recently argued for a Kantian view of the morality of suicide with surprising, even radical, implications. More specifically, they have argued that Kantianism (1) requires that those with dementia or other rationality-eroding conditions end their lives before their condition results in their loss of identity as moral agents and (2) requires subjecting the fully demented or those confronting future dementia to non-voluntary euthanasia. Properly understood, Kant's ethics have neither of these implications (1) wrongly assumes that rational agents' duty of self-preservation entails a duty of self-destruction when they become non-rational, (2) further neglects Kant's distinction between duties to self and duties to others and wrongly assumes that duties can be owed to rational agents only during the time of their existence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Resident work hours: why keeping the status quo may not be such a bad thing

Directory of Open Access Journals (Sweden)

Roshan Razik

2013-09-01

Full Text Available Resident duty hours have become an increasingly debated topic in post-graduate medical education. Work-hour restrictions have been implemented for first-year residents in the US and more recently for all residents in Quebec. Current and future work-hour rules affect a variety of stakeholders: government, hospitals, residency training programs, patients, and most of all residents. In this article, we hope to examine the issue from a Canadian perspective and delineate some of the reasons why changing the current call structure may have potentially deleterious effects to all those concerned.

45 CFR 7.1 - Duty of employee to report inventions.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Duty of employee to report inventions. 7.1 Section 7.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION EMPLOYEE INVENTIONS § 7.1 Duty of employee to report inventions. Every Department employee is required to report to...

29 CFR 793.15 - Duties away from the station.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Duties away from the station. 793.15 Section 793.15 Labor... Requirements for Exemption § 793.15 Duties away from the station. An employee who is “employed by” a radio or television station in one or more of the named occupations may perform his work at the station or away from...

Recovery of Sleep, Performance, and Mood Following 38 Hours of Sleep Deprivation Using Naps as a Countermeasure

National Research Council Canada - National Science Library

Caldwell, J

1998-01-01

In certain situations, soldiers must continue to perform their duties over an extended period of time, knowing that their regular sleep period will be missed and their time awake will extend well past 24 hours...

The Impact of 2011 ACGME Duty Hour Restrictions on Internal Medicine Resident Workload and Education

Science.gov (United States)

Vucicevic, Darko; Mookadam, Farouk; Webb, Brandon J.; Labonte, Helene R.; Cha, Stephen S.; Blair, Janis E.

2015-01-01

The Accreditation Council for Graduate Medical Education (ACGME) implemented work hour restrictions for physicians in training in 2003 that were revised July 1, 2011. Current published data are insufficient to assess whether such work hour restrictions will have long-term impact on residents' education. We searched computer-generated reports…

Idle emissions from medium heavy-duty diesel and gasoline trucks.

Science.gov (United States)

Khan, A B M S; Clark, Nigel N; Gautam, Mridul; Wayne, W Scott; Thompson, Gregory J; Lyons, Donald W

2009-03-01

Idle emissions data from 19 medium heavy-duty diesel and gasoline trucks are presented in this paper. Emissions from these trucks were characterized using full-flow exhaust dilution as part of the Coordinating Research Council (CRC) Project E-55/59. Idle emissions data were not available from dedicated measurements, but were extracted from the continuous emissions data on the low-speed transient mode of the medium heavy-duty truck (MHDTLO) cycle. The four gasoline trucks produced very low oxides of nitrogen (NOx) and negligible particulate matter (PM) during idle. However, carbon monoxide (CO) and hydrocarbons (HCs) from these four trucks were approximately 285 and 153 g/hr on average, respectively. The gasoline trucks consumed substantially more fuel at an hourly rate (0.84 gal/hr) than their diesel counterparts (0.44 gal/hr) during idling. The diesel trucks, on the other hand, emitted higher NOx (79 g/hr) and comparatively higher PM (4.1 g/hr), on average, than the gasoline trucks (3.8 g/hr of NOx and 0.9 g/hr of PM, on average). Idle NOx emissions from diesel trucks were high for post-1992 model year engines, but no trends were observed for fuel consumption. Idle emissions and fuel consumption from the medium heavy-duty diesel trucks (MHDDTs) were marginally lower than those from the heavy heavy-duty diesel trucks (HHDDTs), previously reported in the literature.

The duty to do the best for one's patient.

Science.gov (United States)

Crisp, Roger

2015-03-01

This paper is a discussion of the duty of doctors to do what is best for their patients. What is required by this duty is shown to depend on the circumstances, including any financial constraints on the doctor. The duty to do the best is a duty of benevolence, and this virtue itself has to be understood as bounded by other virtues, including justice and professional responsibility. An Aristotelian account of medical benevolence is developed, and the issues of supererogation and individual judgement are discussed within this framework. The paper ends with the claim that the patient-centred conception of benevolence defended in the paper is in line with consequentialist and deontological ethical traditions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Achieving Accreditation Council for Graduate Medical Education duty hours compliance within advanced surgical training: a simulation-based feasibility assessment.

Science.gov (United States)

Obi, Andrea; Chung, Jennifer; Chen, Ryan; Lin, Wandi; Sun, Siyuan; Pozehl, William; Cohn, Amy M; Daskin, Mark S; Seagull, F Jacob; Reddy, Rishindra M

2015-11-01

Certain operative cases occur unpredictably and/or have long operative times, creating a conflict between Accreditation Council for Graduate Medical Education (ACGME) rules and adequate training experience. A ProModel-based simulation was developed based on historical data. Probabilistic distributions of operative time calculated and combined with an ACGME compliant call schedule. For the advanced surgical cases modeled (cardiothoracic transplants), 80-hour violations were 6.07% and the minimum number of days off was violated 22.50%. There was a 36% chance of failure to fulfill any (either heart or lung) minimum case requirement despite adequate volume. The variable nature of emergency cases inevitably leads to work hour violations under ACGME regulations. Unpredictable cases mandate higher operative volume to ensure achievement of adequate caseloads. Publically available simulation technology provides a valuable avenue to identify adequacy of case volumes for trainees in both the elective and emergency setting. Copyright © 2015 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

Training for the future NHS: training junior doctors in the United Kingdom within the 48-hour European working time directive.

Science.gov (United States)

Datta, Shreelatta T; Davies, Sally J

2014-01-01

Since August 2009, the National Health Service of the United Kingdom has faced the challenge of delivering training for junior doctors within a 48-hour working week, as stipulated by the European Working Time Directive and legislated in the UK by the Working Time Regulations 1998. Since that time, widespread concern has been expressed about the impact of restricted duty hours on the quality of postgraduate medical training in the UK, particularly in the "craft" specialties--that is, those disciplines in which trainees develop practical skills that are best learned through direct experience with patients. At the same time, specialist training in the UK has experienced considerable change since 2007 with the introduction of competency-based specialty curricula, workplace-based assessment, and the annual review of competency progression. The challenges presented by the reduction of duty hours include increased pressure on doctors-in-training to provide service during evening and overnight hours, reduced interaction with supervisors, and reduced opportunities for learning. This paper explores these challenges and proposes potential responses with respect to the reorganization of training and service provision.

75 FR 38168 - Federal Motor Vehicle Theft Prevention Standard; Final Listing of 2011 Light Duty Truck Lines...

Science.gov (United States)

2010-07-01

... Theft Prevention Standard; Final Listing of 2011 Light Duty Truck Lines Subject to the Requirements of... light-duty truck lines subject to the requirements of the Federal motor vehicle theft prevention... exemption from the parts marking requirements of the Theft Prevention Standard for the Jaguar XJ vehicle...

40 CFR 51.918 - Can any SIP planning requirements be suspended in 8-hour ozone nonattainment areas that have air...

Science.gov (United States)

2010-07-01

... suspended in 8-hour ozone nonattainment areas that have air quality data that meets the NAAQS? 51.918 Section 51.918 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... 8-hour Ozone National Ambient Air Quality Standard § 51.918 Can any SIP planning requirements be...

Joint Duty Prerequisite for Promotion to 07 (Brigadier General

Science.gov (United States)

1989-03-13

NUMBER)(O LTC Julius E. Coats, Jr. 9. PERFORMING ORGANIZATIN NAME AND ADDRESS I0. PROGRAM ELEMENT. PROJECT. tASK U.S. Army War College AREA 4 WORK...new personnel policy; to wit, the Army leadership at all levels should view joint duty re- quirement for selection for flag officer with a positive...the Army leadership at all levels should view joint duty requirement for selection for flag officer with a positive attitude, not as a means for

Fitness for duty

International Nuclear Information System (INIS)

Barnes, D.; Matney, C.

1991-01-01

A Fitness For Duty training program was developed to satisfy the requirements of the NRC, 10 CFR 26, 10 CFR 707 and to meet requirements at the Westinghouse Savannah River Company. Interactive videodisc technology was selected as the training medium using the TenCore authoring language. Computer-based training was chosen because of the large number of trainees, the advantages of the reduced overall cost, and the increased trainee retention of course material compared to traditional instruction. The resulting training program utilizes extensive role playing exercises in which employees and supervisors are exposed to real life situations. Extensive interactions by the trainees are required in that they must answer questions concerning the behav ior of individuals, random and for-cause drug testing, and the employee assistance program. Feedback is given in each case. Emphasis is placed on recognition of deteriorating job performance

Functions and requirements for the light duty utility arm integrated system

International Nuclear Information System (INIS)

Kiebel, G.R.

1996-01-01

The Light Duty Utility Arm (LDUA) Integrated System is a mobile robotic system designed to remotely deploy and operate a variety of tools in uninhabitable underground radiological and hazardous waste storage tanks. The system primarily provides a means to inspect, survey, monitor, map and/or obtain specific waste and waste tank data in support of the Tank Waste Remediation System (TWRS) mission at Hanford and remediation programs at other U.S. Department of Energy (DOE) sites

Design criteria for the light duty utility arm system end effectors

International Nuclear Information System (INIS)

Pardini, A.F.; Kiebel, G.R.

1995-12-01

The purpose of this document is to provide criteria for the design of end effectors that will be used as part of the Light Duty Utility Arm (LDUA) System. Actual component design, fabrication, testing, and inspection will be performed by various DOE laboratories, industry, and academia. This document augments WHC-SD-TD-FRD-003, 'Functions and Requirements for the Light Duty Utility Arm Integrated System' (F). All requirements dictated in the F shall also be applicable in this document. Whenever conflicts arise between this document and the F, this document shall take precedence

78 FR 57881 - Monosodium Glutamate from China and Indonesia; Institution of Antidumping and Countervailing Duty...

Science.gov (United States)

2013-09-20

... than fair value and alleged to be subsidized by the Governments of China and Indonesia. Unless the... duties will each be collectively allocated one hour within which to make an oral presentation at the... investigations. Parties may file written testimony in connection with their presentation at the conference no...

77 FR 60133 - Agency Information Collection Activities: Deferral of Duty on Large Yachts Imported for Sale

Science.gov (United States)

2012-10-02

... Activities: Deferral of Duty on Large Yachts Imported for Sale AGENCY: U.S. Customs and Border Protection... collection requirement concerning Deferral of Duty on Large Yachts Imported for Sale. This request for...: Title: Deferral of Duty on Large Yachts Imported for Sale. OMB Number: 1651-0080. Form Number: None...

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

Science.gov (United States)

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 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.

New Approach To Hour-By-Hour Weather Forecast

Science.gov (United States)

Liao, Q. Q.; Wang, B.

2017-12-01

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

76 FR 43343 - Large Power Transformers From Korea; Institution of Antidumping Duty Investigation and Scheduling...

Science.gov (United States)

2011-07-20

..., that are alleged to be sold in the United States at less than fair value. Unless the Department of... duties will each be collectively allocated one hour within which to make an oral presentation at the... investigation. Parties may file written testimony in connection with their presentation at the conference no...

ADMINISTRATIVE CIRCULAR NO. 20 USE OF PRIVATE VEHICLES FOR OFFICIAL DUTY - INSURANCE

CERN Multimedia

Human Resources Division - Tel. 73634

2002-01-01

Administrative Circular No. 20 on the use of private vehicles for official duty is shortly to be revised with a view to making certain procedures more flexible. CERN no longer requires members of the personnel to take out optional private insurances (insurance for official journeys, legal assistance insurance) in the case of duty travel for the Organization, since the associated risks are covered by CERN's own insurance. Pending the above mentioned revision, members of the personnel may continue to use their private vehicles for official duty in accordance with the others provisions laid down in the Circular Reminder: Owners of private vehicles must of course be insured by the normal compulsory car insurance required by the laws of the Host States when driving on and off the CERN sites.

A mid year comparison study of career satisfaction and emotional states between residents and faculty at one academic medical center

Directory of Open Access Journals (Sweden)

Wessel Kristen

2006-07-01

Full Text Available Abstract Background The Accreditation Council for Graduate Medical Education's (ACGME new requirements raise multiple challenges for academic medical centers. We sought to evaluate career satisfaction, emotional states, positive and negative experiences, work hours and sleep among residents and faculty simultaneously in one academic medical center after implementation of the ACGME duty hour requirements. Methods Residents and faculty (1330 in the academic health center were asked to participate in a confidential survey; 72% of the residents and 66% of the faculty completed the survey. Results Compared to residents, faculty had higher levels of satisfaction with career choice, competence, importance and usefulness; lower levels of anxiousness and depression. The most positive experiences for both groups corresponded to strong interpersonal relationships and educational value; most negative experiences to poor interpersonal relationships and issues perceived outside of the physician's control. Approximately 13% of the residents and 14% of the faculty were out of compliance with duty hour requirements. Nearly 5% of faculty reported working more than 100 hours per week. For faculty who worked 24 hour shifts, nearly 60% were out of compliance with the duty-hour requirements. Conclusion Reasons for increased satisfaction with career choice, positive emotional states and experiences for faculty compared to residents are unexplained. Earlier studies from this institution identified similar positive findings among advanced residents compared to more junior residents. Faculty are more frequently at risk for duty-hour violations. If patient safety is of prime importance, faculty, in particular, should be compliant with the duty hour requirements. Perhaps the ACGME should contain faculty work hours as part of its regulatory function.

Duty of care is underpinned by a range of obligations.

Science.gov (United States)

Griffith, Richard

The courts have long established that nurses are in a duty situation and owe a duty of care to their patients (Kent v Griffiths [2001]). Traditionally, the profession set the standard of care and nurses were required to act in accordance with a practice accepted by a responsible body of their peers (Bolam v Friern HMC [1957]).The introduction of the Human Rights Act 1998 gave rise to a positive obligation on government to ensure that laws, policies and procedures are in place to protect violations of human rights. Nurses must now inform their practice with relevant statute law, common law and professional standards in order to properly discharge their duty of care. Richard Griffith considers the law that now underpins a nurse's duty of care and uses a recent report from the Health Service Ombudsman for England to illustrate the obligations that underpin the nurse-patient relationship.

Transparency, Trust and Security: An Evaluation of the Insurer's Precontractual Duties

Directory of Open Access Journals (Sweden)

Daleen Millard

2014-12-01

Full Text Available Transparency in insurance law attaches to the rights and duties of the parties, the relationships between insurers, insurance intermediaries such as agents and brokers, insurance supervisory law and insurance dispute resolution procedures. Regarding the rights and duties of the insurer and the prospective policyholder, it requires insurers to disclose precontractual information in a timely manner that is clear, understandable, legible and unambiguous. Transparency as a value is incredibly important in insurance contracts. This contribution focuses exclusively on the insurer's duty of disclosure during precontractual negotiations. Although the insured's duty of disclosure has enjoyed more attention in the past, the duty clearly applies to the insurance proposer as well as the insurer. The purpose of this contribution is to evaluate the nature and extent of the insurer's transparency duties as informed by both common and statutory laws. The insurer's duty is derived primarily from the statutory rights of access to information in accordance with the provisions of the Constitution of the Republic of South Africa and the Promotion of Access to Information Act. It is furthermore supported by specific insurance consumer protection law found in the detailed provisions on mandatory disclosures in the Financial Advisory and Intermediary Services Act, the Long-term Insurance Act, the Short-term Insurance Act and, finally, the Policyholder Protection Rules issued in accordance with these acts. Strict rules on advertising can be found in the General Code of Conduct issued under the FAIS Act. The Act furthermore specifically targets the activities of insurance intermediaries in precontractual disclosures. The fact that insurance products and services have been exempted from the scope of the Consumer Protection Act from 28 February 2014 should not diminish the insured's right to rely on universal consumer protection principles as envisaged by South African

Duty to disclose in medical genetics: a legal perspective.

Science.gov (United States)

Pelias, M Z

1991-06-01

As technical knowledge and public information in medical genetics continue to expand, the geneticist may expect to be held responsible for informing patients and clients about new developments in research and diagnosis. The long legal evolution of the physician's duty to disclose, and more recent findings of a physician's duty to recall former patients to inform them about newly discovered risks of treatment, indicate that medical geneticists may have a duty to disclose both current and future information about conditions that are or could be inherited. Recent case law supports findings of professional liability for both present and future disclosure, even in the absence of an active physician-patient relationship. The requirement of candid and complete disclosure will affect the counseling approach in testing for deleterious genes and in providing medical treatment for minors with hereditary diseases. Finding a duty to recall may impose further professional burdens on the geneticist to reach beyond the immediate counseling arena and to recontact patients, perhaps years after their initial visit to genetics clinic.

Light Duty Utility Arm Software Test Plan

International Nuclear Information System (INIS)

Kiebel, G.R.

1995-01-01

This plan describes how validation testing of the software will be implemented for the integrated control and data acquisition system of the Light Duty Utility Arm System (LDUA). The purpose of LDUA software validation testing is to demonstrate and document that the LDUA software meets its software requirements specification

Battery Dimensioning and Life Cycle Costs Analysis for a Heavy-Duty Truck Considering the Requirements of Long-Haul Transportation

Directory of Open Access Journals (Sweden)

Ivan Mareev

2017-12-01

Full Text Available The use of heavy-duty battery electric trucks for long-haul transportation is challenging because of the required high energy amounts and thus the high capacity of traction batteries. Furthermore a high capacity battery implies high initial costs for the electric vehicle. This study investigates the required battery capacity for battery electric trucks considering the requirements of long-haul transportation in Germany and compares the life cycle costs of battery electric trucks and conventional diesel trucks in different transportation scenarios. The average consumption is simulated for different battery electric truck configurations on the main German highways and transportation scenarios incorporating battery charging during driver rest periods. The results show that in average case the required battery would restrict the payload to only 80% of a usual diesel truck payload that might be acceptable considering the statistical payload use. The life cycle costs in the examined scenarios also considering the charging infrastructure show that battery electric trucks can already perform on the same costs level as diesel trucks in certain scenarios.

Light Duty Utility Arm computer software configuration management plan

International Nuclear Information System (INIS)

Philipp, B.L.

1998-01-01

This plan describes the configuration management for the Light Duty Utility Arm robotic manipulation arm control software. It identifies the requirement, associated documents, and the software control methodology. The Light Duty Utility Ann (LDUA) System is a multi-axis robotic manipulator arm and deployment vehicle, used to perform surveillance and characterization operations in support of remediation of defense nuclear wastes currently stored in the Hanford Underground Storage Tanks (USTs) through the available 30.5 cm (12 in.) risers. This plan describes the configuration management of the LDUA software

The Impact of the 2011 Accreditation Council for Graduate Medical Education Duty Hour Reform on Quality and Safety in Trauma Care.

Science.gov (United States)

Marwaha, Jayson S; Drolet, Brian C; Maddox, Suma S; Adams, Charles A

2016-06-01

In 2011, the ACGME limited duty hours for residents. Although studies evaluating the 2011 policy have not shown improvements in general measures of morbidity or mortality, these outcomes might not reflect changes in specialty-specific practice patterns and secondary quality measures. All trauma admissions from July 2009 through June 2013 at an academic Level I trauma center were evaluated for 5 primary outcomes (eg, mortality and length of stay), and 10 secondary quality measures and practice patterns (eg, operating room [OR] visits). All variables were compared before and after the reform (July 1, 2011). Piecewise regression was used to study temporal trends in quality. There were 11,740 admissions studied. The reform was not strongly associated with changes in any primary outcomes except length of stay (7.98 to 7.36 days; p = 0.01). However, many secondary quality metrics changed. The total number of OR and bedside procedures per admission (6.72 to 7.34; p care might have changed after the reform. Indeed, a consistent change in resource use patterns was manifested by substantial post-reform increases in measures such as bedside procedures and OR visits. No secondary quality measures exhibited improvements strongly associated with the reform. Several factors, including attending oversight, might have insulated major outcomes from change. Our findings show that some less-commonly studied quality metrics related to costs of care changed after the 2011 reform at our institution. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Free-piston Stirling engine/linear alternator 1000-hour endurance test

Science.gov (United States)

Rauch, J.; Dochat, G.

1985-01-01

The Free Piston Stirling Engine (FPSE) has the potential to be a long lived, highly reliable, power conversion device attractive for many product applications such as space, residential or remote site power. The purpose of endurance testing the FPSE was to demonstrate its potential for long life. The endurance program was directed at obtaining 1000 operational hours under various test conditions: low power, full stroke, duty cycle and stop/start. Critical performance parameters were measured to note any change and/or trend. Inspections were conducted to measure and compare critical seal/bearing clearances. The engine performed well throughout the program, completing more than 1100 hours. Hardware inspection, including the critical clearances, showed no significant change in hardware or clearance dimensions. The performance parameters did not exhibit any increasing or decreasing trends. The test program confirms the potential for long life FPSE applications.

75 FR 78726 - Agency Information Collection Activities: North American Free Trade Agreement Duty Deferral

Science.gov (United States)

2010-12-16

... Activities: North American Free Trade Agreement Duty Deferral AGENCY: U.S. Customs and Border Protection (CBP... collection requirement concerning the North American Free Trade Agreement (NAFTA) Duty Deferral. This request...: 1651-0071. Abstract: The provisions of North American Free Trade Agreement (NAFTA) were adopted by the...

40 CFR 86.1818-12 - Greenhouse gas emission standards for light-duty vehicles, light-duty trucks, and medium-duty...

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Greenhouse gas emission standards for... Complete Otto-Cycle Heavy-Duty Vehicles § 86.1818-12 Greenhouse gas emission standards for light-duty... group of six greenhouse gases: Carbon dioxide, nitrous oxide, methane, hydrofluorocarbons...

Evaluation of radiological medical practice during night duty

International Nuclear Information System (INIS)

Tasu, J.P.; Rocher, L.; Miquel, A.; Rondeau, Y.; Blery, M.; Nguyen, D.T.; Spira, A.; Livartowski, J.; Ellrodt, A.

2000-01-01

To evaluate the radiological activity during night duty, in a University Hospital, during 100 days, the radiological activity has been evaluated from examinations requiring radiologist (including US and CT, special X-ray examinations). The urgent nature and the agreement between the suspected disease and the final diagnose have been compared with the level of the clinician (medical student, resident, senior). 981 radiological examinations were performed on an emergency basis. In 39%, the examination was urgent or very urgent and for 61% little urgent or non-urgent. The level of the clinician was correlated with the degree of emergency evaluated by the radiologist and with the agreement between suspected disease and the final diagnose (p<0.0001). During night duty, the medical activity in radiology is not justified only be emergency, but also the continuous hospital activities. Better formation of the physician is required to limit the number of examinations. (authors)

Hennepin County`s experience with heavy-duty ethanol vehicles

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-01-01

From November 1993 to October 1996, Hennepin County, which includes Minneapolis, field-tested two heavy-duty snowplow/road maintenance trucks fueled by ethanol. The overall objective of this program was to collect data from original equipment manufacturer alternative fuel heavy-duty trucks, along with comparable data from a similarly configured diesel-powered vehicle, to establish economic, emissions, performance, and durability data for the alternative fuel technology. These ethanol trucks, along with an identical third truck equipped with a diesel engine, were operated year round to maintain the Hennepin county roads. In winter, the trucks were run in 8-hour shifts plowing and hauling snow from urban and suburban roads. For the rest of the year, the three trucks were used to repair and maintain these same roads. As a result of this project, a considerable amount of data was collected on E95 fuel use, as well as maintenance, repair, emissions, and operational characteristics. Maintenance and repair costs of the E95 trucks were considerably higher primarily due to fuel filter and fuel pump issues. From an emissions standpoint, the E95 trucks emitted less particulate matter and fewer oxides of nitrogen but more carbon monoxide and hydrocarbons. Overall, the E95 trucks operated as well as the diesel, as long as the fuel filters were changed frequently. This project was a success in that E95, a domestically produced fuel from a renewable energy source, was used in a heavy-duty truck application and performed the same rigorous tasks as the diesel counterparts. The drawbacks to E95 as a heavy-duty fuel take the form of higher operational costs, higher fuel costs, shorter range, and the lack of over-the-road infrastructure.

46 CFR 15.710 - Working hours.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Working hours. 15.710 Section 15.710 Shipping COAST... Limitations and Qualifying Factors § 15.710 Working hours. In addition to prescribing watch requirements, 46 U.S.C. 8104 sets limitations on the working hours of credentialed officers and crew members...

Physicians' attentional performance following a 24-hour observation period: do we need to regulate sleep prior to work?

Science.gov (United States)

Smyth, P; Maximova, K; Jirsch, J D

2017-08-01

The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta. Among 70 physicians, 52 (74%) performed overnight call; 18 did not perform overnight call and were recruited to control for the learning effect of repetitive neuropsychological testing. Attentional Network Test (ANT) measured physicians' attention at the beginning and end of the 24-hour observation period. Participants self-reported ideal sleep needs, sleep duration in the 24 hours prior to (ie, baseline) and during the 24-hour observation period (ie, follow-up). Median regression models examined effects on ANT parameters. Sleep deprivation at follow-up was associated with reduced attentional accuracy following the 24-hour observation period, but only for physicians more sleep deprived at baseline. Other components of attention were not associated with sleep deprivation after adjusting for repetitive testing. Age, years since medical school and caffeine use did not impact changes in ANT parameters. Our study suggests that baseline sleep before 24 hours of observation impacts the accuracy of physicians' attentional testing at 24 hours. Further study is required to determine if optimising physician sleep prior to overnight call shifts is a sustainable strategy to mitigate the effects of sleep deprivation. 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/.

A 360 degrees evaluation of a night-float system for general surgery: a response to mandated work-hours reduction.

Science.gov (United States)

Goldstein, Michael J; Kim, Eugene; Widmann, Warren D; Hardy, Mark A

2004-01-01

New York State Code 405 and societal/political pressure have led the RRC and ACGME to mandate strict limitations on resident work hours. In an attempt to meet these limitations, we have switched from the previous Q3 call schedule to a specialized night float (NF) system, the continuity-care system (CCS). The purpose of this CCS is to maximize resident duty time spent on direct patient care, operative experience, and outpatient clinics, while reducing duty hours spent on performing routine tasks and call coverage. The implementation of the CCS is the fundamental step in the restructuring of our residency program. In addition to a change in the call system, we added physician assistants to aid in performing some service tasks. We performed a 360 degrees evaluation of this work in progress. In May 2002, the standard Q3 call system was abolished on the general surgery services at the New York Presbyterian Hospital, Columbia campus. Two dedicated teams were created to provide day and night coverage, a day continuity-care team (DCT) and a night continuity-care team (NCT). The DCTs, consisting of PGY1-5 residents, provide daily in-house coverage from 6 AM to 5 PM with no regular weekday night-call responsibilities. The DCT residents provide Friday night, Saturday, and daytime Sunday call coverage 3 to 4 days per month. The NCT, consisting of 5 PGY1-5 residents, provides nightly continuous care, 5 PM to 6 AM, Sunday through Thursday, with no other weekend call responsibilities. This system creates a schedule with less than 80 duty hours per week, on average, with one 24-hour period off a week, one complete weekend off per month, and no more than 24 hours of consecutive duty time. After 1 year of use, the system was evaluated by a 360 degrees method in which residents, residents' spouses, nurses, and faculty were surveyed using a Likert-type scale. Statistical significance was calculated using the Student t-test. Patient satisfaction was measured both by internal review of

Decontamination trade study for the Light Duty Utility Arm

International Nuclear Information System (INIS)

Rieck, R.H.

1994-01-01

Various methods were evaluated for decontaminating the Light Duty Utility Arm (LDUA). Physical capabilities of each method were compared with the constraints and requirements for the LDUA Decontamination System. Costs were compared and a referred alternative was chosen

Correlation of 2 hour, 4 hour, 8 hour and 12 hour urine protein with 24 hour urinary protein in preeclampsia.

Directory of Open Access Journals (Sweden)

Savita Rani Singhal

2014-09-01

Full Text Available To find shortest and reliable time period of urine collection for determination of proteinuria.It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin >1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient.There was significant correlation (p value < 0.01 in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivity of 92.45%, 95.28%, 91.51%, and 96.23% and a specificity of 68.42%, 94.74%, 84.21% and 84.21% were obtained, respectively.Two-hour urine proteins can be used for assessment of proteinuria in preeclampsia instead of gold standard 24-hour urine collection for early diagnosis and better patient compliance.

Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel.

Science.gov (United States)

Balazs, George C; Donohue, Michael A; Drake, Matthew L; Ipsen, Derek; Nanos, George P; Tintle, Scott M

2015-09-01

To examine the most common presenting complaints of active-duty service members with isolated dorsal wrist ganglions and to determine the rate of return to unrestricted duty after open excision. Surgical records at 2 military facilities were screened to identify male and female active duty service members undergoing isolated open excision of dorsal wrist ganglions from January 1, 2006 to January 1, 2014. Electronic medical records and service disability databases were searched to identify the most common presenting symptoms and to determine whether patients returned to unrestricted active duty after surgery. Postoperative outcomes examined were pain persisting greater than 4 weeks after surgery, stiffness requiring formal occupational therapy treatment, surgical wound complications, and recurrence. A total of 125 active duty military personnel (Army, 54; Navy, 43; and Marine Corps, 28) met criteria for inclusion. Mean follow-up was 45 months. Fifteen percent (8 of 54) of the Army personnel were given permanent waivers from performing push-ups owing to persistent pain and stiffness. Pain persisting greater than 4 weeks after surgery was an independent predictor of eventual need for a permanent push-up waiver. The overall recurrence incidence was 9%. No demographic or perioperative factors were associated with recurrence. Patients whose occupation or activities require forceful wrist extension should be counseled on the considerable risk of residual pain and functional limitations that may occur after open dorsal wrist ganglion excision. Therapeutic IV. Published by Elsevier Inc.

Legal Duties and Legal Liabilities of Coaches toward Athletes

Directory of Open Access Journals (Sweden)

Mirsafian Hamidreza

2016-03-01

Full Text Available Background. It is undeniable that coaches play a major role in the development of athletes. Coaches and athletes have a close relationship and share various experiences that lead to a strong bond between them, and this is of great responsibility for the coach. Therefore, the coach should maintain this bond with mutual respect and trust. Various responsibilities are progressively placed on coaches by law to prevent or minimize injuries to athletes. In other words, since a coach is placed in a position of power and trust, the duty of care will always be placed on him. If certain requirements are not met, the coach may be held financially, or even criminally, liable. In this study, the author explains and discusses coaches’ legal duties, legal liabilities, and the elements required for liability of coaches toward athletes.

Natural Motives and the Motive of Duty: Hume and Kant on Our Duties to Others

OpenAIRE

Korsgaard, Christine M.

2009-01-01

Hume and Kant disagree about the motives involved in the performance of our duties to others. Hume thinks that natural virtues such as benevolence are best performed from “natural” motives, but that there are no natural motives for the performance of the “artificial” virtues, such as justice and fidelity to promises, which are performed from a sense of duty. Kant thinks all duties should be done from the motive of duty. In this paper, I examine the roots of the disagreement. If by a natural m...

Restricted working hours in Austrian residency programs : Survey results.

Science.gov (United States)

Bergmeister, Konstantin D; Aman, Martin; Podesser, Bruno K

2018-04-27

New regulations for working hours of medical doctors have been implemented in Austria based on the European directive 2003/88/EG, limiting on-duty working hours to 48 h per week. Clinical work is, therefore, substantially reduced compared to previous decades, and little is known on physician and students' opinions on this matter. We illustrate survey results concerning on-job training, its difficulties, and implications for restricted working hours. We conducted an internal survey among M.D. and Ph.D. students and medical staff members at the Medical University of Vienna using the MedCampus system (CAMPUSOnline, Graz, Austria) and SPSS (V.21, IBM Corp, Armonk, NY, USA). Participants were 36.5% staff members and 63.5% students. Students rated continuous education of physicians high at 9.19 ± 1.76 and staff members at 8.90 ± 2.48 on a 1-10 (1 unimportant, 10 most important) scale. Students rated limited time resources, while staff considered financial resources as the greatest challenge for in-hospital education. Overall, 28.85% thought that restricted working hours can positively influence education, while 19.04% thought the opposite and 52.11% were undecided. Considering the limited available time and financial resources, education of tomorrow's medical doctors remains an important but difficult task. While participants of our survey rated education as very important despite its many challenges, the opinions towards limited working hours were not as clear. Given that over 50% are still undecided whether reduced work hours may also positively influence medical education, it clearly presents an opportunity to include the next generations of physicians in this undertaking.

14 CFR 91.1059 - Flight time limitations and rest requirements: One or two pilot crews.

Science.gov (United States)

2010-01-01

... OPERATING AND FLIGHT RULES Fractional Ownership Operations Program Management § 91.1059 Flight time... Rest 10 Hours 12 Hours. (6) Minimum After Duty Rest Period for Multi-Time Zone Flights 14 Hours 18... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Flight time limitations and rest...

40 CFR 86.1708-99 - Exhaust emission standards for 1999 and later light-duty vehicles.

Science.gov (United States)

2010-07-01

... for Light-Duty Vehicles and Light-Duty Trucks § 86.1708-99 Exhaust emission standards for 1999 and... are incorporated by reference (see § 86.1). (v) Hybrid electric vehicle requirements. Deterioration factors for hybrid electric vehicles shall be based on the emissions and mileage accumulation of the...

49 CFR 229.137 - Sanitation, general requirements.

Science.gov (United States)

2010-10-01

... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAILROAD LOCOMOTIVE SAFETY STANDARDS Safety Requirements Cabs and... for duty or occupying the cab for duty; and (6) Equipped with a trash receptacle, unless the railroad otherwise provides portable trash receptacles to employees upon reporting for duty or occupying the cab for...

Abolishment of 24-hour continuous medical call duty in quebec: a quality of life survey of general surgical residents following implementation of the new work-hour restrictions.

Science.gov (United States)

Hamadani, Fadi T; Deckelbaum, Dan; Sauve, Alexandre; Khwaja, Kosar; Razek, Tarek; Fata, Paola

2013-01-01

The implementation of work hour restrictions across North America have resulted in decreased levels of self injury and medical errors for Residents. An arbitration ruling in Quebec has led to further curtailment of work hours beyond that proposed by the ACGME. This may threaten Resident quality of life and in turn decrease the educational quality of surgical residency training. We administered a quality of life questionnaire with an integrated education quality assessment tool to all General Surgery residents training at McGill 6 months after the work hour restrictions. Across several strata respondents reveal a decreased sense of educational quality and quality of life. The arbitration argued that work- hour restrictions would be necessary to improve quality of life for trainees and hence improve patient safety. Results from this study demonstrate the exact opposite in a large majority of respondents, who report a poorer quality of life and a self-reported inability on their part to provide continuous and safe patient care. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Commentary: so the pendulum swings--making sense of the duty to protect.

Science.gov (United States)

Fox, Patrick K

2010-01-01

Psychiatry has been struggling for nearly 40 years to make sense of the duty to protect. The great jurisdictional disparity as to what constitutes the duty has been a significant contributing factor. The American Psychiatric Association (APA) released the Model Statute in 1987 to establish a framework to guide legislators and courts toward consensus, to some effect. In response to case law and statutory requirements in most states, psychiatric practice has incorporated the assessment of risk to third parties by patients as an essential element of psychiatric assessment and care. Although court cases shortly after the Tarasoff decision expanded the scope and breadth of the duty to protect, in recent years there appears to have been a shift toward a more narrow interpretation as to what conditions must exist to find a defendant psychiatrist guilty of failing to exercise the duty properly. The threshold for the duty to warn or protect often rests precariously beside the criteria permitting an exception to confidentiality, placing the psychiatrist in a tenuous position. If appellate verdicts continue to find for the defendant psychiatrist in cases claiming a breach of the duty to protect, it could have an impact on how psychiatrists assess and manage threats made by patients toward third parties.

Rights and duties in parenting practices

Directory of Open Access Journals (Sweden)

Ana Paula Solans

2015-10-01

Full Text Available The aim of this presentation is to present the results of three qualitative research on the exercise of rights and duties on Parenting Practices (PP, held in Buenos Aires, Argentina. They included interviews with mothers of children with Unsatisfied Basic Needs concretized between 2009 and 2013. Their analysis revealed that in this set of households were carried out three types of PP: imposition, guide and free will, the latter was the most used. As part of this practice, children managed their hours of sleep, wakefulness and leisure, without the intervention of their parents. It was noted, for example, that children over 10 years decided on matters concerning their schooling, absenting progressively to school, to abandonment. These practices were respected by their parents. By default, the postponement of pleasure (tolerance to frustration will not be exercised: they let children do at will. A trend of teenage pregnancy and the formation of pairs of children between 14-16 years with parental consent was also noted. In this sense, even when children lived in a house in contact with their parents, with a supply of food and available school, the indiscriminate exercise of free will put children's health at risk and full development, curtailing their rights. We recommend further studies such timely interventions to promote programs and projects designed to guide parents on issues related to the development of children as subjects of Rights and Duties.

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

A minimum of 10 hours off duty should be scheduled between shiftsResident physician input into work redesign should be actively solicitedSchedules should be designed that adhere to principles of sleep and circadian science; this includes careful consideration of the effects of multiple consecutive night shifts, and provision of adequate time off after night work, as specified in the IOM reportResident physicians should not be scheduled up to the maximum permissible limits; emergencies frequently occur that require resident physicians to stay longer than their scheduled shifts, and this should be anticipated in scheduling resident physicians' work shiftsHospitals should anticipate the need for iterative improvement as new schedules are initiated; be prepared to learn from the initial phase-in, and change the plan as neededAs resident physician work hours are redesigned, attending physicians should also be considered; a potential consequence of resident physician work hour reduction and increased supervisory requirements may be an increase in work for attending physicians; this should be carefully monitored, and adjustments to attending physician work schedules made as needed to prevent unsafe work hours or working conditions for this group"Home call" should be brought under the overall limits of working hours; work load and hours should be monitored in each residency program to ensure that resident physicians and fellows on home call are getting sufficient sleepMedicare funding for graduate medical education in each hospital should be linked with adherence to the Institute of Medicine limits on resident physician work hours. MOONLIGHTING BY RESIDENT PHYSICIANS: The Institute of Medicine report recommended including external as well as internal moonlighting in working hour limits. The recommendation is: All moonlighting work hours should be included in the ACGME working hour limits and actively monitored. (ABSTRACT TRUNCATED)

40 CFR 86.242-94 - Records required.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Records required. 86.242-94 Section 86.242-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Later Model Year Gasoline-Fueled New Light-Duty Vehicles, New Light-Duty Trucks and New Medium-Duty...

40 CFR Appendix Xii to Part 86 - Tables for Production Compliance Auditing of Heavy-Duty Engines and Heavy-Duty Vehicles...

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Tables for Production Compliance Auditing of Heavy-Duty Engines and Heavy-Duty Vehicles, Including Light-Duty Trucks XII Appendix XII to... Appendix XII to Part 86—Tables for Production Compliance Auditing of Heavy-Duty Engines and Heavy-Duty...

49 CFR 592.6 - Duties of a registered importer.

Science.gov (United States)

2010-10-01

... marking requirements of the theft prevention standard (part 541 of this chapter); or (ii) The vehicle... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) REGISTERED IMPORTERS OF VEHICLES NOT ORIGINALLY MANUFACTURED TO CONFORM TO THE FEDERAL MOTOR VEHICLE SAFETY STANDARDS § 592.6 Duties of a...

Patient safety, resident well-being and continuity of care with different resident duty schedules in the intensive care unit: a randomized trial.

Science.gov (United States)

Parshuram, Christopher S; Amaral, Andre C K B; Ferguson, Niall D; Baker, G Ross; Etchells, Edward E; Flintoft, Virginia; Granton, John; Lingard, Lorelei; Kirpalani, Haresh; Mehta, Sangeeta; Moldofsky, Harvey; Scales, Damon C; Stewart, Thomas E; Willan, Andrew R; Friedrich, Jan O

2015-03-17

Shorter resident duty periods are increasingly mandated to improve patient safety and physician well-being. However, increases in continuity-related errors may counteract the purported benefits of reducing fatigue. We evaluated the effects of 3 resident schedules in the intensive care unit (ICU) on patient safety, resident well-being and continuity of care. Residents in 2 university-affiliated ICUs were randomly assigned (in 2-month rotation-blocks from January to June 2009) to in-house overnight schedules of 24, 16 or 12 hours. The primary patient outcome was adverse events. The primary resident outcome was sleepiness, measured by the 7-point Stanford Sleepiness Scale. Secondary outcomes were patient deaths, preventable adverse events, and residents' physical symptoms and burnout. Continuity of care and perceptions of ICU staff were also assessed. We evaluated 47 (96%) of 49 residents, all 971 admissions, 5894 patient-days and 452 staff surveys. We found no effect of schedule (24-, 16- or 12-h shifts) on adverse events (81.3, 76.3 and 78.2 events per 1000 patient-days, respectively; p = 0.7) or on residents' sleepiness in the daytime (mean rating 2.33, 2.61 and 2.30, respectively; p = 0.3) or at night (mean rating 3.06, 2.73 and 2.42, respectively; p = 0.2). Seven of 8 preventable adverse events occurred with the 12-hour schedule (p = 0.1). Mortality rates were similar for the 3 schedules. Residents' somatic symptoms were more severe and more frequent with the 24-hour schedule (p = 0.04); however, burnout was similar across the groups. ICU staff rated residents' knowledge and decision-making worst with the 16-hour schedule. Our findings do not support the purported advantages of shorter duty schedules. They also highlight the trade-offs between residents' symptoms and multiple secondary measures of patient safety. Further delineation of this emerging signal is required before widespread system change. ClinicalTrials.gov, no. NCT00679809. © 2015 Canadian Medical

Functions and requirements for the Light-Duty Utility Arm Integrated System. Revision 1

International Nuclear Information System (INIS)

Kiebel, G.R.

1996-01-01

The Light Duty Utility Arm (LDUA) Integrated System is a mobile robotic system designed to remotely deploy and operate a variety of tools in uninhabitable underground radiological and hazardous waste storage tanks. The system primarily provides a means to inspect, survey, monitor, map and/or obtain specific waste and waste tank data in support of the Tank Waste Remediation System (TWRS) mission at Hanford and remediation programs at other U.S. Department of Energy (DOE) sites

7 CFR 3550.158 - Active military duty.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Active military duty. 3550.158 Section 3550.158... AGRICULTURE DIRECT SINGLE FAMILY HOUSING LOANS AND GRANTS Regular Servicing § 3550.158 Active military duty...-time active military duty after a loan is closed not exceed six percent. Active military duty does not...

5 CFR 551.421 - Regular working hours.

Science.gov (United States)

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...

19 CFR 159.38 - Rates for estimated duties.

Science.gov (United States)

2010-04-01

... TREASURY (CONTINUED) LIQUIDATION OF DUTIES Conversion of Foreign Currency § 159.38 Rates for estimated duties. For purposes of calculating estimated duties, the port director shall use the rate or rates... 19 Customs Duties 2 2010-04-01 2010-04-01 false Rates for estimated duties. 159.38 Section 159.38...

40 CFR 94.105 - Duty cycles.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Duty cycles. 94.105 Section 94.105... EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Test Procedures § 94.105 Duty cycles. (a) Overview. For....8(e), engines shall be tested using the appropriate duty cycles described in this section. (b...

Climate Change and Individual Duties

OpenAIRE

Augustin Fragnière

2016-01-01

Tackling climate change has often been considered the responsibility of national governments. But do individuals also have a duty to act in the face of this problem? In particular do they have a duty to adopt a greener lifestyle or to press their government to act? This review critically examines the arguments provided for and against such duties in the relevant philosophic literature. It first discusses the problem of causal inefficacy—namely the fact that individual greenhouse gas emissions...

Banking and Financial Services Series. Duty Task List.

Science.gov (United States)

Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

This document contains the occupational duty/task lists for five occupations in the banking and financial services series. Each occupation is divided into seven or eight duties. A separate page for each duty in the occupation lists the tasks in that duty along with its code number and columns to indicate whether that particular duty has been…

Clean Cities Guide to Alternative Fuel and Advanced Medium- and Heavy-Duty Vehicles

Energy Technology Data Exchange (ETDEWEB)

None

2013-08-01

Today's fleets are increasingly interested in medium-duty and heavy-duty vehicles that use alternative fuels or advanced technologies that can help reduce operating costs, meet emissions requirements, improve fleet sustainability, and support U.S. energy independence. Vehicle and engine manufacturers are responding to this interest with a wide range of options across a steadily growing number of vehicle applications. This guide provides an overview of alternative fuel power systems--including engines, microturbines, electric motors, and fuel cells--and hybrid propulsion systems. The guide also offers a list of individual medium- and heavy-duty vehicle models listed by application, along with associated manufacturer contact information, fuel type(s), power source(s), and related information.

Perspective: creating an ethical workplace: reverberations of resident work hours reform.

Science.gov (United States)

Lopez, Lenny; Katz, Joel T

2009-03-01

Medical professionals are a community of highly educated individuals with a commitment to a core set of ideals and principles. This community provides both technical and ethical socialization. The development of ethical physicians is highly linked to experiences in the training period. Moral traits are situation-sensitive psychological and behavioral dispositions. The consequence of long duty hours on the moral development of physicians is less understood. The clinical environment of medical training programs can be so intense as to lead to conditions that may actually deprofessionalize trainees. The dynamic relationship between individual character traits and the situational dependence of their expression suggests that a systems approach will help promote and nurture moral development. Ethical behavior can be supported by systems that make it more difficult to veer from the ideal. Work hours limits are a structural change that will help preserve public safety by preventing physicians from taking the moral shortcuts that can occur with increasing work and time pressures. Work hours rules are beneficial but insufficient to optimize an ethical work and training environment. Additional measures need to be put in place to ensure that ethical tensions are not created between the patient's well-being and the resident's adherence to work hours rules. The ethical ideals of physician autonomy, selflessness, and accountability to the patient must be protected through the judicious and flexible use of work hours limits, physician extenders, census caps, nonteaching services, and high-quality handoffs.

75 FR 63444 - Glycine From the People's Republic of China: Notice of Rescission of Antidumping Duty...

Science.gov (United States)

2010-10-15

... exports, sales, or entries of subject merchandise during the POR.'' See 75 FR at 22107 (emphasis added... crystalline material, like salt or sugar. Glycine is produced at varying levels of purity and is used as a... duties shall be assessed at rates equal to the cash deposit of estimated antidumping duties required at...

Gender Differences and Predictors of Work Hours in a Sample of Ontario Dentists.

Science.gov (United States)

McKay, Julia C; Ahmad, Atyub; Shaw, Jodi L; Rashid, Faahim; Clancy, Alicia; David, Courtney; Figueiredo, Rafael; Quiñonez, Carlos

2016-11-01

To determine the influence of gender on weekly work hours of Ontario dentists. In 2012, a 52-item survey was sent to a random sample of 3000 Ontario dentists (1500 men and 1500 women) to collect information on personal, professional and sociodemographic characteristics. The resulting data were analyzed using descriptive statistics and linear regression modeling. The 867 respondents included 463 men, 401 women and 3 people whose gender was unreported, yielding a response rate of 29%.Most dentists worked full-time, with men working, on average, 2 h/week longer than women. Younger dentists worked more than older dentists. Practice ownership increased weekly work hours, and men reported ownership more often than women. Canadian-trained women worked significantly fewer hours than those trained internationally. Women were more likely than men to work part time and take parental leave and more often reported being primary caregivers and solely responsible for household chores. Women with partner support for such tasks worked more hours than those who were solely responsible. Dentists with children ≤ 3 years of age worked fewer hours than those without children; however, after controlling for spousal responsibility for caregiver duties, this effect was eliminated. More women than men reported making concessions in their career to devote time to family. Gender, age, practice ownership, training location and degree of spousal support for household and caregiving responsibilities were predictors of weekly work hours. For women specifically, training location and household and caregiving responsibilities predicted weekly work hours.

Heavy-Duty Vehicle Thermal Management | Transportation Research | NREL

Science.gov (United States)

Heavy-Duty Vehicle Thermal Management Heavy-Duty Vehicle Thermal Management Infrared image of a control materials and equipment on heavy-duty vehicles. Photo by Dennis Schroeder, NREL Illustration of a Ray David, NREL National Renewable Energy Laboratory (NREL) researchers are assisting heavy-duty

The Duty to Recognize Culture

DEFF Research Database (Denmark)

Nielsen, Morten Ebbe Juul

2012-01-01

On Taylor and Honneth's theories of recognition and whether one can derive a "duty to recognize Culture" from these......On Taylor and Honneth's theories of recognition and whether one can derive a "duty to recognize Culture" from these...

Is it the duty of every citizen to participate in clinical research?

Directory of Open Access Journals (Sweden)

Fermín Roland Schramm

2012-06-01

Full Text Available The complex phenomenon of globalization, considered by many as the main feature of contemporary societies, is not without contradictions and questions of type analítico-conceptual, as well as ethics and policies. At least three kinds of interpretations of the phenomenon can be distinguished in this sense: as a continuity, understood as development and radicalization of the contents of modernity; as a break in relation to it; or as a hybridization between rupture and continuity. It is in this dialectical context in a globalized world, which must become the question of whether or not there is the moral duty of every citizen to participate in a research involving human beings. But to answer argumentativamente satisfactorily, the meaning of these possible new duties of the citizen, required by the world system in rapidly changing and ever should be discussed. This system is at the same time more integrated and more differentiated - and indicated by the polysemic words globalization and citizenship-, considering that this type of duties involve, in principle, the improvement of the State of health and well-being of individuals and populations, but that they can also involve ethically and politically questionable effects, these duties shall be considered as being only duties prima facie.

78 FR 33689 - Organization and Delegation of Powers and Duties

Science.gov (United States)

2013-06-05

... 0311-AA02 Organization and Delegation of Powers and Duties AGENCY: Privacy and Civil Liberties... this rule to provide information to the public about the Board's organization, function, and operations...'s organization and functioning and, therefore, is exempt from requirements related to notice and...

Design criteria for the light duty utility arm system end effectors

International Nuclear Information System (INIS)

Pardini, A.F.

1995-01-01

This document provides the criteria for the design of end effectors that will be used as part of the Light Duty Utility Arm (LDUA) System. The LDUA System consists of a deployment vehicle, a vertical positioning mast, a light duty multi-axis robotic arm, a tank riser interface and confinement, a tool interface plate, a control system, and an operations control trailer. The criteria specified in this document will apply to all end effector systems being developed for use on or with the LDUA system at the Hanford site. The requirement stipulated in this document are mandatory

Duty to warn of genetic harm in breach of patient confidentiality.

Science.gov (United States)

Keeling, Sharon L

2004-11-01

Harm caused by the failure of health professionals to warn an at-risk genetic relative of her or his risk is genetic harm. Genetic harm should be approached using the usual principles of negligence. When these principles are applied, it is shown that (a) genetic harm is foreseeable; (b) the salient features of vulnerability, the health professional's knowledge of the risk to the genetic relative and the determinancy of the affected class and individual result in a duty of care being owed to the genetic relative; (c) the standard of care required to fulfil the duty to warn should be the expectations of a reasonable person in the position of the relative; and (d) causation is satisfied as the harm is caused by the failure of intervention of the health professional. Legislation enacted subsequent to the Report of the Commonwealth of Australia, Panel of Eminent Persons (Chair D Ipp), Review of the Law of Negligence Report (2002) and relevant to a duty to warn of genetic harm is considered. The modes of regulation and penalties for breach of any future duty to warn of genetic harm are considered.

Heavy-Duty Diesel Fuel Analysis

Science.gov (United States)

EPA's heavy-duty diesel fuel analysis program sought to quantify the hydrocarbon, NOx, and PM emission effects of diesel fuel parameters (such as cetane number, aromatics content, and fuel density) on various nonroad and highway heavy-duty diesel engines.

Impact of the Acquisition Corps Membership Requirement 24 Business-Credit Hours on the Navy Acquisition Workforce

Science.gov (United States)

2016-12-01

ROTC Reserve Officers’ Training Corps S&T Science and Technology S&TM Science and Technology Manager SDO Special Duty Officer SME Subject Matter...engineering, industrial property management, information technology , life cycle logistics, program management, production , quality and manufacturing...16  4.  Auditing ........................................................................................16  5.  Test and

Taking action on developmental toxicity: scientists' duties to protect children.

Science.gov (United States)

Shrader-Frechette, Kristin

2012-09-10

Although adaptation and proper biological functioning require developmental programming, pollutant interference can cause developmental toxicity or DT. This commentary assesses whether it is ethical for citizens/physicians/scientists to allow avoidable DT. Using conceptual, economic, ethical, and logical analysis, the commentary assesses what major ethical theories and objectors would say regarding the defensibility of allowing avoidable DT. The commentary argues that (1) none of the four major ethical theories (based, respectively, on virtue, natural law, utility, or equity) can consistently defend avoidable DT because it unjustifiably harms, respectively, individual human flourishing, human life, the greatest good, and equality. (2) Justice also requires leaving "as much and as good" biological resources for all, including future generations possibly harmed if epigenetic change is heritable. (3) Scientists/physicians have greater justice-based duties, than ordinary/average citizens, to help stop DT because they help cause it and have greater professional abilities/opportunities to help stop it. (4) Scientists/physicians likewise have greater justice-based duties, than ordinary/average citizens, to help stop DT because they benefit more from it, given their relatively greater education/consumption/income. The paper shows that major objections to (3)-(4) fail on logical, ethical, or scientific grounds, then closes with practical suggestions for implementing its proposals. Because allowing avoidable DT is ethically indefensible, citizens---and especially physicians/scientists---have justice-based duties to help stop DT.

Automatic control of clock duty cycle

Science.gov (United States)

Feng, Xiaoxin (Inventor); Roper, Weston (Inventor); Seefeldt, James D. (Inventor)

2010-01-01

In general, this disclosure is directed to a duty cycle correction (DCC) circuit that adjusts a falling edge of a clock signal to achieve a desired duty cycle. In some examples, the DCC circuit may generate a pulse in response to a falling edge of an input clock signal, delay the pulse based on a control voltage, adjust the falling edge of the input clock signal based on the delayed pulse to produce an output clock signal, and adjust the control voltage based on the difference between a duty cycle of the output clock signal and a desired duty cycle. Since the DCC circuit adjusts the falling edge of the clock cycle to achieve a desired duty cycle, the DCC may be incorporated into existing PLL control loops that adjust the rising edge of a clock signal without interfering with the operation of such PLL control loops.

Clean Cities Guide to Alternative Fuel and Advanced Medium- and Heavy-Duty Vehicles (Book)

Energy Technology Data Exchange (ETDEWEB)

2013-08-01

Today's fleets are increasingly interested in medium-duty and heavy-duty vehicles that use alternative fuels or advanced technologies that can help reduce operating costs, meet emissions requirements, improve fleet sustainability, and support U.S. energy independence. Vehicle and engine manufacturers are responding to this interest with a wide range of options across a steadily growing number of vehicle applications. This guide provides an overview of alternative fuel power systems?including engines, microturbines, electric motors, and fuel cells?and hybrid propulsion systems. The guide also offers a list of individual medium- and heavy-duty vehicle models listed by application, along with associated manufacturer contact information, fuel type(s), power source(s), and related information.

7 CFR 1250.336 - Duties.

Science.gov (United States)

2010-01-01

..., education, or promotion programs, advertising agencies, public relations firms, public or private research... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE EGG RESEARCH AND PROMOTION Egg Research and Promotion Order Egg Board § 1250.336 Duties. The Board shall have the following duties: (a) To...

40 CFR Appendix X to Part 86 - Sampling Plans for Selective Enforcement Auditing of Heavy-Duty Engines and Light-Duty Trucks

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Sampling Plans for Selective Enforcement Auditing of Heavy-Duty Engines and Light-Duty Trucks X Appendix X to Part 86 Protection of... Plans for Selective Enforcement Auditing of Heavy-Duty Engines and Light-Duty Trucks Table 1—Sampling...

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

Science.gov (United States)

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

2011-01-01

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

19 CFR 10.430 - Export requirements.

Science.gov (United States)

2010-04-01

... Chile customs authority for that purpose) to CBP upon request. (b) Notification of errors in... 19 Customs Duties 1 2010-04-01 2010-04-01 false Export requirements. 10.430 Section 10.430 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY...

Double-duty caregivers: healthcare professionals juggling employment and informal caregiving. A survey on personal health and work experiences.

Science.gov (United States)

Boumans, Nicolle P G; Dorant, Elisabeth

2014-07-01

This study compared the work-related experiences and personal health status of double-duty caregivers with those of caregivers who do not provide informal care to a family member or close friend in need. The interest in providing informal care alongside employment is growing. However, little attention has been paid to the dual role of the healthcare professional who also has caregiving responsibilities for a needy person in his/her private situation. It is important to study the negative and positive consequences of this combination of professional and family care giving. A cross-sectional study. In 2011, we distributed a digital questionnaire to employees with a professional care function working at a healthcare organization in the Netherlands. Descriptive statistics, analyses of covariance and tests of linearity were performed. Analyses of variance demonstrated that as professional healthcare workers provide more hours of informal care in their private lives, their mental and physical health significantly worsens, while their need for recovery increases. Also, statistical significant increases were seen for emotional exhaustion, presenteeism and negative experiences with Work-Home and Home-Work Interferences. Remarkably, positive Home-Work Interference increased significantly with increasing hours of informal care. Double-duty caregivers appeared to be equally motivated and satisfied with their work as their co-workers. No differences were seen with respect to absenteeism. Double-duty caregivers prove to be employees who are at risk of developing symptoms of overload. This finding calls for special attention, with long-term solutions at both legislative and organizational level. © 2013 John Wiley & Sons Ltd.

19 CFR 181.13 - Failure to comply with requirements.

Science.gov (United States)

2010-04-01

... warrant where an exporter or a producer in the United States fails to comply with any requirement of this... 19 Customs Duties 2 2010-04-01 2010-04-01 false Failure to comply with requirements. 181.13 Section 181.13 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY...

19 CFR 191.103 - Additional requirements.

Science.gov (United States)

2010-04-01

... which the alcohol was withdrawn; (iv) Date of withdrawal; (v) Serial number of the tax-paid stamp or... 19 Customs Duties 2 2010-04-01 2010-04-01 false Additional requirements. 191.103 Section 191.103 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

Due diligence duties for an environmental liability

International Nuclear Information System (INIS)

Huebsch, M.

2000-04-01

Jurisdiction turned out well to create a basic ruling for due diligence duties. These due diligence duties are high standards for the law of torts (outside of contracts) within the Austrian civil law and represent a liability-extension for the holder of the source of danger. They establish an action for injunction in particular for preventing (further) damages. Therewith due diligence duties get a general sense in the range of a civil law for environmental liability. The responsible holder of a danger zone will therefore influence his way of acting to protect potential victims and the environment. The burden of proof is on the plaintiff (victims) under the Civil Code. Victims have specific sources of danger including high endangering special facilities in their argumentation with the so-called prima-facie-proof or first-appearance-proof. A turning back of the presentation of evidence to the polluter is wrong. The polluter himself has a continuing liability for dangerous activities and his clerks in the case of an extremely high danger of damage. All due diligence duties can be arranged in three areas: in information-, danger-avoidance- and danger-prevention-duties. The determination of range and essence of the duties has to be adjusted to each individual case. The range of the specific danger area is the essential link. The intensity of due diligence duties is increasing with the size of danger in the way of a movable system depending on the protected interest. Due diligence duties have to be kept within reasonable limits with two criterions: necessarity and demand. Proportionality of actions is a third criterion to avoid exaggeration of due diligence duties to obtain an effective protection for victims including the environment. (author)

38 CFR 17.31 - Duty periods defined.

Science.gov (United States)

2010-07-01

... Definitions and Active Duty § 17.31 Duty periods defined. Full-time duty as a member of the Women's Army Auxiliary Corps, Women's Reserve of the Navy and Marine Corps and Women's Reserve of the Coast Guard. [34 FR..., 1996, § 17.31(b)(5) was redesignated as § 17.31. Protection of Patient Rights ...

Taking action on developmental toxicity: Scientists’ duties to protect children

Directory of Open Access Journals (Sweden)

Shrader-Frechette Kristin

2012-09-01

Full Text Available Abstract Background Although adaptation and proper biological functioning require developmental programming, pollutant interference can cause developmental toxicity or DT. Objectives This commentary assesses whether it is ethical for citizens/physicians/scientists to allow avoidable DT. Methods Using conceptual, economic, ethical, and logical analysis, the commentary assesses what major ethical theories and objectors would say regarding the defensibility of allowing avoidable DT. Results The commentary argues that (1 none of the four major ethical theories (based, respectively, on virtue, natural law, utility, or equity can consistently defend avoidable DT because it unjustifiably harms, respectively, individual human flourishing, human life, the greatest good, and equality. (2 Justice also requires leaving “as much and as good” biological resources for all, including future generations possibly harmed if epigenetic change is heritable. (3 Scientists/physicians have greater justice-based duties, than ordinary/average citizens, to help stop DT because they help cause it and have greater professional abilities/opportunities to help stop it. (4 Scientists/physicians likewise have greater justice-based duties, than ordinary/average citizens, to help stop DT because they benefit more from it, given their relatively greater education/consumption/income. The paper shows that major objections to (3-(4 fail on logical, ethical, or scientific grounds, then closes with practical suggestions for implementing its proposals. Conclusions Because allowing avoidable DT is ethically indefensible, citizens---and especially physicians/scientists---have justice-based duties to help stop DT.

Radiation monitoring data representation for duty personnel

Energy Technology Data Exchange (ETDEWEB)

Gavrilov, S.L.; Kiselev, V.P.; Krasnoperov, S.N.; Kudeshov, E.V.; Maslov, S.Y.; Semin, N.N.; Sirotinskiy, S.E.; Yakovlev, V.Y. [Nuclear Safety Institute of the Russian Academy of Sciences (NSI RAS), Moscow (Russian Federation)

2014-07-01

Currently, Web-GIS technologies are widely used to generate a reliable and intuitive web-based interface to monitor the current radiation situation in various regions of the Russian Federation. The developed 'Server Web-Monitoring' web-application is intended for duty personnel and can operate not only on desktop computers but also on mobile devices. The subsystem of duty personnel notification about any Off-Normal Situation (ONS) (such as: critical threshold exceedances or failures in operation of monitoring systems) is also considered in the paper. Three types of Automated Radiation Monitoring Systems (ARMS) are available for monitoring: - regional ARMS; - facility-level ARMS; - ARMS of nuclear power plant surveillance areas. Google Maps and Google Maps API toolbox are used as the cartographic basis. In the general-monitoring window only general information on each of the local systems is available. Next, the operator can move to monitoring of local ARMS he is interested in. The operator can either view a list of Radiation Situation Monitoring Posts (RSMP) showing the current data in the right frame or hide it and use the map only. Viewing the log of critical threshold exceedances for 24 hours and a report on all RSMPs of a given system over the last 7 days is also possible. The report contains maximum values of measurements for every day and for each RSMP. The developed web-application includes: - monitoring of the radiation situation and its changes on the general map of the Russian Federation and on maps of local ARMS; - displaying 7-day reports for all RSMPs of the selected ARMS; - displaying the log of critical threshold exceedances recorded over the past day. The notification subsystem informs duty personnel on all ONS, namely, on critical threshold exceedances in the incoming data and failures in operation of monitoring systems. The key features of the notification subsystem are: - round-the-clock functioning; - automatic notification in case of

Restricted duty hours for surgeons and impact on residents quality of life, education, and patient care: a literature review

Directory of Open Access Journals (Sweden)

Pfeifer Roman

2009-02-01

Full Text Available Abstract Background Work-hour limitations have been implemented by the Accreditation Council for Graduate Medical Education (ACGME in July 2003 in order to minimize fatigue related medical adverse events. The effects of this regulation are still under intense debate. In this literature review, data of effects of limited work-hours on the quality of life, surgical education, and patient care was summarized, focusing on surgical subspecialities. Methods Studies that assessed the effects of the work-hour regulation published following the implementation of ACGME guidelines (2003 were searched using PubMed database. The following search modules were selected: work-hours, 80-hour work week, quality of life, work satisfaction, surgical education, residency training, patient care, continuity of care. Publications were included if they were completed in the United States and covered the subject of our review. Manuscrips were analysed to identify authors, year of publication, type of study, number of participants, and the main outcomes. Review Findings Twenty-one articles met the inclusion criteria. Studies demonstrate that the residents quality of life has improved. The effects on surgical education are still unclear due to inconsistency in studies. Furthermore, according to several objective studies there were no changes in mortality and morbidity following the implementation. Conclusion Further studies are necessary addressing the effects of surgical education and studying the objective methods to assess the technical skill and procedural competence of surgeons. In addition, patient surveys analysing their satisfaction and concerns can contribute to recent discussion, as well.

77 FR 6704 - Exemptions From Entry Requirements and Report of Arrival Requirements for Certain Department of...

Science.gov (United States)

2012-02-09

... requirements and thus also subject to advanced electronic presentation of cargo information requirements. Under..., Aircraft, Airports, Alcohol and alcoholic beverages, Cigars and cigarettes, Cuba, Customs duties and...

Supervision Duty of School Principals

Directory of Open Access Journals (Sweden)

Kürşat YILMAZ

2009-04-01

Full Text Available Supervision by school administrators is becoming more and more important. The change in the roles ofschool administrators has a great effect on that increase. At present, school administrators are consideredmore than as technical directors, but as instructional leaders. This increased the importance of schooladministrators’ expected supervision acts. In this respect, the aim of this study is to make a conceptualanalysis about school administrators’ supervision duties. For this reason, a literature review related withsupervision and contemporary supervision approaches was done, and the official documents concerningsupervision were examined. As a result, it can be said that school administrators’ supervision duties havebecome very important. And these duties must certainly be carried out by school administrators.

Out-of-hours service in rural areas. An observational study of accessibility, attitudes and quality standards among general practitioners in Iceland.

Science.gov (United States)

Olafsson, G; Sigurdsson, J A

2000-06-01

To examine the access, workload, duties, commitments and quality standards of primary care physicians (GPs) resulting from out-of-hours service. All GPs (n = 96) in rural Iceland. Answers to a postal survey. The participation rate was 80%. The GPs estimated that in 97% of the cases they could be contacted within 5 minutes in an emergency. Under usual circumstances (weather conditions) and within a distance of 10 km, 70% of them could reach the patient within 30 minutes of receiving the call. In severe weather conditions, 50% of the GPs in smaller districts (650-6000 inhabitants) estimated that it could take up to 5 hours or more to reach the patient (which could happen once a year). In the least populated districts, 84% of the GPs had to be on call 14 days or more per month. Serious emergencies (involving special training such as cardiac resuscitation or tracheal intubation) were relatively rare, and GPs expressed the necessity for regular refresher courses in such fields. Modern telecommunication networks guarantee good access to out-of-hours service. The workload and on-call duties are great and do not comply with European Union (EU) recommendations regarding minimal rest time. If GPs in rural areas are to be expected to provide frontline health care, including in severe emergency situations, regular training courses are needed.

The Effects of the 150-Credit-Hour Requirement for the Certified Public Accountant (CPA) Exam On the Career Intentions of Women and Minorities

Science.gov (United States)

Bierstaker, James Lloyd; Howe, Martha A.; Seol, Inshik

2005-01-01

In most states, students who sit for the certified public accountant (CPA) examination are now required to have 150 credit hours of college education. In this article, the authors examined the effects of this requirement on the career intentions of women and minorities. The authors collected data from 600 accounting students and the results…

Private duty home care: what it means to real people across the nation.

Science.gov (United States)

2011-04-01

Private duty home care is growing rapidly to accommodate the needs of more and more seniors, disabled persons, and those with chronic conditions as these populations themselves are fast expanding and projected to continue to do so in the coming years and decades. The services that private duty/privately paid home care providers deliver each day to individuals across the United States can be absolutely essential to allowing them to remain in their own homes and communities leading as active and healthy lives as possible and continuing to contribute in the work force and to society as they are able. Requirements vary from state to state, and while most private duty agencies provide nonmedical companionship, homemaker, and personal care services--often described as assistance with activities of daily living--some incorporate licensed medical care as well.

The duty of the pharmacist and the pharmaceutical industry.

Science.gov (United States)

Dwyer, Peter

2003-01-01

The common law duty of care, an essential element of the tort of negligence, focuses on conduct. Accordingly, any discussion of the existence, nature and content of the duty of care of a pharmaceutical manufacturer and of a pharmacist, requires analysis of their respective functions. Also relevant are the special nature and effects of drug products and their approval for and acceptance in, human therapy based upon a balancing of risks and benefits. Critical to a manufacturer's potential tortuous liability is the so-called 'learned intermediary, role of pharmacists, prescribers and other health professionals and whether they have current and accurate drug product information. Manufacturers are not necessarily the only source of drug information available to health professionals. These responsibilities serve patients who also need to be adequately informed so as to achieve optimal safety and efficacy when using prescribed medications.

43 CFR 422.7 - Authorization to perform law enforcement duties.

Science.gov (United States)

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Authorization to perform law enforcement duties. 422.7 Section 422.7 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR LAW ENFORCEMENT AUTHORITY AT BUREAU OF RECLAMATION PROJECTS Program Requirements § 422.7 Authorization to perfor...

19 CFR 151.22 - Estimated duties on raw sugar.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Estimated duties on raw sugar. 151.22 Section 151... THE TREASURY (CONTINUED) EXAMINATION, SAMPLING, AND TESTING OF MERCHANDISE Sugars, Sirups, and Molasses § 151.22 Estimated duties on raw sugar. Estimated duties shall be taken on raw sugar, as defined...

19 CFR 12.62 - Enforcement; duties of Customs officers.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Enforcement; duties of Customs officers. 12.62 Section 12.62 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY...; duties of Customs officers. (a) In accordance with the authority contained in sections 10 and 12 of the...

19 CFR 10.625 - Refunds of excess customs duties.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Refunds of excess customs duties. 10.625 Section 10.625 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT... and Apparel Goods § 10.625 Refunds of excess customs duties. (a) Applicability. Section 205 of the...

Master plan nurse duty roster using the 0-1 goal programming technique

Science.gov (United States)

Ismail, Wan Rosmanira; Jenal, Ruzzakiah

2013-04-01

The scheduling of nurses is particularly challenging because of the nature of the work which is around the clock. In addition, inefficient duty roster can have an effect on the nurses well being as well as their job satisfaction. In nurse scheduling problem (NSP), nurses are generally allocated to periods of work over a specified time horizon. A typical length of the schedule varies from a few weeks to a month. The schedule will be consistently rebuilt after the specified time period and will result in a time-consuming task for the administrative staff involved. Moreover, the task becomes overwhelming when the staff needs to consider the previous duty rosters in order to maintain the quality of schedules. Therefore, this study suggests the development of a master plan for a nurse duty roster for approximately one year. The master plan starts with the development of a blue print for the nurse duty roster using a 0-1 goal programming technique. The appropriate working period for this blue print is formulated based on the number of night shifts and the number of required nurses for night shift per schedule. Subsequently, the blue print is repeated to complete the annual nurse duty roster. These newly developed procedures were then tested on several data sets. The test results found that the master plan has successfully distributed the annual workload evenly among nurses. In addition, the master plan allows nurses to arrange their career and social activities in advance.

19 CFR 143.5 - System performance requirements.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false System performance requirements. 143.5 Section 143.5 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF... must demonstrate that his system can interface directly with the Customs computer and ensure accurate...

19 CFR 141.1 - Liability of importer for duties.

Science.gov (United States)

2010-04-01

... Customs by the broker. (c) Claim against estate of importer. The claim of the Government for unpaid duties... 19 Customs Duties 2 2010-04-01 2010-04-01 false Liability of importer for duties. 141.1 Section 141.1 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT...

Light-Duty Vehicle Thermal Management | Transportation Research | NREL

Science.gov (United States)

Light-Duty Vehicle Thermal Management Light-Duty Vehicle Thermal Management Image of a semi improving the thermal efficiency of light-duty vehicles (LDVs) while maintaining the thermal comfort that utility vehicles, vans, and light trucks in use on U.S. roads, and the average American drives 11,300

40 CFR 1033.530 - Duty cycles and calculations.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty cycles and calculations. 1033.530... CONTROLS CONTROL OF EMISSIONS FROM LOCOMOTIVES Test Procedures § 1033.530 Duty cycles and calculations. This section describes how to apply the duty cycle to measured emission rates to calculate cycle...

19 CFR 210.74 - Modification of reporting requirements.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Modification of reporting requirements. 210.74 Section 210.74 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Enforcement Procedures and Advisory Opinions § 210.74...

76 FR 61668 - Application(s) for Duty-Free Entry of Scientific Instruments

Science.gov (United States)

2011-10-05

... of biological assemblies composed of protein, nucleic acids, lipid and detergent. The studies will... research. A 120kV electron microscope with an anticontaminator and specimen holder suitable for imaging biological samples at liquid nitrogen temperatures is required for the research. Justification for Duty-Free...

78 FR 59756 - Petition for Waiver of Compliance

Science.gov (United States)

2013-09-27

...), which, in part, requires a train employee to receive 48 hours off duty after initiating an on-duty... allow a train employee to initiate an on-duty period each day for 6 consecutive days followed by 24... docket number and may be submitted by any of the following methods: Web site: http://www.regulations.gov...

A call of duty in hard times: Duty to vote and the Spanish Economic Crisis

Directory of Open Access Journals (Sweden)

Carol Galais

2014-06-01

Full Text Available Although scarce, the literature addressing the effects of the economy on voter turnout and political attitudes has yielded mixed results. By using individual, longitudinal data from Spain—a country devastated by the Great Recession—our study illuminates how the latest economic crisis has impacted citizens’ perceptions of voting. We analyze how economic conditions and perceptions of the economy have transformed the belief that voting is a civic duty, which is one of the strongest attitudinal predictors of turnout. Our results suggest that hard times slightly weaken citizens’ sense of civic duty, particularly among the youngest. However, the adverse effects of the economic crisis are compensated by the positive effects of the electoral context, and as a consequence there is no aggregate decline in civic duty during the period examined (2010–2012.

State duties of protection and fundamental rights

Directory of Open Access Journals (Sweden)

C Starck

2000-05-01

Full Text Available Duties of protection are duties of the state to protect certain legal interests of its citizens. They cover the interests of life, health, freedom and property and also protect some other interests and certain constitutionally recognised institutions. State duties of protection must be considered in connection with fundamental rights. The foundations of modern constitutionalism and attendant procedures are essential to develop guidelines for a constructive critique of the jurisprudence of the Constitutional Court. This is done with reference to the recent history of France, Germany and England. The historical excursus reveals that a single theory underlies the variety of constitutional states. The development of the constitutional state gave rise to the significance of the preservation of freedom through the maintenance of law and the separation of powers. This has given rise to various legal devices, based also in part on experience with moderate rule and earlier theories of the imperium limitatum.A textual analysis of the German Basic Law is undertaken to determine whether and how the duties of protection are expressly created. Furthermore, the duties that have been discovered in the Basic Law by the Federal Constitutional Court are considered. These duties include the protection of human life and health, personal freedom, the right to autonomous development of one's personality, freedom of science, research and teaching, marriage and the family, children, mothers, professional freedom, property and the protection of German nationals against foreign states. Finally the justification of such duties and the constitutional control of the manner of protection are considered.In a final section a critique of relevant constitutional jurisprudence is undertaken. It is argued that claims to protection cannot be directly binding law. They presuppose legislation. If statutory protection is connected with infringements of third-party fundamental rights

[A case study on duty of care in professional nursing].

Science.gov (United States)

Huang, Hui-Man; Liao, Chi-Chun

2013-08-01

Nurses are expected to discharge their duty of care effectively and professionally to prevent medical negligence. Only three articles have previously focused on medical negligence. Duty of care and medical negligence in nursing are topics that have been neglected in Taiwan. (1) Classify the duty of care of professional nurses; (2) Investigate the facts and disputes in the current case; (3) Clarify the legal issues involved with regard to duty-of-care violations in the current case; (4) Explore the causal relationships in a legal context between nurses' duty-of-care violations and patient harm / injury. Literature analysis and a case study are used to analyze Supreme Court Verdict No.5550 (2010). Duty of care for nursing professionals may be classified into seven broad categories. Each category has its distinct correlatives. In nursing practice, every nursing behavior has a corresponding duty. In this case, the case study nurse did not discharge her obstetric professional duty and failed to inform the doctor in a timely manner. Negligence resulted in prenatal death and the case study nurse was found guilty. In order to prevent committing a crime, nurses should gain a better understanding of their duty of care and adequately discharge these duties in daily practice.

Towards a Duty of Care for Biodiversity

Science.gov (United States)

Earl, G.; Curtis, A.; Allan, C.

2010-04-01

The decline in biodiversity is a worldwide phenomenon, with current rates of species extinction more dramatic than any previously recorded. Habitat loss has been identified as the major cause of biodiversity decline. In this article we suggest that a statutory duty of care would complement the current mix of policy options for biodiversity conservation. Obstacles hindering the introduction of a statutory duty of care include linguistic ambiguity about the terms ‘duty of care’ and ‘stewardship’ and how they are applied in a natural resource management context, and the absence of a mechanism to guide its implementation. Drawing on international literature and key informant interviews we have articulated characteristics of duty of care to reduce linguistic ambiguity, and developed a framework for implementing a duty of care for biodiversity at the regional scale. The framework draws on key elements of the common law ‘duty of care’, the concepts of ‘taking reasonable care’ and ‘avoiding foreseeable harm’, in its logic. Core elements of the framework include desired outcomes for biodiversity, supported by current recommended practices. The focus on outcomes provides opportunities for the development of innovative management practices. The framework incorporates multiple pathways for the redress of non-compliance including tiered negative sanctions, and positive measures to encourage compliance. Importantly, the framework addresses the need for change and adaptation that is a necessary part of biodiversity management.

Sleep inertia during a simulated 6-h on/6-h off fixed split duty schedule.

Science.gov (United States)

Hilditch, Cassie J; Short, Michelle; Van Dongen, Hans P A; Centofanti, Stephanie A; Dorrian, Jillian; Kohler, Mark; Banks, Siobhan

Sleep inertia is a safety concern for shift workers returning to work soon after waking up. Split duty schedules offer an alternative to longer shift periods, but introduce additional wake-ups and may therefore increase risk of sleep inertia. This study investigated sleep inertia across a split duty schedule. Sixteen participants (age range 21-36 years; 10 females) participated in a 9-day laboratory study with two baseline nights (10 h time in bed, [TIB]), four 24-h periods of a 6-h on/6-h off split duty schedule (5-h TIB in off period; 10-h TIB per 24 h) and two recovery nights. Two complementary rosters were evaluated, with the timing of sleep and wake alternating between the two rosters (2 am/2 pm wake-up roster versus 8 am/8 pm wake-up roster). At 2, 17, 32 and 47 min after scheduled awakening, participants completed an 8-min inertia test bout, which included a 3-min psychomotor vigilance test (PVT-B), a 3-min Digit-Symbol Substitution Task (DSST), the Karolinska Sleepiness Scale (KSS), and the Samn-Perelli Fatigue Scale (SP-Fatigue). Further testing occurred every 2 h during scheduled wakefulness. Performance was consistently degraded and subjective sleepiness/fatigue was consistently increased during the inertia testing period as compared to other testing times. Morning wake-ups (2 am and 8 am) were associated with higher levels of sleep inertia than later wake-ups (2 pm and 8 pm). These results suggest that split duty workers should recognise the potential for sleep inertia after waking, especially during the morning hours.

Increasing Teachers' Workloads in the Form of Quantitative Expansion in Extracurricular Activities: Aggregated Data Analysis of Past Working Hours Using a General Linear Model

Science.gov (United States)

Kanbayashi, Toshiyuki

2016-01-01

In recent years, teachers' increased workloads have become an issue for policy, and have been multiply pointed out, deriving as they do from peripheral duties such as paperwork, in academic research as well. However, these mentions have not been based on sufficiently solid proof. Here, this paper compares teacher working hours surveys extant from…

38 CFR 3.6 - Duty periods.

Science.gov (United States)

2010-07-01

... arrest, or a cerebrovascular accident which occurred during such training. (Authority: 38 U.S.C. 101(24... the preparatory schools of the United States Air Force Academy, the United States Military Academy, or... school without a release from active duty, and for other individuals who have a commitment to active duty...

Resistance Torque Based Variable Duty-Cycle Control Method for a Stage II Compressor

Science.gov (United States)

Zhong, Meipeng; Zheng, Shuiying

2017-07-01

The resistance torque of a piston stage II compressor generates strenuous fluctuations in a rotational period, and this can lead to negative influences on the working performance of the compressor. To restrain the strenuous fluctuations in the piston stage II compressor, a variable duty-cycle control method based on the resistance torque is proposed. A dynamic model of a stage II compressor is set up, and the resistance torque and other characteristic parameters are acquired as the control targets. Then, a variable duty-cycle control method is applied to track the resistance torque, thereby improving the working performance of the compressor. Simulated results show that the compressor, driven by the proposed method, requires lower current, while the rotating speed and the output torque remain comparable to the traditional variable-frequency control methods. A variable duty-cycle control system is developed, and the experimental results prove that the proposed method can help reduce the specific power, input power, and working noise of the compressor to 0.97 kW·m-3·min-1, 0.09 kW and 3.10 dB, respectively, under the same conditions of discharge pressure of 2.00 MPa and a discharge volume of 0.095 m3/min. The proposed variable duty-cycle control method tracks the resistance torque dynamically, and improves the working performance of a Stage II Compressor. The proposed variable duty-cycle control method can be applied to other compressors, and can provide theoretical guidance for the compressor.

Evolution of high duty cycle echolocation in bats

DEFF Research Database (Denmark)

Fenton, M. B.; Faure, P. A.; Ratcliffe, J. M.

2012-01-01

Duty cycle describes the relative 'on time' of a periodic signal. In bats, we argue that high duty cycle (HDC) echolocation was selected for and evolved from low duty cycle (LDC) echolocation because increasing call duty cycle enhanced the ability of echolocating bats to detect, lock onto and track...... relative to background objects and their prey. HDC echolocators are particularly sensitive to amplitude and frequency glints generated by the wings of fluttering insects. We hypothesize that narrowband/CF calls produced at high duty cycle, and combined with neurobiological specializations for processing....... In contrast, bats using HDC echolocation emit long duration, narrowband calls dominated by a single constant frequency (CF) separated by relatively short periods of silence. HDC bats separate pulse and echo in frequency by exploiting information contained in Doppler-shifted echoes arising from their movements...

75 FR 22162 - Draft NIJ Duty Holster Retention Standard for Law Enforcement

Science.gov (United States)

2010-04-27

...In an effort to obtain comments from interested parties, the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice will make available to the general public two draft documents: (1) A draft standard entitled, ``NIJ Duty Holster Retention Standard for Law Enforcement'' and (2) a draft companion document entitled, ``NIJ Duty Holster Retention Certification Program Requirements.'' The opportunity to provide comments on these two documents is open to industry technical representatives, law enforcement agencies and organizations, research, development and scientific communities, and all other stakeholders and interested parties. Those individuals wishing to obtain and provide comments on the draft documents under consideration are directed to the following Web site: http://www.justnet.org.

Forgiveness and the Limits of Duty

NARCIS (Netherlands)

Archer, Alfred

2017-01-01

Can there be a duty to forgive those who have wronged us? According to a popular view amongst philosophers working on forgiveness the answer is no. Forgiveness, it is claimed, is always elective. This view is rejected by Gamlund (2010a; 2010b) who argues that duties to forgive do exist and then

77 FR 28391 - Announcement of Requirements and Registration for “Ocular Imaging Challenge”

Science.gov (United States)

2012-05-14

...), content (Transitions of Care, CCD/CCR), and standardized vocabularies Eligibility Rules for Participating... employee working on their applications or submissions during assigned duty hours. (6) Shall not be an... prize contest, whether the injury, death, damage, or loss arises through negligence or otherwise...

19 CFR 191.173 - Imported duty-paid derivatives (no manufacture).

Science.gov (United States)

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Imported duty-paid derivatives (no manufacture). 191.173 Section 191.173 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND... § 191.173 Imported duty-paid derivatives (no manufacture). When the basis for drawback under 19 U.S.C...

Epistemic Duties and Failure to Understand one's Evidence

Directory of Open Access Journals (Sweden)

Scott Stapleford

2012-08-01

Full Text Available http://dx.doi.org/10.5007/1808-1711.2012v16n1p147   The paper defends the thesis that our epistemic duty is the duty to proportion our beliefs to the evidence we possess. An inclusive view of evidenced possessed is put forward on the grounds that it makes sense of our intuitions about when it is right to say that a person ought to believe some proposition P. A second thesis is that we have no epistemic duty to adopt any particular doxastic attitudes. The apparent tension between the two theses is resolved by applying the concept of duty to belief indirectly.

Characterization of In-Use Medium Duty Electric Vehicle Driving and Charging Behavior: Preprint

Energy Technology Data Exchange (ETDEWEB)

Duran, A.; Ragatz, A.; Prohaska, R.; Kelly, K.; Walkowicz, K.

2014-11-01

The U.S. Department of Energy's American Recovery and Reinvestment Act (ARRA) deployment and demonstration projects are helping to commercialize technologies for all-electric vehicles (EVs). Under the ARRA program, data from Smith Electric and Navistar medium duty EVs have been collected, compiled, and analyzed in an effort to quantify the impacts of these new technologies. Over a period of three years, the National Renewable Energy Laboratory (NREL) has compiled data from over 250 Smith Newton EVs for a total of over 100,000 days of in-use operation. Similarly, data have been collected from over 100 Navistar eStar vehicles, with over 15,000 operating days having been analyzed. NREL has analyzed a combined total of over 4 million kilometers of driving and 1 million hours of charging data for commercial operating medium duty EVs. In this paper, the authors present an overview of medium duty EV operating and charging behavior based on in-use data collected from both Smith and Navistar vehicles operating in the United States. Specifically, this paper provides an introduction to the specifications and configurations of the vehicles examined; discusses the approach and methodology of data collection and analysis, and presents detailed results regarding daily driving and charging behavior. In addition, trends observed over the course of multiple years of data collection are examined, and conclusions are drawn about early deployment behavior and ongoing adjustments due to new and improving technology. Results and metrics such as average daily driving distance, route aggressiveness, charging frequency, and liter per kilometer diesel equivalent fuel consumption are documented and discussed.

Behavior-based rules for fitness-for-duty assessment of nuclear power plant personnel

International Nuclear Information System (INIS)

Kennedy, R.S.

1989-01-01

The safe and reliable operation of nuclear power plants requires that plant personnel not be under the influence of any substance, legal or illegal, or mentally or physically impaired from any cause that in any way adversely affects their ability to safely and competently perform their duties. This goal has been formalized by the US Nuclear Regulatory Commission in their proposed rule for a fitness-for-duty program. The purpose of this paper is to describe a performance-based tool based on surrogate tests and dose equivalency methodologies that is a viable candidate for fitness-for-duty assessment. The automated performance test system (APTS) is a microcomputer-based human performance test battery that has been developed over a decade of research supported variously by the National Science Foundation, National Aeronautics and Space Administration, US Department of Energy, and the US Navy and Army. Representing the most psychometrically sound test from evaluations of over 150 well-known tests of basic psychomotor and cognitive skills, the battery provides direct prediction of a worker's fitness for duty. Twenty-four tests are suitable for use, and a dozen have thus far been shown to be sensitive to the effects of legal and illegal drugs, alcohol, fatigue, stress, and other causes of impairment

CRIMES AGAINST OFFICIAL DUTY IN THE REPUBLIC OF MACEDONIA

Directory of Open Access Journals (Sweden)

Darko Majhosev

2015-07-01

Full Text Available The paper analyzes the legal provisions of the Criminal Code of the Republic of Macedonia relating to crimes against official duty. Crimes against official duty represent a group of criminal offenses that occupy a special place in criminal law. This kind of crimes is also called civil servants crimes, that is, they are defined as a violation of duty made by an official in performing his/her official duty. In this paper we will analyze all articles of the Criminal Code that regulate the group of criminal offenses against official duty. Most frequent cases of misuse of official duty are cases of misuse of official position and authorization, unprincipled operation within the service, defraud in the service, receiving a bribe, giving a bribe, unlawful mediation, disclosing an official secret, falsifying an official document and other. The paper will define the terms official and responsible person. In the context of the paper we will show the research referring to the number of registered and accused of crimes against official duty in the Republic of Macedonia in the period from 2004 to 2013.

Vigilance: A Review of the Literature and Applications to Sentry Duty

Energy Technology Data Exchange (ETDEWEB)

See, Judi E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2014-09-01

Vigilance, or sustained attention, involves the ability to maintain focus and remain alert for prolonged periods of time. Problems associated with the ability to sustain attention were first identified in real-world combat situations during World War II, and they continue to abound and evolve as new and different types of situations requiring vigilance arise. This paper provides a review of the vigilance literature that describes the primary psychophysical, task, environmental, pharmacological, and individual factors that impact vigilance performance. The paper also describes how seminal findings from vigilance research apply specifically to the task of sentry duty. The strengths and weaknesses of a human sentry and options to integrate human and automated functions for vigilance tasks are discussed. Finally, techniques that may improve vigilance performance for sentry duty tasks are identified.

19 CFR 113.1 - Authority to require security or execution of bond.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Authority to require security or execution of bond. 113.1 Section 113.1 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY CUSTOMS BONDS General Provisions § 113.1 Authority to require security or...

Assessing the Battery Cost at Which Plug-In Hybrid Medium-Duty Parcel Delivery Vehicles Become Cost-Effective

Energy Technology Data Exchange (ETDEWEB)

Ramroth, L. A.; Gonder, J. D.; Brooker, A. D.

2013-04-01

The National Renewable Energy Laboratory (NREL) validated diesel-conventional and diesel-hybrid medium-duty parcel delivery vehicle models to evaluate petroleum reductions and cost implications of hybrid and plug-in hybrid diesel variants. The hybrid and plug-in hybrid variants are run on a field data-derived design matrix to analyze the effect of drive cycle, distance, engine downsizing, battery replacements, and battery energy on fuel consumption and lifetime cost. For an array of diesel fuel costs, the battery cost per kilowatt-hour at which the hybridized configuration becomes cost-effective is calculated. This builds on a previous analysis that found the fuel savings from medium duty plug-in hybrids more than offset the vehicles' incremental price under future battery and fuel cost projections, but that they seldom did so under present day cost assumptions in the absence of purchase incentives. The results also highlight the importance of understanding the application's drive cycle specific daily distance and kinetic intensity.

7 CFR 1221.110 - Powers and duties.

Science.gov (United States)

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... INFORMATION ORDER Sorghum Promotion, Research, and Information Order Sorghum Promotion, Research, and Information Board § 1221.110 Powers and duties. The Board shall have the following powers and duties: (a) To...

77 FR 26015 - Announcement of Requirements and Registration for “Seeing My World through a Safer Lens: What...

Science.gov (United States)

2012-05-02

... not be an HHS employee working on their applications or submissions during assigned duty hours. (7... outside the scope of their employment should consult their ethics official prior to developing their...

Epistemic duties and failure to understand one’s evidence

Directory of Open Access Journals (Sweden)

Scott Stapleford

2012-04-01

Full Text Available The paper defends the thesis that our epistemic duty is the duty to proportion our beliefs to the evidence we possess. An inclusive view of evidenced possessed is put forward on the grounds that it makes sense of our intuitions about when it is right to say that a person ought to believe some proposition P. A second thesis is that we have no epistemic duty to adopt any particular doxastic attitudes. The apparent tension between the two theses is resolved by applying the concept of duty to belief indirectly.

Expanding the scope of practice for radiology managers: radiation safety duties.

Science.gov (United States)

Orders, Amy B; Wright, Donna

2003-01-01

In addition to financial responsibilities and patient care duties, many medical facilities also expect radiology department managers to wear "safety" hats and complete fundamental quality control/quality assurance, conduct routine safety surveillance in the department, and to meet regulatory demands in the workplace. All managers influence continuous quality improvement initiatives, from effective utilization of resource and staffing allocations, to efficacy of patient scheduling tactics. It is critically important to understand continuous quality improvement (CQI) and its relationship with the radiology manager, specifically quality assurance/quality control in routine work, as these are the fundamentals of institutional safety, including radiation safety. When an institution applies for a registration for radiation-producing devices or a license for the use of radioactive materials, the permit granting body has specific requirements, policies and procedures that must be satisfied in order to be granted a permit and to maintain it continuously. In the 32 U.S. Agreement states, which are states that have radiation safety programs equivalent to the Nuclear Regulatory Commission programs, individual facilities apply for permits through the local governing body of radiation protection. Other states are directly licensed by the Nuclear Regulatory Commission and associated regulatory entities. These regulatory agencies grant permits, set conditions for use in accordance with state and federal laws, monitor and enforce radiation safety activities, and audit facilities for compliance with their regulations. Every radiology department and associated areas of radiation use are subject to inspection and enforcement policies in order to ensure safety of equipment and personnel. In today's business practice, department managers or chief technologists may actively participate in the duties associated with institutional radiation safety, especially in smaller institutions, while

Fitness for duty - a regulator's view

International Nuclear Information System (INIS)

Johnson, E.H.; Hall, R.E.

1987-01-01

Fitness for duty is a legal, moral, emotional, and political issue. It is therefore that type of issue that one would expect industry to run from, opting instead for government intervention and prescriptive regulations. This would allow the industry to hide behind the shield of doing what is necessary to comply. But fitness for duty is also a rational business issue. It involves getting a reasonable return on the investment in the people who are necessary to run the nuclear industry. It is within this context that the US Nuclear Regulatory Commission (NRC) has exercised its discretion to not undertake new rule making, instead giving the industry the mandate of pursuing this issue. The NRC has deferred rule making as long as the industry programs are effective in producing the desired results. The NRC has also retained the right to follow up on operational events and to evaluate the effectiveness of the programs in place. The industry, under the leadership of NUMARC, has risen to this challenge and has adopted the August 1985 Edison Electric Institute (EEI) fitness-for-duty program guidelines for implementation by all utilities. In evaluating the effectiveness of programs, the NRC is conducting inspections at some utilities. These inspections have confirmed that the EEI guidelines are being used as the basis for fitness-for-duty programs. Even though the nuclear industry has taken a generally strong stand on fitness for duty and has adopted reasonable guidelines for its assurance, there still remain several challenges

20 CFR 702.402 - Employer's duty to furnish; duration.

Science.gov (United States)

2010-04-01

... Care and Supervision § 702.402 Employer's duty to furnish; duration. It is the duty of the employer to furnish appropriate medical care (as defined in § 702.401(a)) for the employee's injury, and for such... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Employer's duty to furnish; duration. 702.402...

28 CFR 49.2 - Duties of custodian.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Duties of custodian. 49.2 Section 49.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) ANTITRUST CIVIL PROCESS ACT § 49.2 Duties of custodian. (a) Upon taking physical possession of documentary material, answers to interrogatories, or...

The impact of transitioning from a 24-hour to a 16-hour call model amongst a cohort of Canadian anesthesia residents at McMaster University – a survey study

Directory of Open Access Journals (Sweden)

Sussman D

2015-08-01

Full Text Available David Sussman, James E Paul Department of Anesthesia, McMaster University, Hamilton, ON, Canada Purpose: The primary objective of this study was to assess anesthesia residents' opinions and perceptions on wellness/burnout, fatigue, education, and patient safety after the initiation of a reduced call model (16-hour call. Methods: A prospective cohort study was conducted at three time points during the 2013–2014 academic year. A web-based questionnaire consisting of 23 questions was electronically distributed to all anesthesia residents from postgraduate years (PGY 1 to 5 who were part of the active call roster (n=84 at McMaster University in Hamilton, Ontario. Descriptive summaries were calculated, counts and percentages were used for categorical variables, and answers to open text questions were reviewed for themes. Results: A response rate of 67% was obtained for this study. A majority of anesthesia residents (65% approved of 16-hour call, felt that their overall quality of life as a senior resident (PGY3 or greater or junior resident (PGY2 and below had improved (73% and 55%, respectively, and reported overall feeling less fatigued. Most respondents indicated that the quality of education remained unchanged (47%, or had improved (31%. And most felt better prepared for the royal college exam (52%. Most felt patient safety had improved or was unchanged (both 48%. Conclusion: The study demonstrates that 16-hour call improved resident wellness, reduced burnout and fostered an environment where residents are less fatigued and more satisfied with their educational experience promoting an environment of patient safety. Overall, the anesthesia residency group demonstrated that not only is 16-hour call preferred but beneficial. Keywords: resident wellness, reduced call model, duty hours, patient safety, cohort study, fatigue 

32 CFR 935.21 - Civil rights, powers, and duties.

Science.gov (United States)

2010-07-01

... INSULAR REGULATIONS WAKE ISLAND CODE Civil Law § 935.21 Civil rights, powers, and duties. In any case in... the laws of the United States or this part, the civil rights, powers, and duties as they obtain under... 32 National Defense 6 2010-07-01 2010-07-01 false Civil rights, powers, and duties. 935.21 Section...

Rhabdomyolysis in a Sickle Cell Trait Positive Active Duty Male Soldier.

Science.gov (United States)

Saxena, Pulkit; Chavarria, Christopher; Thurlow, John

2016-01-01

Exertional rhabdomyolysis is a complication of sickle cell trait (SCT) likely first reported in the military population over 40 years ago. Although commonly a benign condition, numerous studies and case reports have identified SCT positive patients to be at increased risk for rhabdomyolysis, compartment syndrome and sudden cardiac death. We report a recent case of an SCT positive African American active duty male Soldier who suffered exertional rhabdomyolysis following an Army Physical Fitness Test. His course was complicated by acute renal failure requiring hemodialysis, and he eventually recovered renal function. The diagnosis was significantly delayed despite a typical clinical presentation and available SCT screening results. The case highlights the importance of the recognition of SCT as a risk factor for severe rhabdomyolysis, and suggests more must be done for an effective SCT screening program for the active duty military population.

Return-to-Duty Rates Following Minimally Invasive Spine Surgery Performed on Active Duty Military Patients in an Ambulatory Surgery Center.

Science.gov (United States)

Granger, Elder; Prada, Stefan; Bereczki, Zoltan; Weiss, Michael; Wade, Chip; Davis, Reginald

2018-05-21

Low back pain is a primary health care utilization driver in the US population. Health care evaluation visits for low back pain are as common as medical evaluation for the common cold. Low back pain is the most common reason for reductions in activities of daily living and work activity in the general population. Although these statistics are compelling, in the military population, there is arguably a significantly greater economic impact on the military population, as the cost to train, retain, and deploy a service member is a tremendous cost. The current study retrospectively examines surgical outcomes, return to duty, and patient-centric outcomes among 82 active duty or reserve military patients who underwent an outpatient minimally invasive spine surgery Laminotomy Foraminotomy Decompression for the treatment of lumbar spinal stenosis in an ambulatory surgery center. Overall, our results indicate that within the 82 active duty military service members, 100% of the service members return to duty within 3 mo. Additionally, there was a significant reduction in self-reported pain and disability 12 mo postoperative, whereas the average length of surgery was 62 min with an average estimated blood loss of 30.64 mL. The current study indicates that minimally invasive procedures for the treatment of lumbar spinal stenosis in an ambulatory surgery center setting are an effective option for active duty servicemen to reduce return-to-duty rates and symptomatic back-related pain and disability.

Wi-Fi Coexistence with Duty Cycled LTE-U

Directory of Open Access Journals (Sweden)

Yimin Pang

2017-01-01

Full Text Available Coexistence of Wi-Fi and LTE-Unlicensed (LTE-U technologies has drawn significant concern in industry. In this paper, we investigate the Wi-Fi performance in the presence of duty cycle based LTE-U transmission on the same channel. More specifically, one LTE-U cell and one Wi-Fi basic service set (BSS coexist by allowing LTE-U devices to transmit their signals only in predetermined duty cycles. Wi-Fi stations, on the other hand, simply contend the shared channel using the distributed coordination function (DCF protocol without cooperation with the LTE-U system or prior knowledge about the duty cycle period or duty cycle of LTE-U transmission. We define the fairness of the above scheme as the difference between Wi-Fi performance loss ratio (considering a defined reference performance and the LTE-U duty cycle (or function of LTE-U duty cycle. Depending on the interference to noise ratio (INR being above or below −62 dbm, we classify the LTE-U interference as strong or weak and establish mathematical models accordingly. The average throughput and average service time of Wi-Fi are both formulated as functions of Wi-Fi and LTE-U system parameters using probability theory. Lastly, we use the Monte Carlo analysis to demonstrate the fairness of Wi-Fi and LTE-U air time sharing.

Inversion of the ‘Duty of Care’

DEFF Research Database (Denmark)

Tsinovoi, Alexei; Adler-Nissen, Rebecca

2017-01-01

technologies and the proliferation of new security threats. In recent years the state’s duty of care has received fresh political and scholarly attention, but Diplomatic Studies have so far overlooked how the recent waves of neoliberal reforms have introduced a new political rationality into policy......The concept of ‘duty of care’ for citizens abroad is grounded in a political rationality where the population is seen as an object for protection by the state. In today’s globalised world, however, this rationality is challenged by increased citizen mobility, budget cuts, new information...... of the duty of care through new citizen-based practices, steered at a distance by the state....

How Do Stamp Duties Affect the Housing Market?

OpenAIRE

Davidoff, Ian; Leigh, Andrew

2013-01-01

Land transfer taxes are a substantial portion of the cost of moving house in many developed countries. Since stamp duties are endogenous with respect to the house price, we create an instrumental variable that is the stamp duty on a property, given that postcode's starting house price and the national house price trend. In a specification with postcode and year fixed effects, this instrument effectively captures policy changes and nonlinearities in the stamp duty schedule. We find that the im...

On pandemics and the duty to care: whose duty? who cares?

Science.gov (United States)

Ruderman, Carly; Tracy, C Shawn; Bensimon, Cécile M; Bernstein, Mark; Hawryluck, Laura; Shaul, Randi Zlotnik; Upshur, Ross EG

2006-01-01

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease

40 CFR Appendix II to Part 1039 - Steady-State Duty Cycles

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Steady-State Duty Cycles II Appendix... Appendix II to Part 1039—Steady-State Duty Cycles (a) The following duty cycles apply for constant-speed engines: (1) The following duty cycle applies for discrete-mode testing: D2 mode number Engine speed...

40 CFR Appendix II to Part 1042 - Steady-State Duty Cycles

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Steady-State Duty Cycles II Appendix..., App. II Appendix II to Part 1042—Steady-State Duty Cycles (a) The following duty cycles apply as specified in § 1042.505(b)(1): (1) The following duty cycle applies for discrete-mode testing: E3 mode No...

Duty periods for establishing eligibility for health care. Final rule.

Science.gov (United States)

2013-12-26

The Department of Veterans Affairs (VA) is amending its medical regulations concerning eligibility for health care to re-establish the definitions of "active military, naval, or air service,'' "active duty,'' and "active duty for training.'' These definitions were deleted in 1996; however, we believe that all duty periods should be defined in part 17 of the Code of Federal Regulations (CFR) to ensure proper determination of eligibility for VA health care. We are also providing a more complete definition of "inactive duty training.''

Mothers' perceptions of their health choices, related duties and responsibilities: A qualitative interview study.

Science.gov (United States)

Kangasniemi, Mari; Blomberg, Katja; Korhonen, Anne

2015-11-01

to describe mothers' perceptions of their health choices, related duties and responsibilities. descriptive exploratory study with qualitative research method. interviews conducted after the clients' regular health visits to one publicly provided maternity clinic in a southern city in Finland. 13 mothers aged between 21 and 40-years-old, who were pregnant or had given birth in the past four weeks. Six of participants were pregnant or had delivered for first time and it was the second to fourth pregnancy for the remainder. one-to-one semi-structured interviews using the inductive content analysis method. women reported increased responsibility for their health choices for themselves and their baby during pregnancy. However, their duties and responsibilities were seldom discussed at maternity clinics. The duty to reconsider their health choices was described as a predictor of commitment to their pregnancy and motherhood, but they recognised that it required sufficient knowledge to realise this. In addition, the mothers said their health choices changed from private to one of public interest during this period. health choices are connected to maternal duties and responsibilities, but they can sometimes lack clarity during this new phase of life. In future, more research should be conducted to study maternal duties and responsibilities in different contexts. findings highlight the skills of nurses and midwives at maternity clinics to discuss and support mothers' moral pondering during pregnancy. Although health choices in general are well recognised as a part of maternal counselling, these findings suggest a moral perspective should be incorporated into the advice that is provided. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chemistry, Courtrooms, and Common Sense. Part I: Negligence and Duty.

Science.gov (United States)

Gass, J. Ric

1990-01-01

Discussed are concepts involved in legal liability for laboratory accidents. The focus of this article is on negligence, duty, and responsibility issues. Highlighted are the basis of a lawsuit, negligent tort, duty and breech of duty, and cause and harm. Thirty-one cases are cited. (CW)

Comparison of EGR-VTG control schemes for an EPA2010 heavy-duty diesel engine

NARCIS (Netherlands)

Criens, C.H.A.; Willems, F.P.T.; Steinbuch, M.

2011-01-01

Next generation heavy-duty diesel engines require tight air path control to meet upcoming emission legislation with minimal fuel consumption. This study concentrates on the emission control of a 13l, 360 kW EGR diesel engine, which is compliant with EPA2010 emission targets. Currently, an

Sleep on Long Haul Layovers and Pilot Fatigue at the Start of the Next Duty Period.

Science.gov (United States)

Cosgrave, Jan; Wu, Lora J; van den Berg, Margo; Signal, T Leigh; Gander, Philippa H

2018-01-01

Layovers are critical for pilot recovery between flights and minimum layover durations are required by regulation. However, research on the factors affecting layover sleep and safety performance indicators (SPIs) before subsequent flights is relatively sparse. The present project combined data from 6 studies, including 8 long-range and 5 ultra-long range out-and-back trips across a range of different layover destinations (299 pilots in 4-person crews, 410 layovers, 1-3 d layover duration). Sleep was monitored via actigraphy from 3 d pre-trip to at least 3 d post-trip. Pilots rated their sleepiness (Karolinska Sleepiness Scale, KSS) and fatigue (Samn-Perelli scale, SP) at duty start for the inbound flight. Mixed model ANOVAs identified independent associations between fatigue and sleepiness SPIs and operational factors (domicile time of duty start for the inbound flight in six 4-h bins, layover duration, and total sleep time (TST) in the 24 h prior to inbound duty start). TST was greatest on layovers ending between 1200-1559 domicile time (time in the city from which the outbound flight departed) and TST was a significant predictor of both KSS and SP ratings at duty start for the inbound flight. TST in the 24 h prior to the inbound flight was greatest when duty start time allowed for the inclusion of a full domicile night time period. In this dataset, circadian end-time of layovers is a key determinant of pilot fatigue status at the beginning of the inbound duty period.Cosgrove J, Wu LJ, van den Berg M, Signal TL, Gander PH. Sleep on long haul layovers and pilot fatigue at the start of the next duty period. Aerosp Med Hum Perform. 2018; 89(1):19-25.

Legal, ethical and professional aspects of duty of care for nurses.

Science.gov (United States)

Dowie, Iwan

2017-12-13

Duty of care is a fundamental aspect of nursing, and many nurses consider this to be an important part of their professional duties as a nurse. However, the legal underpinnings of duty of care are often overlooked, and, as such, nurses may be unsure about when to act if they encounter emergency situations or serious incidents, especially when they are off duty. This article examines the legal, ethical and professional aspects of duty of care, what these mean for nurses in practice, and how duty of care is intrinsically linked with standards of care and negligence. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

32 CFR 13.4 - Duties and responsibilities of the defense.

Science.gov (United States)

2010-07-01

... COMMISSIONS RESPONSIBILITIES OF THE CHIEF DEFENSE COUNSEL, DETAILED DEFENSE COUNSEL, AND CIVILIAN DEFENSE COUNSEL § 13.4 Duties and responsibilities of the defense. (a) Regular duties. The Defense shall perform... 32 National Defense 1 2010-07-01 2010-07-01 false Duties and responsibilities of the defense. 13.4...

49 CFR 1103.15 - The practitioner's duty to clients, generally.

Science.gov (United States)

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false The practitioner's duty to clients, generally... Practitioner's Duties and Responsibilities Toward A Client § 1103.15 The practitioner's duty to clients... all clients to observe the statutory law to the best of his knowledge or as interpreted by competent...

Antidumping duties, undertakings and foreign direct investment in the EU

NARCIS (Netherlands)

Belderbos, R.A.; Vandenbussche, H.; Veugelers, R.

2004-01-01

We study the effects of EU antidumping policy when foreign firms can ‘jump’ antidumping duties through foreign direct investment (FDI) in the EU. We show that duty jumping or duty pre-empting FDI occurs if the EU administration has broader objectives than protecting EU industry's profitability and

40 CFR 66.61 - Duty to pay.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Duty to pay. 66.61 Section 66.61... COLLECTION OF NONCOMPLIANCE PENALTIES BY EPA Payment § 66.61 Duty to pay. (a) Except where the owner or... who submits a petition pursuant to § 66.52 shall pay the penalty amount calculated by the owner or...

Determining your duties.

Science.gov (United States)

Summers, J

1989-04-01

This issue's discussion has two goals. First, we shall examine the reasons clinical personnel gravitate to the Kantian concept of duty. Second, we shall examine a technique used within Kantian theory that will help you decide when an ethical dilemma obligates you to act regardless of the consequences.

Sensitivity study on Duty cycles for Actuator fatigue analysis

OpenAIRE

Jacamon, Pauline

2016-01-01

During the aircraft's ight, the control surfaces that enable the aircraft to perform the required maneuvers and the actuator that control them have to withstand loads. Those loads will a ect the actuators lifetime and that is why it is very important to be able to predict their amplitude in order to make sure the actuators will last long enough and be ecient enough during the aircraft lifetime. Duty cycles are thus computed in order to compute the actuators fatigue severity and endurance crit...

Job search, hours restrictions, and desired hours of work

NARCIS (Netherlands)

Bloemen, H.G.

2008-01-01

A structural empirical job search model is presented that incorporates the labor supply decision of individuals. The arrival of a job offer is modeled as a random draw from a wage-hours offer distribution. Subjective information is used on desired working hours to identify optimal hours from offered

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

work hours to 12–16 hour maximum shiftsA minimum of 10 hours off duty should be scheduled between shiftsResident physician input into work redesign should be actively solicitedSchedules should be designed that adhere to principles of sleep and circadian science; this includes careful consideration of the effects of multiple consecutive night shifts, and provision of adequate time off after night work, as specified in the IOM reportResident physicians should not be scheduled up to the maximum permissible limits; emergencies frequently occur that require resident physicians to stay longer than their scheduled shifts, and this should be anticipated in scheduling resident physicians’ work shiftsHospitals should anticipate the need for iterative improvement as new schedules are initiated; be prepared to learn from the initial phase-in, and change the plan as neededAs resident physician work hours are redesigned, attending physicians should also be considered; a potential consequence of resident physician work hour reduction and increased supervisory requirements may be an increase in work for attending physicians; this should be carefully monitored, and adjustments to attending physician work schedules made as needed to prevent unsafe work hours or working conditions for this group“Home call” should be brought under the overall limits of working hours; work load and hours should be monitored in each residency program to ensure that resident physicians and fellows on home call are getting sufficient sleepMedicare funding for graduate medical education in each hospital should be linked with adherence to the Institute of Medicine limits on resident physician work hours Moonlighting by resident physicians The Institute of Medicine report recommended including external as well as internal moonlighting in working hour limits. The recommendation is: All moonlighting work hours should be included in the ACGME working hour limits and actively monitored. Hospitals should

5 CFR 330.208 - Qualification requirements.

Science.gov (United States)

2010-01-01

... perform the duties and responsibilities of the position. (c) The sex of an individual may not be... qualified for a position if he or she: (1) Meets OPM-established or approved qualification standards and requirements for the position, including any minimum educational requirements, and any selection placement...

California State Implementation Plan; Final Approval of Revision; Yolo-Solano Air Quality Management District; Reasonably Available Control Technology Requirements for 1997 8-hour Ozone NAAQS

Science.gov (United States)

EPA is taking final action to approve a revision to the Yolo-Solano Air Quality Management District (YSAQMD) portion of the California SIP concerning YSAQMD regarding RACT)requirements the 1997 8-hour ozone NAAQS and approve negative declarations into SIP.

Factors influencing accruement of contact hours for nurses.

Science.gov (United States)

Kubsch, Sylvia; Henniges, Amy; Lorenzoni, Nancy; Eckardt, Sally; Oleniczak, Sandra

2003-01-01

A decline in attendance at continuing education (CE) in nursing activities was observed in a Midwest state where CE attendance is not required. The purpose of this research study was to identify the effect of attitude, extrinsic and intrinsic reinforcement, and deterrents on contact hour accrual. A convenience sample of 282 registered nurses was surveyed using a researcher-constructed instrument determined to be valid and reliable. Registered nurses earning 0 to 15 contact hours annually reported accruing fewer contact hours in 1999 than in an average year. Registered nurses who earned 16 to 45+ contact hours annually reported earning more contact hours in 1999 than in an average year. Intrinsic reinforcement was found to be a significant motivator (r [257] = .242; p Operant Conditioning Theory has use in explaining registered nurse attendance at CE activities. CE planners should consider placing more emphasis on intrinsic rather than extrinsic reinforcement to encourage staff to attend CE activities.

Transparency in corporate governance: Extent of directors duty to declare interest in company’s transactions

Directory of Open Access Journals (Sweden)

Anthony O. Nwafor

2015-04-01

Full Text Available The realization that the directors occupy important position in corporate governance, and as business men and women, cannot be prevented from having dealings with the company, demand a close scrutiny of corporate transactions in which they are directly or indirectly involved or have an interest to ensure that such interest is not placed above their duty to the company. One of the ways in which the law strives to achieve this balance is by imposing a duty on the director to disclose to the board any interest he has in company’s transactions. This requirement which was previously governed by the common law and the company’s articles, is presently increasingly finding a place in companies statutes in different jurisdictions. The paper examines, through a comparative analysis, the provisions on the duty of the director to disclose interest in company’s transactions in South Africa and United Kingdom with the aim of discovering the extent to which the statute in both jurisdictions upholds the common law prescriptions. The paper argues that the need for transparency in corporate governance and the preservation of the distinct legal personality of the company demand that the duty to disclose interest should be upheld even in those cases of companies run by a sole director.

Heavy-Duty Vehicle Port Drayage Drive Cycle Characterization and Development

Energy Technology Data Exchange (ETDEWEB)

Prohaska, Robert; Konan, Arnaud; Kelly, Kenneth; Lammert, Michael

2016-10-06

In an effort to better understand the operational requirements of port drayage vehicles and their potential for adoption of advanced technologies, National Renewable Energy Laboratory (NREL) researchers collected over 36,000 miles of in-use duty cycle data from 30 Class 8 drayage trucks operating at the Port of Long Beach and Port of Los Angeles in Southern California. These data include 1-Hz global positioning system location and SAE J1939 high-speed controller area network information. Researchers processed the data through NREL's Drive-Cycle Rapid Investigation, Visualization, and Evaluation tool to examine vehicle kinematic and dynamic patterns across the spectrum of operations. Using the k-medoids clustering method, a repeatable and quantitative process for multi-mode drive cycle segmentation, the analysis led to the creation of multiple drive cycles representing four distinct modes of operation that can be used independently or in combination. These drive cycles are statistically representative of real-world operation of port drayage vehicles. When combined with modeling and simulation tools, these representative test cycles allow advanced vehicle or systems developers to efficiently and accurately evaluate vehicle technology performance requirements to reduce cost and development time while ultimately leading to the commercialization of advanced technologies that meet the performance requirements of the port drayage vocation. The drive cycles, which are suitable for chassis dynamometer testing, were compared to several existing test cycles. This paper presents the clustering methodology, accompanying results of the port drayage duty cycle analysis and custom drive cycle creation.

Setting standards for planning off duty and audit of practice.

Science.gov (United States)

Walker, Linda; Minchin, Anne; Pickard, Jane

The off duty or rostering system is an important part of managing any ward or department. This article looks at the issues that need to be considered when drawing up and managing off duty. It recommends standards for off-duty planning and shares the results of an audit carried out against some of these standards in one NHS trust.

Why Stamp Duties are an Increasing Financial Burden on Australian Home Buyers

OpenAIRE

Wood, Gavin A.

1994-01-01

The purchaser of housing incurs stamp duty liabilities in all Australian States. These stamp duties are levied on the conveyance of residential property and mortgage sums secured. In general, stamp duties were a growing financial burden on home buyers during the period 1985-1991. This paper examines the role of house price inflation in causing increases in average rates of stamp duty, the responsiveness of average rates of stamp duty to future changes in the nominal tax base and the effective...

Responsibilities and duties in the realm of work

Directory of Open Access Journals (Sweden)

Babić Jovan

2009-01-01

Full Text Available Employee responsibilities are prior to working rights and they are an equally important part of business ethics. There are three main parts in articulation of these responsibilities: 1. general responsibilities and duties in the process of work and in workplace, where we face the challenges of honesty, confidence, reliability, and such. 2. specific professional duties tied with profession that has heghtened responsibility of some sort, where we may find characteristic virtues connected with those professions. 3. managerial duties and responsibilities based on specific positions of managers and leaders as deciders in most important issues in business. The decisions that managers and leaders have to make have great impact to all those involved in business, and temptations they face are hard and far-reaching. The issues analyzed in the paper include work discipline, loyalty to the company, conflicts of various kinds of interests, limits of obedience, virtues accompanying various kinds of duties and obligations. .

Conflicting duties over confidentiality in Argentina and Peru.

Science.gov (United States)

Cavallo, Mercedes

2011-02-01

The medical duty of confidentiality represents a key element for the provision of reproductive and sexual health services. In some Latin American countries, such as Argentina and Peru, the legal systems impose—or are interpreted as imposing—on health professionals the duty of confidentiality, but also the duty to report the commission of a public order offense that they know about owing to the practicing of their profession. In these countries, the conflicting duties and the criminalization of abortion cause severe public health and human rights problems when health professionals assist their patients for post-abortion treatment. Typically, patients are deterred from seeking prompt medical care, and their privacy, autonomy, and dignity are violated. A 2010 ruling from the Supreme Court of Argentina and a 2004 ruling from the Inter-American Court of Human Rights emerge as important instruments that grant a more adequate protection of medical confidentiality. © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

THE EVOLUTION AND COMPLEXITY OF DIRECTORS' DUTY OF CARE

Directory of Open Access Journals (Sweden)

Adina Ponta

2015-11-01

Full Text Available The duty of care, which sets the standard of conduct of a „good director” is currently governed by the Romanian Companies Act and the Civil Code. The corroboration of the two legal acts is challenging, the paper in hand aims at a comparative view of the legal norms and at the appraisal of the content of this fiduciary duty in the modern context of the competitive economy. The nature of this fiduciary duty and the cases when it can be defied according to the Romanian Law are discussed in terms of the literature and the case law that inspired the legislator. By creating parallels between the content of the agency and the traditional characters of the director's office, mainly tagged with legal prerogatives, the study will reveal the importance of the fiduciary characters of the director’s function. The conclusions will catch the effects of standardizing the substantive exercise of the duty of care and the importance of defining the fiduciary character of directors’ duties, both with respect to case law and as well for healthy business relationships.

Out-of-hours demand in primary care: frequency, mode of contact and reasons for encounter in Switzerland.

Science.gov (United States)

Huber, Carola A; Rosemann, Thomas; Zoller, Marco; Eichler, Klaus; Senn, Oliver

2011-02-01

To investigate the demand for traditional out-of-hours general practitioner (GP) emergency care in Switzerland including GPs' satisfaction and reasons for encounter (RFE). During a 2-month period (2009), a questionnaire-based, cross-sectional study was performed in GPs participating in the mandatory out-of-hours service in the city of Zurich, Switzerland. The number and mode of patient contacts were assessed to investigate the demand for GP care in traditional out-of-hours services. GPs and patient characteristics, including RFE according to the International Classification of Primary Care, were noted. Descriptive statistics and non-parametric tests were conducted. Out of the 295 out-of-hours episodes during the study period, 148 (50%) duty periods were documented by a total of 93 GPs (75% men) with a mean (SD) age of 48.0 (6.2) years. The median (interquartile range) number of out-of-hours contacts was 5 (3-8) and the demand for home visits was significantly more common compared with practice and telephone consultations. A total of 112 different RFEs were responsible for the 382 documented patient contacts with fever accounting for the most common complaint (13.9%). Although 80% of GPs agreed to be satisfied overall with their profession as primary care provider, 57.6% among them were dissatisfied with the current out-of-hours service. Inappropriate payment and interference with their daily work in practice were most frequently reported. Our findings indicate that there is still strong patient demand for out-of-hours care with special need for home visits, suggesting that new organizational models such as integrating GPs into emergency care may not be an appropriate approach for all patients. Therefore, the ongoing reorganization of the out-of-hours-service in many health care systems has to be evaluated carefully in order not to miss important patient needs. © 2010 Blackwell Publishing Ltd.

Orthopedic resident work-shift analysis: are we making the best use of resident work hours?

Science.gov (United States)

Hamid, Kamran S; Nwachukwu, Benedict U; Hsu, Eugene; Edgerton, Colston A; Hobson, David R; Lang, Jason E

2014-01-01

Surgery programs have been tasked to meet rising demands in patient surgical care while simultaneously providing adequate resident training in the midst of increasing resident work-hour restrictions. The purpose of this study was to quantify orthopedic surgery resident workflow and identify areas needing improved resident efficiency. We hypothesize that residents spend a disproportionate amount of time involved in activities that do not relate directly to patient care or maximize resident education. We observed 4 orthopedic surgery residents on the orthopedic consult service at a major tertiary care center for 72 consecutive hours (6 consecutive shifts). We collected minute-by-minute data using predefined work-task criteria: direct new patient contact, direct existing patient contact, communications with other providers, documentation/administrative time, transit time, and basic human needs. A seventh category comprised remaining less-productive work was termed as standby. In a 720-minute shift, residents spent on an average: 191 minutes (26.5%) performing documentation/administrative duties, 167.0 minutes (23.2%) in direct contact with new patient consults, 129.6 minutes (17.1%) in communication with other providers regarding patients, 116.2 (16.1%) minutes in standby, 63.7 minutes (8.8%) in transit, 32.6 minutes (4.5%) with existing patients, and 20 minutes (2.7%) attending to basic human needs. Residents performed an additional 130 minutes of administrative work off duty. Secondary analysis revealed residents were more likely to perform administrative work rather than directly interact with existing patients (p = 0.006) or attend to basic human needs (p = 0.003). Orthopedic surgery residents spend a large proportion of their time performing documentation/administrative-type work and their workday can be operationally optimized to minimize nonvalue-adding tasks. Formal workflow analysis may aid program directors in systematic process improvements to better align

Six days on the road? Never again : service industry appeals to producers for help resolving hours of service issues

Energy Technology Data Exchange (ETDEWEB)

Lorenz, A.W.

2007-04-15

Road accidents are a leading cause of work-related deaths in western Canada. Northern Alberta has 3 times as many motor vehicle accidents per capita as the rest of the province. The federal government has heavily invested in the development of new rules mandating the amount of rest that drivers are now required to have before driving vehicles. However, the rules impose restrictions that difficult for oilfield workers to adhere to. The new rules reduce the maximum number of hours a worker may work, and state that workers must have 1 or 3 days off every 7 or 14 days. Workers in the oil and gas industry often need to travel long distances to remote areas where sleep accommodations are not available. Under the new standard, waiting time on location cannot be considered as off-duty, and drivers are not allowed to clock standby time as off-duty, nor are they permitted to sleep in the truck's sleeper berth on lease sites. Many trucks are not equipped with sleeper berths, and there is currently a critical shortage of motel accommodations in Alberta. A recent meeting conducted by various agencies to address the new driving standards has resulted in a request for sleeper berth permits. The agencies will also provide an effective means of verifying that a driver has had access to sleeping accommodation under the terms of the suggested sleeper berth alternative. It was concluded that if Transport Canada agrees to give Alberta the authority to grant permits, it will help to resolve issues unique to Alberta's oilfield contractors. 2 figs.

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

Science.gov (United States)

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.

[Duties of physicians or other healthcare workers connected with diagnosis, treatment, dissemination of information, assessment and registration of TB patients].

Science.gov (United States)

Zielonka, Tadeusz M

2015-01-01

Effective laws provide a series of duties to be performed by physicians and other medical personnel associated with TB. Every TB case and death resulting from TB as well as any case of undesirable result of BCG test requires notification and filling in of a special form. The physician has a duty to inform TB patients their legal guardians, close relatives or friends about the need to undergo sanitary and diagnostic procedure, treatment or vaccination, as well as on how to prevent disease from spreading. Persons failing to comply with the relevant numerous legal requirements in this respect are subject to a fine.TB patients can use special sick benefits extending up to 270 days. There is a requirement to use appropriate codes to define TB irrespective of LCD-10 classification.

Overview of psychiatric ethics V: utilitarianism and the ethics of duty.

Science.gov (United States)

Robertson, Michael; Morris, Kirsty; Walter, Garry

2007-10-01

The aim of this paper is to describe the ethical theories of utilitarianism and the ethics of duty (Kant's ethics) and to evaluate their value as theoretical bases of psychiatric ethics. Utilitarianism is a well-established moral philosophy and has significant instrumental value in dealing with common ethical problems faced by psychiatrists. Despite its capacity to generate solutions to ethical problems, utilitarianism requires a process of what Rawls described as 'reflective equilibrium' to avoid morally repugnant choices, based on utility. The criticisms of utilitarianism, such as the problems of quantifying utility and the responsibility for consequences, are very relevant for psychiatry. Singer's model of utilitarian thinking is particularly problematic for our profession. Kant's ethics provides the pretext for duty bound codes of ethics for psychiatrists, but suffers from problems of flawed claims to the universalizability prescribed by Kant's 'categorical imperative'. Kant's valorization of reason as the core of the autonomy of persons is a valuable insight in understanding psychiatrists' ethical obligations to their patients.

The patient's duty to adhere to prescribed treatment: an ethical analysis.

Science.gov (United States)

Resnik, David B

2005-04-01

This article examines the ethical basis for the patient's duty to adhere to the physician's treatment prescriptions. The article argues that patients have a moral duty to adhere to the physician's treatment prescriptions, once they have accepted treatment. Since patients still retain the right to refuse medical treatment, their duty to adhere to treatment prescriptions is a prima facie duty, which can be overridden by their other ethical duties. However, patients do not have the right to refuse to adhere to treatment prescriptions if their non-adherence poses a significant threat to other people. This paper also discusses the use of written agreements between physicians and patients as a strategy for promoting patient adherence.

7 CFR 46.32 - Duties of growers' agents.

Science.gov (United States)

2010-01-01

... fails to perform any specification or duty, express or implied, is in violation of the Act and may be... or duty, express or implied, arising out of any undertaking in connection with transactions subject... statement describing the terms and conditions under which he will handle the produce of the grower during...

31 CFR 406.4 - Duties of customs officers.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Duties of customs officers. 406.4... 1934 AND GOLD REGULATIONS § 406.4 Duties of customs officers. The appropriate officials of the Bureau of Customs are hereby authorized and designated as the officers who shall perform such administrative...

Norwegian NOx emissions excise duty hits shipping and offshore industry

International Nuclear Information System (INIS)

Gulseth, Oeystein Arff; Fjeld-Nielsen, Siri

2007-01-01

The regulatory framework concerning the new excise duty appears as complex and unfinished, raising more questions than providing answers. The duty will entail a significant expense item for the businesses liable to register and it is therefore important to have an overview of how the regulatory framework should be understood. Errors made since 1 January 2007 may lead to future reassessments of duties, with interest (author) (ml)

PROVISION OF THE DUTY SERVICE IN GYNECOLOGY AND OBSTETRICS IN SLOVENIA

Directory of Open Access Journals (Sweden)

Iztok Takač

2018-02-01

Full Text Available Background: Duty service of gyecology and obstetrics in Slovenia is organized on the regional basis and consists of ten regional hospitals, two hospitals for gynecology and obstetrics and two university clinical centres. Methods: Heads of hospitals where duty service is performed, have answered the questionnaires about the doctors who perform duty service. Results: Specialists and trainees in gynecology and obstetrics perform duty service on 21 posts and on 6 on-call posts. In Slovenia there are 287 active specialists in gynecology and obstetrics. 139 (48.4% among them are active on the primary level (outpatient clinics and 148 (51.6% in the hospitals and both clinical centres. Among hospital gynecologists and obstetricians 54 (36.5% of them are older than 55 years. Conclusions: Duty service of gyecology and obstetrics in Slovenia does not meet legislation criteria regard- ing doctors’ work time. Adequate changes for increasing the number of available doctors for duty service are proposed.

15 CFR 270.105 - Duties of a Team.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Duties of a Team. 270.105 Section 270... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.105 Duties of a Team. (a) A Team's Lead...

45 CFR 1618.5 - Duties of the Corporation.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Duties of the Corporation. 1618.5 Section 1618.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION ENFORCEMENT PROCEDURES § 1618.5 Duties of the Corporation. (a) Whenever there is reason to believe that a recipient or an...

[Travel time and distances to Norwegian out-of-hours casualty clinics].

Science.gov (United States)

Raknes, Guttorm; Morken, Tone; Hunskår, Steinar

2014-11-01

Geographical factors have an impact on the utilisation of out-of-hours services. In this study we have investigated the travel distance to out-of-hours casualty clinics in Norwegian municipalities in 2011 and the number of municipalities covered by the proposed recommendations for secondary on-call arrangements due to long distances. We estimated the average maximum travel times and distances in Norwegian municipalities using a postcode-based method. Separate analyses were performed for municipalities with a single, permanently located casualty clinic. Altogether 417 out of 430 municipalities were included. We present the median value of the maximum travel times and distances for the included municipalities. The median maximum average travel distance for the municipalities was 19 km. The median maximum average travel time was 22 minutes. In 40 of the municipalities (10 %) the median maximum average travel time exceeded 60 minutes, and in 97 municipalities (23 %) the median maximum average travel time exceeded 40 minutes. The population of these groups comprised 2 % and 5 % of the country's total population respectively. For municipalities with permanent emergency facilities(N = 316), the median average flight time 16 minutes and median average distance 13 km.. In many municipalities, the inhabitants have a long average journey to out-of-hours emergency health services, but seen as a whole, the inhabitants of these municipalities account for a very small proportion of the Norwegian population. The results indicate that the proposed recommendations for secondary on-call duty based on long distances apply to only a small number of inhabitants. The recommendations should therefore be adjusted and reformulated to become more relevant.

47 CFR 25.273 - Duties regarding space communications transmissions.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Duties regarding space communications transmissions. 25.273 Section 25.273 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Technical Operations § 25.273 Duties regarding space...

Screw expander for light duty diesel engines

Science.gov (United States)

1983-01-01

Preliminary selection and sizing of a positive displacement screw compressor-expander subsystem for a light-duty adiabatic diesel engine; development of a mathematical model to describe overall efficiencies for the screw compressor and expander; simulation of operation to establish overall efficiency for a range of design parameters and at given engine operating points; simulation to establish potential net power output at light-duty diesel operating points; analytical determination of mass moments of inertia for the rotors and inertia of the compressor-expander subsystem; and preparation of engineering layout drawings of the compressor and expander are discussed. As a result of this work, it was concluded that the screw compressor and expander designed for light-duty diesel engine applications are viable alternatives to turbo-compound systems, with acceptable efficiencies for both units, and only a moderate effect on the transient response.

Driving behaviors and on-duty road accidents: a French case-control study.

Science.gov (United States)

Fort, Emmanuel; Chiron, Mireille; Davezies, Philippe; Bergeret, Alain; Charbotel, Barbara

2013-01-01

A case-control study was carried out to identify driving behaviors associated with the risk of on-duty road accident and to compare driving behaviors according to the type of journey (on duty, commuting, and private) for on-duty road accident victims. Cases were recruited from the Rhône Road Trauma Registry between January 2004 and October 2005 and were on duty at the time of the accident. Control subjects were recruited from the electoral rolls of the case subjects' constituencies of residence. Cases' and controls' driving behavior data were collected by self-administered questionnaire. A logistic regression was performed to identify behavioral risk factors for on-duty road accidents, taking into account age, sex, place of residence, road accident risk exposure, socio-occupational category, and type of road user. A second analysis focused specifically on the case subjects, comparing their self-assessed usual behaviors according to the type of journey. Significant factors for multivariate analysis of on-duty road accidents were female gender, history of on-duty road accidents during the previous 10 years, severe time pressure at work, and driving a vehicle not belonging to the driver. On-duty road accident victims reported behavioral risk factors more frequently in relation to driving for work than driving for private reasons or commuting: nonsystematic seat belt use, cell phone use at least once daily while driving, and history of accidents with injury during the previous 10 years. This study provides knowledge on behavioral risk factors for on-duty road accidents and differences in behavior according to the type of journey for subjects who have been on-duty road accident victims. These results will be useful for the design of on-duty road risk prevention.

[Patients' rights--doctors' duties].

Science.gov (United States)

Jaeger, L; Bertram, E; Grate, S; Mischkowsky, T; Paul, D; Probst, J; Scala, E; Wbllenweber, H D

2015-06-01

On 26 February 2013 the new "Law on Patients' Rights" (hereinafter also the "Law") became effective. This Law strengthens patients' rights vis-à-vis the insurdnce company and also regulates patients' rights regarding their relation to the doctor. This has consequences for the laws on medical liability all doctors must consider. The doctor's performance is and remains a service and such service does not hold any guarantee of success. Nevertheless, this Law primarily reads as a "law on the duties of physicians". To duly take into account these duties and to avoid mistakes and misinterpretation of the Law, the Ethics Committee of the Consortium of Osteosynthesis Trauma Germany (AOTRAUMA-D) has drafted comments on the Law. Brief summaries of its effects are to be found at the end of the respective comment under the heading "Consequences for Practice". The text of the law was influenced particularly by case law, as continuously developed by the German Federal Court of Justice ("BGH"). The implementation of the Law on Patients' Rights was effected by the newly inserted sections 630a to 630h of the German Civil Code (the "BGB"), which are analysed below. The following comments are addressed to physicians only and do not deal with the specific requirements and particularities of the other medical professions such as physiotherapy, midwifery and others so on. Special attention should be paid to the comments on the newly inserted Duty to inform, which has to be fullfilled prior to any diagnostic or therapeutic procedure (sec. 630c para 2 sentence 1 BGB). Under certain conditions the doctor also has to inform the patient about the circumstances that lead to the presumed occurance of a therapeutic or diagnostic malpractice (sec. 630c para. 2 sentence 2 BGB), based on the manifestation of an undesired event or an undesired outcome. As before, the patient's valid consent to any procedure (sec. 630d BGB) is directly linked to the comprehensive and timely provision of information

Clinical negligence and duty of candour.

Science.gov (United States)

Shekar, Vinita; Singh, Mark; Shekar, Kishore; Brennan, Peter

2011-12-01

The Department of Health is considering imposing a legal duty of candour on health care providers to ensure that an apology and explanation are given to patients when errors occur during medical treatment. This aims to improve quality of care and reduce adverse events during medical treatment. We present the current system of clinical negligence and the future of medical ethics. We discuss relevant cases with regard to duty of candour, and highlight the existence of serious imbalances in which patients' rights and corresponding ethical duties of professionals predominate over the responsibilities of patients themselves. It is known that most adverse events arise because of multiple factors for which no individual should be blamed. To improve healthcare services there is a need for a system in which lessons can be learnt from mistakes, and services can be improved in the interest of patient safety, and for transparency in the broad principles on which the decisions are based within which clinical performance is supervised and monitored. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

General regulatory guide for the operator staff on duty, II-1

International Nuclear Information System (INIS)

1989-01-01

This, second chapter of regulations includes the rights and duties of the operator's staff: head of the team, operator on duty, mechanic of the system, electrician, reactor mechanic, operation dosimetryst on duty. Procedures and obligations are described for each individual staff member on duty during preparations for reactor start-up, regular operation at nominal power, approach to preset power level, change of the operating regime without shutdown, approach to a certain power level of the xenon poisoned core, stop reactor operation and bringing the reactor into shutdown state [sr

ACGME proposes dropping the 16 hour resident shift limit

Directory of Open Access Journals (Sweden)

Robbins RA

2016-11-01

Full Text Available No abstract available. Article truncated after 150 words. The Accreditation Council for Graduate Medical Education (ACGME is proposing that first-year residents would no longer be limited to 16-hour shifts during the 2017-2018 academic year under a controversial proposal released today (1. Instead, individual residency programs could assign first-year trainees to shifts as long as 28 hours, the current limit for all other residents. The 28-hour maximum includes 4 transitional hours that's designed in part to help residents improve continuity of care. The plan to revise training requirements does not change other rules designed to protect all residents from overwork. including the maximum80 hours per week. The ACGME capped the shifts of first-year residents at 16 hours in 2011 as a part of an ongoing effort to make trainee schedules more humane and avoid clinical errors caused by sleep deprivation. ACGME CEO Thomas Nasca, MD, told Medscape Medical News that the problem arises largely from first-year residents not being ...

Probabilistic safety analysis on an SBWR 72 hours after the initiating event

International Nuclear Information System (INIS)

Dominguez Bautista, M.T.; Peinador Veira, M.

1996-01-01

Passive plants, including SBWRs, are designed to carry out safety functions with passive systems during the first 72 hours after the initiation event with no need for manual actions or external support. After this period, some recovery actions are required to enable the passive systems to continue performing their safety functions. The study was carried out by the INITEC-Empresarios Agrupados Joint Venture within the framework of the international group collaborating with GE on this project. Its purpose has been to assess, by means of probabilistic criteria, the importance to safety of each of these support actions, in order to define possible requirements to be considered in the design in respect of said recovery actions. In brief, the methodology developed for this objective consists of (1) quantifying success event trees from the PSA up to 72 hours, (2) determining the actions required in each sequence to maintain Steady State after 72 hours, (3) identifying available alternative core cooling methods in each sequence, (4) establishing the approximate (order of magnitude) realizability of each alternative method, (5) calculating the frequency of core damage as a function of the failure probability of post-72-hour actions and (6) analysing the importance of post-72-hour actions. The results of this analysis permit the establishment, right from the conceptual design phase, of the requirements that will arise to ensure these actions in the long term, enhancing their reliability and preventing the accident from continuing beyond this period. (Author)

Requirements for internal contamination monitoring units

International Nuclear Information System (INIS)

Werner, E.; Beyer, D.; Doerfel, H.; Erlenbach, H.; Fischbach, G.; Henrichs, K.; Keller, K.D.; Koenig, K.; Riedel, W.; Scheler, R.; Schieferdecker, H.

1994-01-01

For the evaluation of internal contamination by officially authorized monitoring units according to section 63 (6) of the German radiation protection ordinance, a directive will be prepared in order to define uniform requirements for the laboratories in charge of incorporation monitoring by appointment of the relevant authorities. These requirements refer to equipment, to performance of measurements, to interpretation of measured values, to quality control as well as to documentation and to delivery of results. The duties of such laboratories comprise measurements of radioactivity, evaluation of intakes of radionuclides and of the resulting internal radiation dose, but also transmission of results to the employer, to the central dose registry, and under certain circumstances to the authorities. Among the requirements to be met by the laboratory for incorporation control are a sufficient measuring efficiency, the implementation of in-house checks, and the participation in intercomparison programs. For the accomplishment of such duties the laboratory needs appropriate apparatus, rooms, facilities, and staffing. (orig.) [de

25 CFR 11.1003 - Law enforcement officer's duties.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Law enforcement officer's duties. 11.1003 Section 11.1003 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Juvenile Offender Procedure § 11.1003 Law enforcement officer's duties. A law enforcement officer who takes a minor into...

Lower wages for less hours? A simultaneous wage-hours model for Germany

OpenAIRE

Wolf, Elke

2000-01-01

In this paper the impact of working hours on the gross hourly wage rate of West German women is analyzed. We use a simultaneous wage-hours model which takes into account the participation decision. First, our estimates show that the hourly wage rate is strongly a¤ected by the working hours. In order to avoid any assumptions about the functional form, we estimate linear spline functions. Second, we detect di¤erent wage-hours profiles for specific groups of individuals. Despite these di¤erences...

Availability and End-to-end Reliability in Low Duty Cycle Multihop Wireless Sensor Networks.

Science.gov (United States)

Suhonen, Jukka; Hämäläinen, Timo D; Hännikäinen, Marko

2009-01-01

A wireless sensor network (WSN) is an ad-hoc technology that may even consist of thousands of nodes, which necessitates autonomic, self-organizing and multihop operations. A typical WSN node is battery powered, which makes the network lifetime the primary concern. The highest energy efficiency is achieved with low duty cycle operation, however, this alone is not enough. WSNs are deployed for different uses, each requiring acceptable Quality of Service (QoS). Due to the unique characteristics of WSNs, such as dynamic wireless multihop routing and resource constraints, the legacy QoS metrics are not feasible as such. We give a new definition to measure and implement QoS in low duty cycle WSNs, namely availability and reliability. Then, we analyze the effect of duty cycling for reaching the availability and reliability. The results are obtained by simulations with ZigBee and proprietary TUTWSN protocols. Based on the results, we also propose a data forwarding algorithm suitable for resource constrained WSNs that guarantees end-to-end reliability while adding a small overhead that is relative to the packet error rate (PER). The forwarding algorithm guarantees reliability up to 30% PER.

Availability and End-to-end Reliability in Low Duty Cycle MultihopWireless Sensor Networks

Directory of Open Access Journals (Sweden)

Timo D. Hämäläinen

2009-03-01

Full Text Available A wireless sensor network (WSN is an ad-hoc technology that may even consist of thousands of nodes, which necessitates autonomic, self-organizing and multihop operations. A typical WSN node is battery powered, which makes the network lifetime the primary concern. The highest energy efficiency is achieved with low duty cycle operation, however, this alone is not enough. WSNs are deployed for different uses, each requiring acceptable Quality of Service (QoS. Due to the unique characteristics of WSNs, such as dynamic wireless multihop routing and resource constraints, the legacy QoS metrics are not feasible as such. We give a new definition to measure and implement QoS in low duty cycle WSNs, namely availability and reliability. Then, we analyze the effect of duty cycling for reaching the availability and reliability. The results are obtained by simulations with ZigBee and proprietary TUTWSN protocols. Based on the results, we also propose a data forwarding algorithm suitable for resource constrained WSNs that guarantees end-to-end reliability while adding a small overhead that is relative to the packet error rate (PER. The forwarding algorithm guarantees reliability up to 30% PER.

7 CFR 1230.39 - Powers and duties of the Delegate Body.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Powers and duties of the Delegate Body. 1230.39... Order National Pork Producers Delegate Body § 1230.39 Powers and duties of the Delegate Body. The Delegate Body shall have the following powers and duties: (a) To meet annually; (b) To recommend the rate...

Hourly awakening vs continuous contact lens sensor measurements of 24-hour intraocular pressure: effect on sleep macrostructure and intraocular pressure rhythm.

Science.gov (United States)

Aptel, Florent; Tamisier, Renaud; Pépin, Jean-Louis; Mottet, Benjamin; Hubanova, Ralitsa; Romanet, Jean-Paul; Chiquet, Christophe

2014-10-01

All studies of 24-hour intraocular pressure (IOP) rhythm conducted to date have used repeated IOP measurements requiring nocturnal awakenings, potentially disturbing sleep macrostructure. To evaluate the effects on sleep architecture and IOP rhythm of hourly awakening vs a contact lens sensor (CLS) to continuously monitor IOP without awakening. Cross-sectional study at a referral center of chronobiology among 12 young healthy volunteers, with a mean (SD) age of 22.3 (2.3) years. Volunteers underwent two 24-hour IOP measurement sessions during a 2-month period. The eye order and session order were randomized. During one session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was measured hourly using a portable noncontact tonometer (session with nocturnal hourly awakening). During the other session, the IOP of the first eye was continuously monitored using a CLS, and the IOP of the fellow eye was not measured (session without nocturnal awakening). Overnight polysomnography was performed during the 2 sessions. A nonlinear least squares, dual-harmonic regression analysis was used to model the 24-hour IOP rhythm from the CLS data. Comparisons of acrophase, bathyphase, amplitude, and the midline estimating statistic of rhythm were used to evaluate the effect of hourly awakening on IOP rhythm. To evaluate the effects of hourly awakening on sleep architecture, comparisons of sleep structure were used, including total sleep period, rapid eye movement, wake after sleep onset, absolute and relative total sleep time, and non-rapid eye movement sleep (N1, N2, and N3). A 24-hour IOP rhythm was found in all individuals for the sessions with and without awakening (P  .30). Hourly awakening during noncontact tonometer IOP measurements did not seem to alter the mean variables of the 24-hour IOP pattern evaluated using CLS, including signal, maximum signal, minimum signal, acrophase, and bathyphase (P > .15). The 24-hour IOP

Heavy-Duty Vehicle Port Drayage Drive Cycle Characterization and Development: Preprint

Energy Technology Data Exchange (ETDEWEB)

Prohaska, Robert; Konan, Arnaud; Kelly, Kenneth; Lammert, Michael

2016-08-01

In an effort to better understand the operational requirements of port drayage vehicles and their potential for adoption of advanced technologies, National Renewable Energy Laboratory (NREL) researchers collected over 36,000 miles of in-use duty cycle data from 30 Class 8 drayage trucks operating at the Port of Long Beach and Port of Los Angeles in Southern California. These data include 1-Hz global positioning system location and SAE J1939 high-speed controller area network information. Researchers processed the data through NREL's Drive-Cycle Rapid Investigation, Visualization, and Evaluation tool to examine vehicle kinematic and dynamic patterns across the spectrum of operations. Using the k-medoids clustering method, a repeatable and quantitative process for multi-mode drive cycle segmentation, the analysis led to the creation of multiple drive cycles representing four distinct modes of operation that can be used independently or in combination. These drive cycles are statistically representative of real-world operation of port drayage vehicles. When combined with modeling and simulation tools, these representative test cycles allow advanced vehicle or systems developers to efficiently and accurately evaluate vehicle technology performance requirements to reduce cost and development time while ultimately leading to the commercialization of advanced technologies that meet the performance requirements of the port drayage vocation. The drive cycles, which are suitable for chassis dynamometer testing, were compared to several existing test cycles. This paper presents the clustering methodology, accompanying results of the port drayage duty cycle analysis and custom drive cycle creation.

An Hourly Dose-Escalation Desensitization Protocol for Aspirin-Exacerbated Respiratory Disease.

Science.gov (United States)

Chen, Justin R; Buchmiller, Brett L; Khan, David A

2015-01-01

Aspirin desensitization followed by maintenance therapy effectively improves symptom control in patients with aspirin exacerbated respiratory disease (AERD). The majority of current desensitization protocols use 3-hour dosing intervals and often require 2 to 3 days to complete. We evaluated hourly dose escalations in a subset of patients with chronic rhinosinusitis, nasal polyps, and asthma who historically reacted to aspirin within 1 hour or were avoiding aspirin with the goal of developing a safe and efficient desensitization protocol. Fifty-seven aspirin desensitizations were performed under the hourly protocol. All patients had refractory nasal polyposis as an indication for aspirin desensitization. The clinical characteristics of each subject were analyzed in relation to aspects of his or her reactions during the procedure. Ninety-eight percent of study patients were successfully treated under the hourly protocol, including those with a history of severe reactions and intubation. None required further medication than is available in an outpatient allergy clinic. A total of 96% of reactors recorded a bronchial or naso-ocular reaction within 1 hour of the preceding dose. Of the total patients on this protocol, 40% were able to complete the procedure in a single day, and 60% within 2 days. Patients with AERD who have a history of symptoms less than 1 hour after aspirin exposure can be safely desensitized with a 1-hour dose-escalation protocol that can often be completed in a single day. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

On-road emissions of light-duty vehicles in europe.

Science.gov (United States)

Weiss, Martin; Bonnel, Pierre; Hummel, Rudolf; Provenza, Alessio; Manfredi, Urbano

2011-10-01

For obtaining type approval in the European Union, light-duty vehicles have to comply with emission limits during standardized laboratory emissions testing. Although emission limits have become more stringent in past decades, light-duty vehicles remain an important source of nitrogen oxides and carbon monoxide emissions in Europe. Furthermore, persisting air quality problems in many urban areas suggest that laboratory emissions testing may not accurately capture the on-road emissions of light-duty vehicles. To address this issue, we conduct the first comprehensive on-road emissions test of light-duty vehicles with state-of-the-art Portable Emission Measurement Systems. We find that nitrogen oxides emissions of gasoline vehicles as well as carbon monoxide and total hydrocarbon emissions of both diesel and gasoline vehicles generally remain below the respective emission limits. By contrast, nitrogen oxides emissions of diesel vehicles (0.93 ± 0.39 grams per kilometer [g/km]), including modern Euro 5 diesel vehicles (0.62 ± 0.19 g/km), exceed emission limits by 320 ± 90%. On-road carbon dioxide emissions surpass laboratory emission levels by 21 ± 9%, suggesting that the current laboratory emissions testing fails to accurately capture the on-road emissions of light-duty vehicles. Our findings provide the empirical foundation for the European Commission to establish a complementary emissions test procedure for light-duty vehicles. This procedure could be implemented together with more stringent Euro 6 emission limits in 2014. The envisaged measures should improve urban air quality and provide incentive for innovation in the automotive industry.

Electrification Beyond Light Duty: Class 2b-3 Commercial Vehicles

Energy Technology Data Exchange (ETDEWEB)

Birky, Alicia [Energetics Incorporated; Laughlin, Michael [Energetics Incorporated; Tartaglia, Katie [Energetics Incorporated; Price, Rebecca [Energetics Incorporated; Lim, Brandon [Energetics Incorporated; Lin, Zhenhong [ORNL

2018-01-01

The class 2b-3 truck market covers a wide range of commercial truck applications across a half-million vehicle sales annually. This report collected public information and stakeholder input to assess the opportunity for electrification in this market. Although class 2b-3 pickup truck and van bodies are very similar to personal light vehicles, their functional requirements are quite different due to the demands of the commercial market. These demands vary by application and often vary from day to day for a single application. Fleet customers purchase these vehicles to perform a particular job for their business and are concerned about the overall cost of doing that job. Therefore, the vehicles must meet the job requirements cost effectively. Customers also are sensitive to initial cost. Electrification offers the potential to reduce vehicle operating costs and possibly improve vehicle functionality. However, the current market for class 2b-3 electrified trucks is very small, and the trucks are costly. Increased production volumes are key to cost reductions and may be assisted by sharing components with larger or smaller truck classes. Expanding demand is also crucial and stakeholders identified several niche markets with duty cycles that are likely well-suited to electrified class 2b-3 trucks. To expand beyond these niches, class 2b-3 electric solutions must be robust, flexible, and adaptable in order to cover a wide range of vocations, applications, and duty cycles.

28 CFR 549.13 - Programming, duty, and housing restrictions.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Programming, duty, and housing... INSTITUTIONAL MANAGEMENT MEDICAL SERVICES Infectious Disease Management § 549.13 Programming, duty, and housing restrictions. (a) The CD will assess any inmate with an infectious disease for appropriateness for programming...

The internal-Rawlsian unsustainability of Rawls's duty of assistance

NARCIS (Netherlands)

Kamminga, Menno R.

2018-01-01

Philosophers interested in John Rawls’s international political theorizing have paid considerable attention to the duty of assistance as a key notion of his Law of Peoples. However, in focusing on contentious-theoretical and practical implications of this duty, they have not thoroughly examined the

Appraisal of circulation routine duties in academic libraries | Hassan ...

African Journals Online (AJOL)

... of brown charging system, book reservation, keeping of reserved collection, circulation of reserved books, treatment of overdue, lost of books on loan and library statistics among other as duties perform in circulation department of libraries. Keywords: Library Service, Circulation Duties, Challenges, Academic Libraries ...

25 CFR 11.1103 - Law enforcement officer's duties.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Law enforcement officer's duties. 11.1103 Section 11.1103 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Minor-in-Need-of-Care Procedure § 11.1103 Law enforcement officer's duties. Upon taking a minor into custody the officer...

Medium and Heavy Duty Vehicle Field Evaluations (Presentation)

Energy Technology Data Exchange (ETDEWEB)

Walkowicz, K.

2014-06-01

This presentation discusses field evaluations of medium- and heavy-duty vehicles performed by NREL. The project provides medium-duty (MD) and heavy-duty (HD) test results, aggregated data, and detailed analysis, including 3rd party unbiased data (data that would not normally be shared by industry in an aggregated and detailed manner). Over 5.6 million miles of advanced technology MD and HD truck data have been collected, documented, and analyzed on over 240 different vehicles since 2002. Data, analysis, and reports are shared within DOE, national laboratory partners, and industry for R&D planning and strategy. The results help guide R&D for new technology development, help define intelligent usage of newly developed technology, and help fleets/users understand all aspects of advanced technology.

19 CFR 115.40 - Technical requirements for containers.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Technical requirements for containers. 115.40...; DEPARTMENT OF THE TREASURY CARGO CONTAINER AND ROAD VEHICLE CERTIFICATION PURSUANT TO INTERNATIONAL CUSTOMS CONVENTIONS Procedures for Approval of Containers After Manufacture § 115.40 Technical requirements for...

40 CFR 86.206-11 - Equipment required; overview.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Equipment required; overview. 86.206-11 Section 86.206-11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... New Medium-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.206-11 Equipment required...

40 CFR 86.206-94 - Equipment required; overview.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Equipment required; overview. 86.206-94 Section 86.206-94 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR... New Medium-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.206-94 Equipment required...

75 FR 42380 - Revocation of Antidumping Duty Order on Sorbitol From France

Science.gov (United States)

2010-07-21

... Duty Order on Sorbitol From France AGENCY: Import Administration, International Trade Administration... sunset review of the antidumping duty order on sorbitol from France. See Initiation of Five-year... the existing antidumping duty order on sorbitol from France would not be likely to lead to...

The effect of limiting residents' work hours on their surgical training: a Canadian perspective.

Science.gov (United States)

Romanchuk, Ken

2004-05-01

Restrictions in residents' work hours have been in place in Canada for roughly a decade, having been negotiated rather than imposed. The changes in residents' schedules that resulted are roughly equivalent to the limitation of 80 duty hours per week in the United States. When work-hours restrictions began, surgery faculty were worried that residents' experience would be compromised. But these fears have not materialized. Why? The author maintains there are many reasons. (1) Most surgical procedures are now faster, and lengthy inpatient care has diminished, all of which saves time. (2) Formerly difficult or risky procedures are now performed more frequently and safely, which increases residents' education about difficult conditions. (3) A variety of resources (e.g., skills-transfer courses, surgical simulators, etc.) are now available for residents to learn and evolve surgical techniques, and residents take advantage of these resources, being highly motivated to learn the best in the time available to them. (4) There have been positive changes in residents' education that have helped them become more efficient learners than before, with improved resources and skills for faster access to information. The author maintains that in his present surgery residency program, the residents still work extremely hard but are more protected from the unending demands for patient care. They have more time for orderly study and greater opportunities to develop skills other than technical ones. They are in a happier work setting, which the author strongly believes facilitates improved patient care.

IMPACT OF CPO EXPORT DUTIES ON MALAYSIAN PALM OIL INDUSTRY

OpenAIRE

Ibragimov Abdulla; Fatimah Mohamed Arshad; B. K. Bala; Kusairi Mohd Noh; Muhammad Tasrif

2014-01-01

In January 2013, Malaysia reduced the export duty structure to be in line with the Indonesia’s duty structure. Both countries export crude and processed palm oil. Since Malaysia and Indonesia are close competitors and they compete in the same market, a change in export duty rate in one country will affect the other. Indonesia, as the world’s biggest palm oil producer, has drastically widened the values between the crude palm oil and refined palm oil export taxes since October 2011...

The legal nature of the duty of care and skill: Contract or delict ...

African Journals Online (AJOL)

This article evaluates the legal nature of the duty of care and skill of directors. In terms of the Companies Act 71 of 2008 this duty is essentially delictual in nature. This article evaluates whether the duty is in fact delictual in nature. Case law, which considered the duty of care and skill and where it had been sought to establish ...

EPA Nonregulatory Nonroad Duty Cycles

Science.gov (United States)

EPA nonregulatory, nonroad duty cycles for equipment such as agricultural tractors, backhoe loaders,crawlers tractors, excavators, arc welding skid steer loaders, and wheel loaders. Also,test procedures, laboratory methods, and emissions for this equipmen

The ethanol heavy-duty truck fleet demonstration project

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

This project was designed to test and demonstrate the use of a high- percentage ethanol-blended fuel in a fleet of heavy-duty, over-the- road trucks, paying particular attention to emissions, performance, and repair and maintenance costs. This project also represents the first public demonstration of the use of ethanol fuels as a viable alternative to conventional diesel fuel in heavy-duty engines.

19 CFR 122.4 - English language required.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false English language required. 122.4 Section 122.4... TREASURY AIR COMMERCE REGULATIONS General Definitions and Provisions § 122.4 English language required. A translation in the English language shall be attached to the original and each copy of any form or document...

78 FR 40428 - Fresh Garlic from the People's Republic of China: Initiation of Antidumping Duty New Shipper...

Science.gov (United States)

2013-07-05

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-831] Fresh Garlic from the People... fresh garlic from the People's Republic of China (PRC) meet the statutory and regulatory requirements... INFORMATION: Background The Department published the antidumping duty order on fresh garlic from the PRC in...

78 FR 88 - Fresh Garlic From the People's Republic of China: Initiation of Antidumping Duty New Shipper...

Science.gov (United States)

2013-01-02

... DEPARTMENT OF COMMERCE International Trade Administration [A-570-831] Fresh Garlic From the People... fresh garlic from the People's Republic of China (PRC) meets the statutory and regulatory requirements... The Department published the antidumping duty order on fresh garlic from the PRC in the Federal...

The fiduciary duties of healthcare directors in the "zone of insolvency".

Science.gov (United States)

Peregrine, Michael W; Schwartz, James R; Burgdorfer, James E; Gordon, David C

2002-01-01

Directors of healthcare organizations normally owe fiduciary duties to their shareholders or, in the case of nonprofits, to the charitable mission of the organization. As an organization descends to bankruptcy, however, the board's duties may shift. At some point, the board may be imposed with different and often conflicting obligations to the corporate enterprise as a whole, with a primary criterion being the interests of creditors. In this article, the authors analyze the murky areas of the Zone and give guidance as to when the board's duty may shift-and as to how directors should proceed both in determining their duties and in working to fulfill them.

What effects have resident work-hour changes had on education, quality of life, and safety? A systematic review.

Science.gov (United States)

Harris, Joshua D; Staheli, Greg; LeClere, Lance; Andersone, Diana; McCormick, Frank

2015-05-01

More than 15 years ago, the Institute of Medicine (IOM) identified medical error as a problem worthy of greater attention; in the wake of the IOM report, numerous changes were made to regulations to limit residents' duty hours. However, the effect of resident work-hour changes remains controversial within the field of orthopaedics. We performed a systematic review to determine whether work-hour restrictions have measurably influenced quality-of-life measures, operative and technical skill development, resident surgical education, patient care outcomes (including mortality, morbidity, adverse events, sentinel events, complications), and surgeon and resident attitudes (such as perceived effect on learning and training experiences, personal benefit, direct clinical experience, clinical preparedness). We performed a systematic review of PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Google Scholar using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria were any English language peer-reviewed articles that analyzed the effect(s) of orthopaedic surgery resident work-hour restrictions on patient safety, resident education, resident/surgeon quality of life, resident technical operative skill development, and resident surgeon attitudes toward work-hour restrictions. Eleven studies met study inclusion criteria. One study was a prospective analysis, whereas 10 studies were of level IV evidence (review of surgical case logs) or survey results. Within our identified studies, there was some support for improved resident quality of life, improved resident sleep and less fatigue, a perceived negative impact on surgical operative and technical skill, and conflicting evidence on the topic of resident education, patient outcomes, and variable attitudes toward the work-hour changes. There is a paucity of high-level or clear evidence evaluating the effect of the changes to resident work

32 CFR 199.16 - Supplemental Health Care Program for active duty members.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability... the supplemental health care program for active duty members of the uniformed services, the provision...

49 CFR 371.10 - Duties and obligations of brokers.

Science.gov (United States)

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Duties and obligations of brokers. 371.10 Section... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS BROKERS OF PROPERTY § 371.10 Duties and obligations of brokers. Where the broker acts on behalf of a person bound by...

76 FR 44574 - Antidumping Duty Investigation and Countervailing Duty Investigation of Hard Red Spring Wheat...

Science.gov (United States)

2011-07-26

... Investigation and Countervailing Duty Investigation of Hard Red Spring Wheat From Canada: Notice of Court... of Appeals for the Federal Circuit (``CAFC''), in Canadian Wheat Board v. United States, 2010-1083 (Fed. [[Page 44575

Fretting fatigue cracking of a center guide bolt supporting the combustion chamber in a heavy-duty gas turbine engine

Energy Technology Data Exchange (ETDEWEB)

Neidel, Andreas; Fischer, Boromir; Gaedicke, Tobias [Siemens AG, Energy Sector, Gasturbinenwerk Berlin (Germany). Werkstoffprueflabor

2018-04-01

The slotted center guide bolt of the center guide feature of the lower part of the outer shell of an annular combustion chamber was found fractured in a heavy-duty gas turbine engine used for power generation, after approximately 5.500 operating hours. The incident was a one-off event and not a recurring incident. No similar events were reported from the fleet; hence the failure was not considered a field issue. The metallurgical root cause investigation that was ordered to determine the failure mechanism revealed that the incident center guide bolt failed by fretting fatigue cracking, a high cycle fatigue (HCF) phenomenon.

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

International Nuclear Information System (INIS)

Seabold, J.E.; Conrad, G.R.; Ponto, J.A.; Kimball, D.A.; Frey, E.E.; Ahmed, F.; Coughlan, J.D.; Jensen, K.C.

1987-01-01

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 acute 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

76 FR 23208 - Alternative to Minimum Days Off Requirements

Science.gov (United States)

2011-04-26

... Language X. Voluntary Consensus Standards XI. Finding of No Significant Environmental Impact XII. Paperwork... the Current Fitness for Duty Requirements On September 3, 2010, the Nuclear Energy Institute (NEI... to the minimum days off requirements considered the collective advantages and disadvantages of having...

75 FR 68189 - Crewmember Requirements When Passengers are Onboard

Science.gov (United States)

2010-11-05

... substituted for the required flight attendant must be trained and qualified on that aircraft type as a pilot... additional responsibility might divert the pilot's attention from performing preflight duties. Upon further... pilots and flight engineers substituting for flight attendants. Current emergency training requirements...

40 CFR 1048.510 - What transient duty cycles apply for laboratory testing?

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false What transient duty cycles apply for... Procedures § 1048.510 What transient duty cycles apply for laboratory testing? (a) Starting with the 2007 model year, measure emissions by testing the engine on a dynamometer with the duty cycle described in...

25 CFR 11.706 - Appointment and duties of appraiser.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Appointment and duties of appraiser. 11.706 Section 11... OFFENSES AND LAW AND ORDER CODE Probate Proceedings § 11.706 Appointment and duties of appraiser. (a) Upon ordering an estate to be probated, the court shall appoint a disinterested and competent person as an...

31 CFR 401.4 - Duties of Bureau of Customs.

Science.gov (United States)

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Duties of Bureau of Customs. 401.4... TRANSPORT COUNTERFEIT COINS, OBLIGATIONS, SECURITIES, AND PARAPHERNALIA § 401.4 Duties of Bureau of Customs... director of customs pursuant to the said act of August 9, 1939, and the regulations in this part, the...

Fitness for duty in the nuclear power industry: A review of technical issues

International Nuclear Information System (INIS)

Barnes, V.; Fleming, I.; Grant, T.

1988-09-01

This report presents information gathered and analyzed in support of the United States Nuclear Regulatory Commission's (NRC's) efforts to develop a rule that will ensure that workers with unescorted access to protected areas in nuclear power plants are fit for duty. The primary potential fitness-for-duty concern addressed in the report is impairment caused by substance abuse, although other sources of impairment on the job are discussed. The report examines the prevalence of fitness-for-duty problems and discusses the use and effects of illicit drugs, prescription drugs, over-the-counter preparations and alcohol. The ways in which fitness-for-duty concerns are being addressed in both public- and private-sector industries are reviewed, and a description is provided of fitness-for-duty practices in six organizations that, like the nuclear industry, are regulated and whose operations can affect public health and safety. Methods of ensuring fitness for duty in the nuclear industry are examined in detail. The report also addresses methods of evaluating the effectiveness of fitness-for-duty programs in the nuclear power industry

49 CFR 99.735-81 - Post-employment duties and responsibilities.

Science.gov (United States)

2010-10-01

... benefit an employee's prospective private employer. All Government employees and special Government... RESPONSIBILITIES AND CONDUCT Responsibilities of the Government Employee and Special Government Employee Following Departure From Government Service § 99.735-81 Post-employment duties and responsibilities. The duties and...

High duty factor structures for e+e- storage rings

International Nuclear Information System (INIS)

Allen, M.A.; Karvonen, L.G.

1976-01-01

The next generation e + e - storage rings will need rf systems similar to those required for a continuous-duty linac of over 50 MeV. For the PEP Storage Ring at 18 GeV, it is presently planned to provide a peak accelerating voltage of 77 MV in 18 aluminum accelerating structures, each structure consisting of five slot-coupled cells operating in the π mode. Operating experience with the SPEAR five-cell structure is discussed. Power to each structure is provided by a 125-kW high-efficiency four-cavity klystron. No isolation has been used and the resulting interaction between the accelerating structures, klystrons and the stored beams is discussed

Medium Duty Electric Vehicle Demonstration Project

Energy Technology Data Exchange (ETDEWEB)

Mackie, Robin J. D. [Smith Electric Vehicles Corporation, Kansas City, MO (United States)

2015-05-31

The Smith Electric Vehicle Demonstration Project (SDP) was integral to the Smith business plan to establish a manufacturing base in the United States (US) and produce a portfolio of All Electric Vehicles (AEV’s) for the medium duty commercial truck market. Smith focused on the commercial depot based logistics market, as it represented the market that was most ready for the early adoption of AEV technology. The SDP enabled Smith to accelerate its introduction of vehicles and increase the size of its US supply chain to support early market adoption of AEV’s that were cost competitive, fully met the needs of a diverse set of end users and were compliant with Federal safety and emissions requirements. The SDP accelerated the development and production of various electric drive vehicle systems to substantially reduce petroleum consumption, reduce vehicular emissions of greenhouse gases (GHG), and increase US jobs.

40 CFR Appendix II to Part 1054 - Duty Cycles for Laboratory Testing

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Laboratory Testing II.... 1054, App. II Appendix II to Part 1054—Duty Cycles for Laboratory Testing (a) Test handheld engines with the following steady-state duty cycle: G3 mode No. Engine speed a Torque(percent) b Weighting...

Transportable Heavy Duty Emissions Testing Laboratory and Research Program

Energy Technology Data Exchange (ETDEWEB)

David Lyons

2008-03-31

The objective of this program was to quantify the emissions from heavy-duty vehicles operating on alternative fuels or advanced fuel blends, often with novel engine technology or aftertreatment. In the first year of the program West Virginia University (WVU) researchers determined that a transportable chassis dynamometer emissions measurement approach was required so that fleets of trucks and buses did not need to be ferried across the nation to a fixed facility. A Transportable Heavy-Duty Vehicle Emissions Testing Laboratory (Translab) was designed, constructed and verified. This laboratory consisted of a chassis dynamometer semi-trailer and an analytic trailer housing a full scale exhaust dilution tunnel and sampling system which mimicked closely the system described in the Code of Federal Regulations for engine certification. The Translab was first used to quantify emissions from natural gas and methanol fueled transit buses, and a second Translab unit was constructed to satisfy research demand. Subsequent emissions measurement was performed on trucks and buses using ethanol, Fischer-Tropsch fuel, and biodiesel. A medium-duty chassis dynamometer was also designed and constructed to facilitate research on delivery vehicles in the 10,000 to 20,000lb range. The Translab participated in major programs to evaluate low-sulfur diesel in conjunction with passively regenerating exhaust particulate filtration technology, and substantial reductions in particulate matter were recorded. The researchers also participated in programs to evaluate emissions from advanced natural gas engines with closed loop feedback control. These natural gas engines showed substantially reduced levels of oxides of nitrogen. For all of the trucks and buses characterized, the levels of carbon monoxide, oxides of nitrogen, hydrocarbons, carbon dioxide and particulate matter were quantified, and in many cases non-regulated species such as aldehydes were also sampled. Particle size was also

Stamp duties in Indian states - a case for reform

OpenAIRE

Alm, James; Annez, Patricia; Modi, Arbind

2004-01-01

The authors review the options for reform of stamp duties on immovable property transfers collected by Indian state governments. After briefly reviewing some of the many administrative difficulties experienced with the tax, they turn to an examination of its economic impacts. A review of stamp duties internationally indicates that Indian rates are exceptionally high, at rates often above 1...

12 CFR 905.4 - Duties of the Finance Board.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Duties of the Finance Board. 905.4 Section 905.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOUSING FINANCE BOARD ORGANIZATION AND OPERATIONS DESCRIPTION OF ORGANIZATION AND FUNCTIONS Functions and Responsibilities of Finance Board § 905.4 Duties of the Finance Board. (a) Bank Syste...

Working Hours and Productivity

OpenAIRE

Collewet, Marion; Sauermann, Jan

2017-01-01

This paper studies the link between working hours and productivity using daily information on working hours and performance of a sample of call centre agents. We exploit variation in the number of hours worked by the same employee across days and weeks due to central scheduling, enabling us to estimate the effect of working hours on productivity. We find that as the number of hours worked increases, the average handling time for a call increases, meaning that agents become less productive. Th...

Comparison of 44-hour and fixed 24-hour ambulatory blood pressure monitoring in dialysis patients.

Science.gov (United States)

Liu, Wenjin; Ye, Hong; Tang, Bing; Sun, Zhiping; Wen, Ping; Wu, Wenhui; Bian, Xueqing; Shen, Xia; Yang, Junwei

2014-01-01

The two most commonly used strategies to evaluate dialysis patients' blood pressure (BP) level are 44-hour and 24-hour ambulatory blood pressure monitoring (ABPM). The objective of this study was to find an appropriate 24-hour period that correlated well with the 44-hour BP level and determine the differences between these strategies. In a group of 51 dialysis patients, the authors performed 44-hour ABPM and extracted data for a fixed 24-hour ABPM. The fixed 24-hour ABPM started at 6 am on the nondialysis day. A strong correlation was found between all parameters of 44-hour and the fixed 24-hour ABPM, with paired sample t test showing only small magnitude changes in a few parameters. Both 24-hour ABPM and 44-hour ABPM were superior to clinic BP in predicting left ventricular mass index (LVMI) by multiple regression analysis. It was found that 44-hour ambulatory arterial stiffness index (AASI), but not 24-hour AASI, had a positive association with LVMI (r=0.328, P=.021). However, after adjustment for 44-hour systolic blood pressure, this association disappeared. Fixed 24-hour ABPM is a good surrogate of 44-hour ABPM to some extent, while 44-hour ABPM can provide more accurate and detailed information. ©2013 Wiley Periodicals, Inc.

Effect of nursing care hours on the outcomes of Intensive Care assistance.

Directory of Open Access Journals (Sweden)

Tatiana do Altíssimo Nogueira

Full Text Available To correlate the average number of nursing care hours dedicated to Intensive Care Unit (ICU patients with nursing care indicators.Transverse, descriptive study conducted between 2011 and 2013. Data were obtained from the electronic records system and from the nursing staff daily schedule. Generalized Linear Models were used for analysis.A total of 1,717 patients were included in the study. The average NAS (Nursing Activities Score value was 54.87. The average ratio between the number of nursing care hours provided to the patient and the number of nursing care hours required by the patient (hours ratio was 0.87. Analysis of the correlation between nursing care indicators and the hours ratio showed that the indicators phlebitis and ventilator-associated pneumonia significantly correlated with hours ratio; that is, the higher the hours ratio, the lower the incidence of phlebitis and ventilator-associated pneumonia.The number of nursing care hours directly impacts patient outcomes, which makes adjustment of nurse staffing levels essential.

75 FR 77305 - Security-Based Swap Data Repository Registration, Duties, and Core Principles

Science.gov (United States)

2010-12-10

... Repository Registration, Duties, and Core Principles; Proposed Rule #0;#0;Federal Register / Vol. 75 , No... Swap Data Repository Registration, Duties, and Core Principles AGENCY: Securities and Exchange... process, duties, and core principles. DATES: Comments should be submitted on or before January 24, 2011...

Implementation of self-rostering (the PRIO-project): effects on working hours, recovery, and health.

Science.gov (United States)

Garde, Anne Helene; Albertsen, Karen; Nabe-Nielsen, Kirsten; Carneiro, Isabella Gomes; Skotte, Jørgen; Hansen, Sofie Mandrup; Lund, Henrik; Hvid, Helge; Hansen, Åse Marie

2012-07-01

The aim of this study was to (i) investigate the consequences of self-rostering for working hours, recovery, and health, and (ii) elucidate the mechanisms through which recovery and health are affected. Twenty eight workplaces were allocated to either an intervention or reference group. Intervention A encompassed the possibility to specify preferences for starting time and length of shift down to 15 minutes intervals. Interventions B and C included the opportunity to choose between a number of predefined duties. Questionnaires (N=840) on recovery and health and objective workplace reports of working hours (N=718) were obtained at baseline and 12 months later. The interaction term between intervention and time was tested in mixed models and multinomial logistic regression models. The odds ratio (OR) of having short [OR 4.8, 95 % confidence interval (95% CI) 1.9-12.3] and long (OR 4.8, 95% CI 2.9-8.0) shifts increased in intervention A. Somatic symptoms (β= -0.10, 95% CI -0.19- -0.02) and mental distress (β= -0.13, 95% CI -0.23- -0.03) decreased, and sleep (β= 1.7, 95% CI 0.04-0.30) improved in intervention B, and need for recovery was reduced in interventions A (β= -0.17, 95% CI -0.29- -0.04) and B (β= -0.17, 95% CI -0.27- -0.07). There were no effects on recovery and health in intervention C, and overall, there were no detrimental effects on recovery or health. The benefits of the intervention were not related to changes in working hours and did not differ by gender, age, family type, degree of employment, or working hour arrangements. After implementation of self-rostering, employees changed shift length and timing but did not compromise most recommendations for acceptable shift work schedules. Positive consequences of self-rostering for recovery and health were observed, particularly in intervention B where worktime control increased but less extensively than intervention A. The effect could not be statistically explained by changes in actual working hours.

Experimental comparison of R123 and R245fa as working fluids for waste heat recovery from heavy-duty diesel engine

International Nuclear Information System (INIS)

Shu, Gequn; Zhao, Mingru; Tian, Hua; Huo, Yongzhan; Zhu, Weijie

2016-01-01

Organic Rankine Cycle (ORC) on-board is a solution for vehicles to save energy and reduce emission. Considering the characteristics of waste heat from vehicle, the criterions of the suitable working fluid are very strict. R123 and R245fa have been widely used in companies and labs, however, the difference of their properties under different engine conditions still requires further study. During this research, a series of experiments have been done to compare the performance of these two working fluids, what's more, to determine under which engine conditions they are suitable separately. These experimental comparisons are new and important for the targeting design of ORC for vehicles. The result shows that, considering the difference of thermodynamic properties and the limited cooling capacity on board, R123 shows its advantage for the waste heat recovery at heavy duty, while R245fa is more suitable at light-and-medium duty. These properties make R123 suitable for the ORC designed for long-haul heavy-duty truck, while R245fa is suggested for city bus. The following performance test of R123 for waste heat recovery from heavy-duty diesel engine shows that the maximum fuel consumption improvement can be as much as 2.8%. - Highlights: • R123 is more suitable for heavy duty and steady working condition. • R245fa shows its advantage at light-and-medium duty and varying working condition. • R123 suits better for long-haul heavy-duty truck, while R245fa for city bus. • The maximum fuel consumption improvement is as much as 2.8%.

78 FR 38811 - Organization and Delegation of Powers and Duties; Correction

Science.gov (United States)

2013-06-28

... 0311-AA02 Organization and Delegation of Powers and Duties; Correction AGENCY: Privacy and Civil... amendment: PART 1000--ORGANIZATION AND DELEGATION OF POWERS AND DUTIES OF THE PRIVACY AND CIVIL LIBERTIES...

40 CFR 1065.514 - Cycle-validation criteria for operation over specified duty cycles.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Cycle-validation criteria for operation over specified duty cycles. 1065.514 Section 1065.514 Protection of Environment ENVIRONMENTAL... Over Specified Duty Cycles § 1065.514 Cycle-validation criteria for operation over specified duty...

On-call duty effects on sleep-state physiological stability in male medical interns.

Directory of Open Access Journals (Sweden)

Yu-Hsuan Lin

Full Text Available BACKGROUND: On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC analysis to test our hypothesis. METHODS: We used electrocardiogram (ECG-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period. RESULTS: The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. CONCLUSION: Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.

The duty health physicist program at Byron Nuclear Power Station

International Nuclear Information System (INIS)

Goldsmith, D.G.; Carey, T.R.

1987-01-01

The Duty Health Physicist Program at Byron Station was established to deal with routine health physics tasks and provide an interface between frontline and upper radiation-chemistry management. The program consists of a weekly rotation of selected members of the health physics staff into the duty health physicist position to handle the assigned duty tasks. The tasks include, but are not limited to, daily isotopic and air sample review, effluent release package review, maximum permissible concentration calculations, dose approvals, as-low-as-reasonably-achievable action review of pending jobs, and general availability to answer questions and address problems in health-physics-related areas of plant operation. The daily attendance of the duty health physicist at the radiation-chemistry and station plan-of-the-day meetings has increased the overall presence and visibility of the health physics program to upper station management and other station departments. Since its inception in July of 1985, the Duty Health Physics Program has been a major contributor to the observed 50% reduction in reportable personnel errors in the radiation-chemistry department (based on personnel-error-related deviation reports and license event reports generated on the radiation-chemistry department at Byron Station). Although difficulty to quantify, other important benefits of this program are also discussed in this paper

Family victim advocates: the importance of critical job duties

Directory of Open Access Journals (Sweden)

Teresa H. Young

Full Text Available Child advocacy centers across the United States intervened in more than 250,000 child abuse cases in 2011(National Children's Alliance, 2012. Understanding the work of family victim advocates is imperative to helping children and families in child abuse cases. In this exploratory study, we surveyed advocates and program directors from child advocacy centers (CACs across the United States to compare their perceptions of the critical job duties of family victim advocates. Data analysis revealed that CAC directors rated the importance of these duties significantly higher than family victim advocates. Results suggest the need for additional training to ensure that family victim advocates understand the importance of critical job duties to meet the needs of children and families in child abuse cases.

Heavy Duty Vehicle Futures Analysis.

Energy Technology Data Exchange (ETDEWEB)

Askin, Amanda Christine; Barter, Garrett.; West, Todd H.; Manley, Dawn Kataoka

2014-05-01

This report describes work performed for an Early Career Research and Development project. This project developed a heavy-duty vehicle (HDV) sector model to assess the factors influencing alternative fuel and efficiency technology adoption. This model builds on a Sandia light duty vehicle sector model and provides a platform for assessing potential impacts of technological advancements developed at the Combustion Research Facility. Alternative fuel and technology adoption modeling is typically developed around a small set of scenarios. This HDV sector model segments the HDV sector and parameterizes input values, such as fuel prices, efficiencies, and vehicle costs. This parameterization enables sensitivity and trade space analyses to identify the inputs that are most associated with outputs of interest, such as diesel consumption and greenhouse gas emissions. Thus this analysis tool enables identification of the most significant HDV sector drivers that can be used to support energy security and climate change goals.

77 FR 23659 - Revocation of Antidumping Duty Order: Certain Orange Juice From Brazil

Science.gov (United States)

2012-04-20

... Duty Order: Certain Orange Juice From Brazil AGENCY: Import Administration, International Trade...) initiated a sunset review of the antidumping duty order on certain orange juice (OJ) from Brazil.\\1\\ On...), the Department is revoking the antidumping duty order on OJ from Brazil. \\1\\ See Initiation of Five...

16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of users of consumer reports... CREDIT REPORTING ACT DUTIES OF USERS OF CONSUMER REPORTS REGARDING ADDRESS DISCREPANCIES § 641.1 Duties of users of consumer reports regarding address discrepancies. (a) Scope. This section applies to...

41 CFR 301-11.100 - What will I be paid for lodging under Lodgings-plus per diem?

Science.gov (United States)

2010-07-01

... Management Federal Travel Regulation System TEMPORARY DUTY (TDY) TRAVEL ALLOWANCES ALLOWABLE TRAVEL EXPENSES... Lodgings-plus per diem? When travel is more than 12 hours and overnight lodging is required you are... point. ...

Fatigue Risk Management: The Impact of Anesthesiology Residents' Work Schedules on Job Performance and a Review of Potential Countermeasures.

Science.gov (United States)

Wong, Lily R; Flynn-Evans, Erin; Ruskin, Keith J

2018-04-01

Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being. We then propose countermeasures that have been implemented to mitigate the effects of fatigue and describe how training programs or practice groups who must work overnight can adapt these strategies for use in a hospital setting. Countermeasures include the use of scheduling interventions, strategic naps, microbreaks, caffeine use during overnight and extended shifts, and the use of bright lights in the clinical setting when possible or personal blue light devices when the room lights must be turned off. Although this review focuses primarily on anesthesiology residents in training, many of the mitigation strategies described here can be used effectively by physicians in practice.

Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

Science.gov (United States)

Olapade-Olaopa, E O; Sewankambo, N; Iputo, J E; Rugarabamu, P; Amlak, A H; Mipando, M; Monekosso G L

2016-09-01

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

A 540-[Formula: see text] Duty Controlled RSSI With Current Reusing Technique for Human Body Communication.

Science.gov (United States)

Jang, Jaeeun; Lee, Yongsu; Cho, Hyunwoo; Yoo, Hoi-Jun

2016-08-01

An ultra-low-power duty controlled received signal strength indicator (RSSI) is implemented for human body communication (HBC) in 180 nm CMOS technology under 1.5 V supply. The proposed RSSI adopted 3 following key features for low-power consumption; 1) current reusing technique (CR-RSSI) with replica bias circuit and calibration unit, 2) duty controller, and 3) reconfigurable gm-boosting LNA. The CR-RSSI utilizes stacked amplifier-rectifier-cell (AR-cell) to reuse the supply current of each blocks. As a result, the power consumption becomes 540 [Formula: see text] with +/-2 dB accuracy and 75 dB dynamic range. The replica bias circuit and calibration unit are adopted to increase the reliability of CR-RSSI. In addition, the duty controller turns off the RSSI when it is not required, and this function leads 70% power reduction. At last, the gm-boosting reconfigurable LNA can adaptively vary its noise and linearity performance with respect to input signal strength. Fro current reusing technique m this feature, we achieve 62% power reduction in the LNA. Thanks to these schemes, compared to the previous works, we can save 70% of power in RSSI and LNA.

A simple method to downscale daily wind statistics to hourly wind data

OpenAIRE

Guo, Zhongling

2013-01-01

Wind is the principal driver in the wind erosion models. The hourly wind speed data were generally required for precisely wind erosion modeling. In this study, a simple method to generate hourly wind speed data from daily wind statistics (daily average and maximum wind speeds together or daily average wind speed only) was established. A typical windy location with 3285 days (9 years) measured hourly wind speed data were used to validate the downscaling method. The results showed that the over...

7 CFR 1210.328 - Duties.

Science.gov (United States)

2010-01-01

..., advertising or promotion, and the payment of the costs thereof with funds received pursuant to this Plan; (e... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan National Watermelon Promotion Board § 1210.328 Duties. The...

Kansas Consortium Plug-in Hybrid Medium Duty

Energy Technology Data Exchange (ETDEWEB)

None, None

2012-03-31

On September 30, 2008, the US Department of Energy (DoE), issued a cooperative agreement award, DE-FC26-08NT01914, to the Metropolitan Energy Center (MEC), for a project known as “Kansas Consortium Plug-in Hybrid Medium Duty Certification” project. The cooperative agreement was awarded pursuant to H15915 in reference to H. R. 2764 Congressionally Directed Projects. The original agreement provided funding for The Consortium to implement the established project objectives as follows: (1) to understand the current state of the development of a test protocol for PHEV configurations; (2) to work with industry stakeholders to recommend a medium duty vehicle test protocol; (3) to utilize the Phase 1 Eaton PHEV F550 Chassis or other appropriate PHEV configurations to conduct emissions testing; (4) and to make an industry PHEV certification test protocol recommendation for medium duty trucks. Subsequent amendments to the initial agreement were made, the most significant being a revised Scope of Project Objectives (SOPO) that did not address actual field data since it was not available as originally expected. This project was mated by DOE with a parallel project award given to the South Coast Air Quality Management District (SCAQMD) in California. The SCAQMD project involved designing, building and testing of five medium duty plug-in hybrid electric trucks. SCAQMD had contracted with the Electric Power Research Institute (EPRI) to manage the project. EPRI provided the required match to the federal grant funds to both the SCAQMD project and the Kansas Consortium project. The rational for linking the two projects was that the data derived from the SCAQMD project could be used to validate the protocols developed by the Kansas Consortium team. At the same time, the consortium team would be a useful resource to SCAQMD in designating their test procedures for emissions and operating parameters and determining vehicle mileage. The years between award of the cooperative

Operator alertness and performance on 8-hour and 12-hour work shifts

International Nuclear Information System (INIS)

Baker, T.L.; Campbell, S.S.; Dawson, D.; Moore-Ede, M.

1989-01-01

Recently, much attention has been paid to the alertness and performance problems of rotational shiftworkers in the nuclear power industry. Growing awareness of higher rates of human errors and accidents on night shifts and reports of operations personnel falling asleep on the job have contributed to the heightened interest in this subject. The industry is now considering the effects of different shift rotation systems, including evaluation of the most recent of industry trends in shift scheduling-schedules that include 12 hour work shifts. Surveys show that within the past 5 years about 20% of commercially operational nuclear power plants have instituted schedules that use only 12 hour shifts, or schedules using a combination of 8-hour and 12-hour shifts. Many more plants routinely use 12-hour work shifts during plant outages and refueling operations. In response to this growing trend, the NRC has funded research which is a first attempt to compare alertness, operator performance, and sleep-wake patterns in subjects working simulated 8-hour and 12-hour shifts at the Human Alertness Research Center (HARC), located at the Institute of Circadian Physiology in Boston, MA. This paper will describe in greater detail the design of the study, measurement techniques for alertness and sleep, work routine, work task performance measures, and cognitive performance test protocols. It will review the role of circadian factors in human alertness and performance, and discuss previous research findings in this area. It will discuss other variables that are known to influence human alertness in the workplace, such as caffeine, alcohol, and working environment. The physiological basis for shift worker sleep problems will be explained in the context of the ongoing research project at HARC. Finally, the paper presents previous research on shift work and fatigue which may be relevant to a comparison of 8-hour and 12-hour shifts

40 CFR Appendix II to Part 1045 - Duty Cycles for Propulsion Marine Engines

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty Cycles for Propulsion Marine... Pt. 1045, App. II Appendix II to Part 1045—Duty Cycles for Propulsion Marine Engines (a) The following duty cycle applies for discrete-mode testing: E4 Mode No. Enginespeed 1 Torque(percent) 2...

78 FR 79662 - Stainless Steel Plate in Coils From Belgium: Final Results of Antidumping Duty Administrative...

Science.gov (United States)

2013-12-31

... Secretary, for Antidumping and Countervailing Duty Operations, through Melissa Skinner, Director, Office III... Duty Operations, through Melissa Skinner, Director, Office III Antidumping and Countervailing Duty..., Deputy Assistant Secretary, for Antidumping and Countervailing Duty Operations, through Melissa Skinner...

7 CFR 1209.39 - Duties.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Duties. 1209.39 Section 1209.39 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... statements to be prepared in conformity with generally accepted accounting principles and to be audited by an...

7 CFR 1215.30 - Duties.

Science.gov (United States)

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Duties. 1215.30 Section 1215.30 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS... statements to be prepared in conformity with generally accepted accounting principles and to be audited by an...

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

Science.gov (United States)

2010-07-01

... minimum hourly wage required under the contract pursuant to the provisions of the Service Contract Act of... premium payment of one-half times such minimum hourly wage for all hours worked in excess of 40 hours in... this section are met. (ii) The apprentice or trainee comes within the definition contained in § 5.2(n...

40 CFR 1039.510 - Which duty cycles do I use for transient testing?

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Which duty cycles do I use for... ENGINES Test Procedures § 1039.510 Which duty cycles do I use for transient testing? (a) Measure emissions by testing the engine on a dynamometer with one of the following transient duty cycles to determine...

Development of Heavy-Duty and High-Precision Hydraulic Manipulator for Inspection, Maintenance and Decommission of Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Lee, Sung Uk; Seo, Yong-chil; Jung, Kyung Min; Kim, Chang-hoi; Choi, Byung-seon; Moon, Jei-kwon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

Robotic manipulators have been used for inspection, maintenance and decommission of nuclear power plants because nuclear power plants have high radiation and human workers cannot easily access the plants. And also, to inspecting, maintaining and decommissioning nuclear power plants require various manipulators. Only one manipulator cannot response to many required tasks. The existing manipulators that was used at nuclear power plants can only operate only focused specific task and cannot be used at several tasks. The actuators used at manipulators are varied and many companies sell actuators depending on power, torque and speed. However, the commercial product is not standardized. Therefore, the development of manipulator is time consuming and expensive. The essential item of a manipulator is an actuator module. If actuator module is standardized, it’s easier to develop a manipulator and also maintain a manipulator. Recently, manipulator having high-radiation, high-duty and high-precision is necessary to inspection, maintain and decommissioning of nuclear power plants. Hydraulic actuator has been used to development high-duty manipulator. But control performance of a hydraulic actuator is not better than that of an electric actuator so that hydraulic manipulator cannot easily satisfy the required precision. In this paper, we developed high-duty and high-precision actuator modules and hydraulic manipulator using the developed actuator modules. The developed hydraulic manipulator have a payload of 250kg and a precision of ±1mm. Four modularized hydraulic actuator modules were developed for inspection, maintenance and decommission. Using the developed actuator modules, the manipulator for decommissioning is easily developed. And also, various manipulators having different kinematic structure for specific tasks will be easily developed by using hydraulic modules.

Development of Heavy-Duty and High-Precision Hydraulic Manipulator for Inspection, Maintenance and Decommission of Nuclear Power Plants

International Nuclear Information System (INIS)

Lee, Sung Uk; Seo, Yong-chil; Jung, Kyung Min; Kim, Chang-hoi; Choi, Byung-seon; Moon, Jei-kwon

2016-01-01

Robotic manipulators have been used for inspection, maintenance and decommission of nuclear power plants because nuclear power plants have high radiation and human workers cannot easily access the plants. And also, to inspecting, maintaining and decommissioning nuclear power plants require various manipulators. Only one manipulator cannot response to many required tasks. The existing manipulators that was used at nuclear power plants can only operate only focused specific task and cannot be used at several tasks. The actuators used at manipulators are varied and many companies sell actuators depending on power, torque and speed. However, the commercial product is not standardized. Therefore, the development of manipulator is time consuming and expensive. The essential item of a manipulator is an actuator module. If actuator module is standardized, it’s easier to develop a manipulator and also maintain a manipulator. Recently, manipulator having high-radiation, high-duty and high-precision is necessary to inspection, maintain and decommissioning of nuclear power plants. Hydraulic actuator has been used to development high-duty manipulator. But control performance of a hydraulic actuator is not better than that of an electric actuator so that hydraulic manipulator cannot easily satisfy the required precision. In this paper, we developed high-duty and high-precision actuator modules and hydraulic manipulator using the developed actuator modules. The developed hydraulic manipulator have a payload of 250kg and a precision of ±1mm. Four modularized hydraulic actuator modules were developed for inspection, maintenance and decommission. Using the developed actuator modules, the manipulator for decommissioning is easily developed. And also, various manipulators having different kinematic structure for specific tasks will be easily developed by using hydraulic modules

77 FR 12407 - Statement of Agency Policy and Interpretation on the Hours of Service Laws as Amended; Response...

Science.gov (United States)

2012-02-29

... 10 hours or 48 or 72 hours after working 6 or 7 days), and is released from that call prior to the... Transportation (Secretary), has long administered statutory hours of service requirements for the three groups of..., in the next 24 hours, and must get 10 hours off either after working that 12 hours or at the end of...

7 CFR 1220.212 - Duties.

Science.gov (United States)

2010-01-01

... administrative functions as it may deem necessary and define the duties and determine the compensation of each... information, and industry information programs contemplated therein. (g) To maintain such books and records... accounting with respect to the receipt and disbursement of all funds entrusted to it. (h) With the approval...

7 CFR 993.36 - Duties.

Science.gov (United States)

2010-01-01

..., which are necessary in connection with the performance of its official duties; (d) To select, from among... of its anticipated expenditures and the recommended rate of assessment for the ensuing crop year, and... submit to the Secretary quarterly statements of the financial operations of the committee, exclusive of...

Requirements of on-site facilities

International Nuclear Information System (INIS)

Burchardt, H.

1977-01-01

1) Requirements of on-site facilities: a) brief description of supplying the site with electricity and water; communication facilities, b) necessary facilities for containment and pipeline installation, c) necessary facilities for storage, safety, accommodation of personnel, housing; workshops; 2) Site management: a) Organisation schedules for 'turn-key-jobs' and 'single commission', b) Duties of the supervisory staff. (orig.) [de

Crew Scheduling Considering both Crew Duty Time Difference and Cost on Urban Rail System

Directory of Open Access Journals (Sweden)

Wenliang Zhou

2016-11-01

Full Text Available Urban rail crew scheduling problem is to allocate train services to crews based on a given train timetable while satisfying all the operational and contractual requirements. In this paper, we present a new mathematical programming model with the aim of minimizing both the related costs of crew duty and the variance of duty time spreads. In addition to iincorporating the commonly encountered crew scheduling constraints, it also takes into consideration the constraint of arranging crews having a meal in the specific meal period of one day rather than after a minimum continual service time. The proposed model is solved by an ant colony algorithm which is built based on the construction of ant travel network and the design of ant travel path choosing strategy. The performances of the model and the algorithm are evaluated by conducting case study on Changsha urban rail. The results indicate that the proposed method can obtain a satisfactory crew schedule for urban rails with a relatively small computational time.

More hours, more jobs? The employment effects of longer working hours

OpenAIRE

Martyn Andrews; Hans-Dieter Gerner; Thorsten Schank; Richard Upward

2015-01-01

Increases in standard hours of work have been a contentious policy issue in Germany. Whilst this might directly lead to a substitution of workers by hours, there may also be a positive employment effect due to reduced costs. Moreover, the response of firms may differ between firms that offer overtime and those that do not. For a panel of German plants (2001–2006) drawn from the IAB Establishment Panel, we are the first to analyse the effect of increased standard hours on employment. Using dif...

Prevalence of Pain Diagnoses and Burden of Pain Among Active Duty Soldiers, FY2012.

Science.gov (United States)

Reif, Sharon; Adams, Rachel Sayko; Ritter, Grant A; Williams, Thomas V; Larson, Mary Jo

2018-03-14

pain occurring in each quarter of FY 2012 (23%) and chronic pain lasting for at least 3 mo (62%). In most pain categories, the majority of soldiers were released without duty limitations. These data provide a deeper understanding of pain diagnoses and burden of pain among active duty soldiers. A substantial proportion of soldiers with pain diagnoses were seen for pain self-reported as only mild, or that did not result in significant restrictions in military duty limitations. However, given the prevalence of multiple pain diagnoses and common reports of moderate or severe pain and long duration, complex interventions may be required to minimize the effect of pain on force readiness. This encounters-based analysis is likely an underestimate of presence of pain, and does not include contextual factors that could better describe the true effect of pain among this population.

Impact of working hours on sleep and mental health.

Science.gov (United States)

Afonso, P; Fonseca, M; Pires, J F

2017-07-01

The number of hours people are required to work has a pervasive influence on both physical and mental health. Excessive working hours can also negatively affect sleep quality. The impact at work of mental health problems can have serious consequences for individuals' as well as for organizations' productivity. To evaluate differences in sleep quality and anxiety and depression symptoms between longer working hours group (LWHG) and regular working hours group (RWHG). To examine factors influencing weekly working hours, sleep quality and anxiety and depressive symptoms. Participants were divided into two groups, RWHG and LWHG, based on working hours, with a cut-off of 48 h per week. We used the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression symptoms and the Pittsburgh Sleep Quality Index (PSQI) to measure the quality and patterns of sleep. The response rate was 23%. Among the 429 study participants, those in the LWHG group (n = 256, 53%) had significantly more depressive and anxiety symptoms and worse sleep quality than those in RWHG (n = 223, 47%). Working time was significantly positively correlated with higher corporate position and HADS scores. Moreover, HADS scores were positively correlated with PSQI scores and negatively correlated with age. This study suggests that longer working hours are associated with poorer mental health status and increasing levels of anxiety and depression symptoms. There was a positive correlation between these symptoms and sleep disturbances. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Working hours and productivity

NARCIS (Netherlands)

Collewet, Marion; Sauermann, Jan

2017-01-01

This paper studies the link between working hours and productivity using daily information on working hours and performance of a sample of call centre agents. We exploit variation in the number of hours worked by the same employee across days and weeks due to central scheduling, enabling us to

29 CFR 778.320 - Hours that would not be hours worked if not paid for.

Science.gov (United States)

2010-07-01

... working hours fall in this category. The agreement of the parties to provide compensation for such hours... regular rate of an employee if the hours are compensated at the same rate as other working hours. The.... Activities of this type include eating meals between working hours. Where it appears from all the pertinent...

32 CFR 47.4 - Policy.

Science.gov (United States)

2010-07-01

... under a curfew. (2) Requiring members to work extended hours or unusual shifts. (3) Changing duty... situated to the Women's Air Forces Service Pilots of World War II. (2) Have rendered service to the United...

Double- and Triple-Duty Caregiving Men: An Examination of Subjective Stress and Perceived Schedule Control.

Science.gov (United States)

DePasquale, Nicole; Zarit, Steven H; Mogle, Jacqueline; Moen, Phyllis; Hammer, Leslie B; Almeida, David M

2018-04-01

Based on the stress process model of family caregiving, this study examined subjective stress appraisals and perceived schedule control among men employed in the long-term care industry (workplace-only caregivers) who concurrently occupied unpaid family caregiving roles for children (double-duty child caregivers), older adults (double-duty elder caregivers), and both children and older adults (triple-duty caregivers). Survey responses from 123 men working in nursing home facilities in the United States were analyzed using multiple linear regression models. Results indicated that workplace-only and double- and triple-duty caregivers' appraised primary stress similarly. However, several differences emerged with respect to secondary role strains, specifically work-family conflict, emotional exhaustion, and turnover intentions. Schedule control also constituted a stress buffer for double- and triple-duty caregivers, particularly among double-duty elder caregivers. These findings contribute to the scarce literature on double- and triple-duty caregiving men and have practical implications for recruitment and retention strategies in the health care industry.

Reduction of particle emissions from light duty vehicles and from taxies; Reduktion af partikelelemissioner fra varebiler og taxier

Energy Technology Data Exchange (ETDEWEB)

Nielsen, Johan; Henriques, M.; Weibel, T.G. [TetraPlan A/S (Denmark)

2006-11-03

This project, 'Reduction of particle emissions from light duty vehicles and from taxies', analyses different strategies to reduce the particle emission, their effect for particle emissions, and the resulting cost for the society and for the companies. The project describes the EU regulation of emissions, the possibilities of reducing the emissions via special requirements in environmental zones and the Danish taxation of light duty vehicles. Further, the project includes interviews with owners of light duty vehicles and taxies and also with Danish producers of particle filters. The strategies analysed in the scenarios include: 1) Promotion of particle filters; 2) Shift from diesel to gasoline and; 3) Downsizing. The effects for particle emissions and for mortality are described. Further, the costs and benefits for the society and the cost for the companies are evaluated. The effects of the scenarios are analysed, both for initiatives implemented at a national level and for implementation in an environmental zone in the municipality of Copenhagen. The main results are that the socioeconomic benefits in the year 2012 are greater than the costs, if taxis and light duty vehicles have filters installed and if they are driving in the Copenhagen area. For light duty vehicles it is only profitable, if the prices of the filters fall to the price level that is expected in the future in the study. Further, the analysis shows that for light duty vehicles and taxies driving all over the country, the socioeconomic benefits achieved by installing particle filters are too small to cover the costs. The analysis shows that it is also profitable socio-economically to change from diesel to petrol for light duty vehicles and for taxies (except taxies driving nationally). The analysis is based on the producer prices including the general net tax level, while the specific taxes are not included. From the point of view of the companies it is not profitable to change to petrol

7 CFR 915.29 - Duties.

Science.gov (United States)

2010-01-01

... duties of such officers; (b) To appoint such employees, agents, and representatives as it may deem... of growers or groups of growers as may be deemed necessary and to pay the travel expenses incurred by... the committee shall not pay the travel expenses of more than three such representatives in connection...

32 CFR 516.71 - Duties.

Science.gov (United States)

2010-07-01

...-record, the Chief, DAJA-LE, will file necessary pleadings and make necessary appearances before the MSPB... appropriate DA personnel are fully apprised of their rights, duties and the nature and basis for an OSC... military members. (7) Ensure that personnel involved are advised of the nature and basis for an OSC...

Effect of Gasoline Properties on Exhaust Emissions from Tier 2 Light-Duty Vehicles -- Final Report: Phase 3; July 28, 2008 - July 27, 2013

Energy Technology Data Exchange (ETDEWEB)

Whitney, K.

2014-05-01

This report covers work the Southwest Research Institute (SwRI) Office of Automotive Engineering has conducted for the U.S. Environmental Protection Agency (EPA), the National Renewable Energy Laboratory (NREL), and the Coordinating Research Council (CRC) in support of the Energy Policy Act of 2005 (EPAct). Section 1506 of EPAct requires EPA to produce an updated fuel effects model representing the 2007 light - duty gasoline fleet, including determination of the emissions impacts of increased renewable fuel use. This report covers the exhaust emissions testing of 15 light-duty vehicles with 27 E0 through E20 test fuels, and 4 light-duty flexible fuel vehicles (FFVs) on an E85 fuel, as part of the EPAct Gasoline Light-Duty Exhaust Fuel Effects Test Program. This program will also be referred to as the EPAct/V2/E-89 Program based on the designations used for it by the EPA, NREL, and CRC, respectively. It is expected that this report will be an attachment or a chapter in the overall EPAct/V2/E-89 Program report prepared by EPA and NREL.

Annual Report: DOE Advanced Combustion Systems & Fuels R&D; Light-Duty Diesel Combustion

Energy Technology Data Exchange (ETDEWEB)

Busch, Stephen [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

2017-11-01

Despite compliance issues in previous years, automakers have demonstrated that the newest generation of diesel power trains are capable of meeting all federal and state regulations (EPA, 2016). Diesels continue to be a cost-effective, efficient, powerful propulsion source for many light- and medium-duty vehicle applications (Martec, 2016). Even modest reductions in the fuel consumption of light- and medium duty diesel vehicles in the U.S. will eliminate millions of tons of CO2 emissions per year. Continued improvement of diesel combustion systems will play an important role in reducing fleet fuel consumption, but these improvements will require an unprecedented scientific understanding of how changes in engine design and calibration affect the mixture preparation, combustion, and pollutant formation processes that take place inside the cylinder. The focus of this year’s research is to provide insight into the physical mechanisms responsible for improved thermal efficiency observed with a stepped-lip piston. Understanding how piston design can influence efficiency will help engineers develop and optimize new diesel combustion systems.

40 CFR 1042.505 - Testing engines using discrete-mode or ramped-modal duty cycles.

Science.gov (United States)

2010-07-01

... ramped-modal duty cycles. 1042.505 Section 1042.505 Protection of Environment ENVIRONMENTAL PROTECTION... duty cycles. This section describes how to test engines under steady-state conditions. In some cases, we allow you to choose the appropriate steady-state duty cycle for an engine. In these cases, you...

Working hours

OpenAIRE

Fialová, Lenka

2012-01-01

Working hours The aim of this thesis that I set was a comprehensive analysis of the working hours issue. The main purpose was to summarize this area of labor law while taking into account the Labour Code amendment which came into force on 1st January 2012. The changes in the related legal terms were also included into this thesis because of the mentioned changes. The thesis is composed of three chapters. Chapter One deals briefly with history of Labour Law and regulatory development. Author`s...

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

Science.gov (United States)

Bae, Sung-Heui; Yoon, Jangho

2014-10-01

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

13 CFR 120.650 - Registration duties of FTA in Secondary Market.

Science.gov (United States)

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Registration duties of FTA in Secondary Market. 120.650 Section 120.650 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Miscellaneous Provisions § 120.650 Registration duties of FTA in Secondary...

Working hours and common mental disorders in English police officers.

Science.gov (United States)

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.

Heavy-Duty Low-Temperature and Diesel Combustion & Heavy-Duty Combustion Modeling

Energy Technology Data Exchange (ETDEWEB)

Musculus, Mark P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2017-11-01

Regulatory drivers and market demands for lower pollutant emissions, lower carbon dioxide emissions, and lower fuel consumption motivate the development of clean and fuel-efficient engine operating strategies. Most current production engines use a combination of both in-cylinder and exhaust emissions-control strategies to achieve these goals. The emissions and efficiency performance of in-cylinder strategies depend strongly on flow and mixing processes associated with fuel injection. Various diesel engine manufacturers have adopted close-coupled post-injection combustion strategies to both reduce pollutant emissions and to increase engine efficiency for heavy-duty applications, as well as for light- and medium-duty applications. Close-coupled post-injections are typically short injections that follow a larger main injection in the same cycle after a short dwell, such that the energy conversion efficiency of the post-injection is typical of diesel combustion. Of the various post-injection schedules that have been reported in the literature, effects on exhaust soot vary by roughly an order of magnitude in either direction of increasing or decreasing emissions relative to single injections (O’Connor et al., 2015). While several hypotheses have been offered in the literature to help explain these observations, no clear consensus has been established. For new engines to take full advantage of the benefits that post-injections can offer, the in-cylinder mechanisms that affect emissions and efficiency must be identified and described to provide guidance for engine design.

20 CFR 220.132 - Physical exertion requirements.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Physical exertion requirements. 220.132 Section 220.132 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD RETIREMENT... of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking...

Independent consultants : fiduciary duties, trade secrets and confidential information

International Nuclear Information System (INIS)

Fraser, B.; Wilhelmson, M.

1999-01-01

Because of cutbacks and downsizing within the petroleum industry, it has become one of the largest users of contract personnel to provide services that were previously provided by senior levels of management. This paper explored the application of common law fiduciary duties and the duty of confidence to the independent workforce. It examined to what extent fiduciary duties apply to independent consultants and the best way for the employer to protect itself from the potential misuse of confidential information. Part 1 of the paper described fiduciary duties. A fiduciary relationship was described as one that possesses the following three characteristics: (1) the fiduciary has scope for the exercise of some discretion of power, (2) the fiduciary can unilaterally exercise that power to affect the beneficiary's practical interests, and (3) the beneficiary is peculiarly vulnerable to the fiduciary holding the discretion of power. Three examples of how the courts treated some arguments regarding fiduciaries were presented. Part 2 of this paper discussed how trade secrets and confidential information should be handled. It was explained, that regardless of fiduciary duties, the unauthorized use of confidential information by an independent contractor can give rise to liability and an award of damages by the courts. Some examples where the Supreme Court of Canada found breach of confidence by a party were presented. Information communicated from an employer to an employee can be divided into the following three categories: (1) publicly accessible and not confidential, (2) confidential and must be treated as such while an employee is employed, but if learned becomes part of the employees skill and knowledge, and (3) specific confidential trade secrets that cannot lawfully be used for anyone's benefit but the employer's. Issues regarding defining rights and obligations by contract were also discussed

Appropriate working hours for surgical training according to Australasian trainees.

Science.gov (United States)

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

2012-04-01

The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Alcohol Use Among Active Duty Women: Analysis AUDIT Scores From the 2011 Health-Related Behavior Survey of Active Duty Military Personnel.

Science.gov (United States)

Jeffery, Diana D; Mattiko, Mark

2016-01-01

Numerous studies document higher substance use among military men after deployment; similar studies focused on military women are limited. This study examines alcohol use of active duty women and deployment factors, social/environmental/attitudinal factors, and psychological/intrapersonal factors. Secondary data analysis of the 2011 Survey of Health-Related Behavior of active duty military personnel was conducted using bivariate statistics and multiple regression analyses with Alcohol Use Disorders Identification Test scores as the dependent variable. Nearly 94% had low risk for alcohol use disorders. Length of combat experience and extent of combat exposure were unrelated to Alcohol Use Disorders Identification Test scores; noncombat deployment was unrelated after controlling for marital status, age of first drink, pay grade, and branch of service. Significant motivators (p risk propensity, lifetime prevalence of suicidal ideation, and depressed mood were significant predictors in the regression model after controlling for covariates. Findings suggest that some active duty women use alcohol to cope with adverse emotional states, whereas others use alcohol consistent with propensity for high-risk behaviors. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Combining Formal and Informal Caregiving Roles: The Psychosocial Implications of Double- and Triple-Duty Care.

Science.gov (United States)

DePasquale, Nicole; Davis, Kelly D; Zarit, Steven H; Moen, Phyllis; Hammer, Leslie B; Almeida, David M

2016-03-01

Women who combine formal and informal caregiving roles represent a unique, understudied population. In the literature, healthcare employees who simultaneously provide unpaid elder care at home have been referred to as double-duty caregivers. The present study broadens this perspective by examining the psychosocial implications of double-duty child care (child care only), double-duty elder care (elder care only), and triple-duty care (both child care and elder care or "sandwiched" care). Drawing from the Work, Family, and Health Study, we focus on a large sample of women working in nursing homes in the United States (n = 1,399). We use multiple regression analysis and analysis of covariance tests to examine a range of psychosocial implications associated with double- and triple-duty care. Compared with nonfamily caregivers, double-duty child caregivers indicated greater family-to-work conflict and poorer partner relationship quality. Double-duty elder caregivers reported more family-to-work conflict, perceived stress, and psychological distress, whereas triple-duty caregivers indicated poorer psychosocial functioning overall. Relative to their counterparts without family caregiving roles, women with combined caregiving roles reported poorer psychosocial well-being. Additional research on women with combined caregiving roles, especially triple-duty caregivers, should be a priority amidst an aging population, older workforce, and growing number of working caregivers. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Modeling Aggregate Hourly Energy Consumption in a Regional Building Stock

Directory of Open Access Journals (Sweden)

Anna Kipping

2017-12-01

Full Text Available Sound estimates of future heat and electricity demand with high temporal and spatial resolution are needed for energy system planning, grid design, and evaluating demand-side management options and polices on regional and national levels. In this study, smart meter data on electricity consumption in buildings are combined with cross-sectional building information to model hourly electricity consumption within the household and service sectors on a regional basis in Norway. The same modeling approach is applied to model aggregate hourly district heat consumption in three different consumer groups located in Oslo. A comparison of modeled and metered hourly energy consumption shows that hourly variations and aggregate consumption per county and year are reproduced well by the models. However, for some smaller regions, modeled annual electricity consumption is over- or underestimated by more than 20%. Our results indicate that the presented method is useful for modeling the current and future hourly energy consumption of a regional building stock, but that larger and more detailed training datasets are required to improve the models, and more detailed building stock statistics on regional level are needed to generate useful estimates on aggregate regional energy consumption.

25 CFR 700.509 - Duties of the designated agency ethics official.

Science.gov (United States)

2010-04-01

... 25 Indians 2 2010-04-01 2010-04-01 false Duties of the designated agency ethics official. 700.509... RELOCATION PROCEDURES Employee Responsibility and Conduct § 700.509 Duties of the designated agency ethics official. The Designated Agency Ethics Official shall coordinate and manage the agency's ethics program...

The Productivity Of Working Hours

OpenAIRE

John Pencavel

2013-01-01

Observations on munition workers, most of them women, are organized to examine the relationship between their output and their working hours. The relationship is nonlinear: below an hours threshold, output is proportional to hours; above a threshold, output rises at a decreasing rate as hours increase. Implications of these results for the estimation of labor supply functions are taken up. The findings also link up with current research on the effects of long working hours on accidents and in...

Impact of U.S. duty drawback on the demand for orange juice

OpenAIRE

Brown, Mark G.; Fernandes, Waldir B.; Spreen, Thomas H.; Lee, Jonq-Ying

2003-01-01

A demand system model differentiating goods by origin is developed to examine impacts of duty drawback on U.S. orange juice exports and prices. An empirical analysis suggests that on average duty drawback has increased annual orange juice exports by about 16.5 million SSE gallons or 11% of export sales, and has supported the U.S. price of orange juice by about 2 cents per gallon. Not all benefits of duty drawback go to exporters. Importers who own drawback credits but do not export product ma...

A Cross-Layer Duty Cycle MAC Protocol Supporting a Pipeline Feature for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Young-Chon Kim

2011-05-01

Full Text Available Although the conventional duty cycle MAC protocols for Wireless Sensor Networks (WSNs such as RMAC perform well in terms of saving energy and reducing end-to-end delivery latency, they were designed independently and require an extra routing protocol in the network layer to provide path information for the MAC layer. In this paper, we propose a new cross-layer duty cycle MAC protocol with data forwarding supporting a pipeline feature (P-MAC for WSNs. P-MAC first divides the whole network into many grades around the sink. Each node identifies its grade according to its logical hop distance to the sink and simultaneously establishes a sleep/wakeup schedule using the grade information. Those nodes in the same grade keep the same schedule, which is staggered with the schedule of the nodes in the adjacent grade. Then a variation of the RTS/CTS handshake mechanism is used to forward data continuously in a pipeline fashion from the higher grade to the lower grade nodes and finally to the sink. No extra routing overhead is needed, thus increasing the network scalability while maintaining the superiority of duty-cycling. The simulation results in OPNET show that P-MAC has better performance than S-MAC and RMAC in terms of packet delivery latency and energy efficiency.

19 CFR 122.117 - Requirements for transit air cargo transport.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Requirements for transit air cargo transport. 122... Requirements for transit air cargo transport. (a) Transportation—(1) Port to port. Transit air cargo may be... surface carrier for transport. Otherwise, all shipments on the transit air cargo manifest shall be...

24-hour society and working environment; 24 jikan shakai to rodo kankyo

Energy Technology Data Exchange (ETDEWEB)

Fujita, Jun' ichi [Kansai Electric Power Corp., Osaka (Japan)

1999-07-25

Naturally, a human being has a rhythm with a period of about one day for hormone distribution and body temperature. This rhythm is called circadian rhythm. An ecological watch controlling this rhythm exists in supraoptic nucleus of brain, and its inherent period is clarified to be about 25 hours. Light, temperature, sound, smell and the like are the elements to improve arousal degree of brain and adjust the interior watch. However, a strong light does not only have the direct effect on improving immediately arousal degree and performance but can also shift the interior watch. Specifically, the interior watch becomes slower when a human body is bathed in an intensive light in midnight, whereas it becomes faster when bathed in an intensive light at daybreak. Consequently, this phenomenon can be used to shift the sleepy peak of a person on night duty from the working time to daytime sleeping time zone. The technology using light to improve arousal degree is utilized in space shuttles, atomic power plants, petroleum refineries and the like in USA. (NEDO)

The information activity of rail passenger information staff: a foundation for information system requirements

Directory of Open Access Journals (Sweden)

Martin Rose

2006-01-01

Full Text Available Introduction. This paper examines the goal-directed information activity of passenger information staff, working in the dynamic environment of rail network control. The explicit aim is to define a meaningful set of information system requirements. The report shows how dynamic situations may lead us to question a number of established theories of information science. Method. Passenger information officers (PIOs were observed on duty within the rail command and control headquarters. Observation sessions totally eight hours involved the manual recording of sequential information flows and the associated activity of PIOs. A semi-structured management interview was also conducted to provide further insight into the organizational context. Analysis. A viewpoint-oriented analysis technique was used to analyse sequential data captured during observation sessions. Event sequences that represent and explain the viewpoints were identified and elaborated into detailed scenario descriptions. Results. The analysis both supports and contests a number of established theories from information science. Additionally, a range of 'mandatory' and 'desirable' system requirements are derived from the scenario and viewpoint analyses. Conclusion. Dynamic situations have a significant impact on information behaviour which is not always predicted by current theories of information science.

Light-duty diesel engine development status and engine needs

Energy Technology Data Exchange (ETDEWEB)

1980-08-01

This report reviews, assesses, and summarizes the research and development status of diesel engine technology applicable to light-duty vehicles. In addition, it identifies specific basic and applied research and development needs in light-duty diesel technology and related health areas where initial or increased participation by the US Government would be desirable. The material presented in this report updates information provided in the first diesel engine status report prepared by the Aerospace Corporation for the Department of Energy in September, 1978.

High duty cycle to low duty cycle: echolocation behaviour of the hipposiderid bat Coelops frithii.

Science.gov (United States)

Ho, Ying-Yi; Fang, Yin-Ping; Chou, Cheng-Han; Cheng, Hsi-Chi; Chang, Hsueh-Wen

2013-01-01

Laryngeally echolocating bats avoid self-deafening (forward masking) by separating pulse and echo either in time using low duty cycle (LDC) echolocation, or in frequency using high duty cycle (HDC) echolocation. HDC echolocators are specialized to detect fluttering targets in cluttered environments. HDC echolocation is found only in the families Rhinolophidae and Hipposideridae in the Old World and in the New World mormoopid, Pteronotus parnellii. Here we report that the hipposiderid Coelops frithii, ostensibly an HDC bat, consistently uses an LDC echolocation strategy whether roosting, flying, or approaching a fluttering target rotating at 50 to 80 Hz. We recorded the echolocation calls of free-flying C. frithii in the field in various situations, including presenting bats with a mechanical fluttering target. The echolocation calls of C. frithii consisted of an initial narrowband component (0.5±0.3 ms, 90.6±2.0 kHz) followed immediately by a frequency modulated (FM) sweep (194 to 113 kHz). This species emitted echolocation calls at duty cycles averaging 7.7±2.8% (n = 87 sequences). Coelops frithii approached fluttering targets more frequently than did LDC bats (C.frithii, approach frequency  = 40.4%, n = 80; Myotis spp., approach frequency  = 0%, n = 13), and at the same frequency as sympatrically feeding HDC species (Hipposideros armiger, approach rate  = 53.3%, n = 15; Rhinolophus monoceros, approach rate  = 56.7%, n = 97). We propose that the LDC echolocation strategy used by C. frithii is derived from HDC ancestors, that this species adjusts the harmonic contents of its echolocation calls, and that it may use both the narrowband component and the FM sweep of echolocations calls to detect fluttering targets.

High duty cycle to low duty cycle: echolocation behaviour of the hipposiderid bat Coelops frithii.

Directory of Open Access Journals (Sweden)

Ying-Yi Ho

Full Text Available Laryngeally echolocating bats avoid self-deafening (forward masking by separating pulse and echo either in time using low duty cycle (LDC echolocation, or in frequency using high duty cycle (HDC echolocation. HDC echolocators are specialized to detect fluttering targets in cluttered environments. HDC echolocation is found only in the families Rhinolophidae and Hipposideridae in the Old World and in the New World mormoopid, Pteronotus parnellii. Here we report that the hipposiderid Coelops frithii, ostensibly an HDC bat, consistently uses an LDC echolocation strategy whether roosting, flying, or approaching a fluttering target rotating at 50 to 80 Hz. We recorded the echolocation calls of free-flying C. frithii in the field in various situations, including presenting bats with a mechanical fluttering target. The echolocation calls of C. frithii consisted of an initial narrowband component (0.5±0.3 ms, 90.6±2.0 kHz followed immediately by a frequency modulated (FM sweep (194 to 113 kHz. This species emitted echolocation calls at duty cycles averaging 7.7±2.8% (n = 87 sequences. Coelops frithii approached fluttering targets more frequently than did LDC bats (C.frithii, approach frequency  = 40.4%, n = 80; Myotis spp., approach frequency  = 0%, n = 13, and at the same frequency as sympatrically feeding HDC species (Hipposideros armiger, approach rate  = 53.3%, n = 15; Rhinolophus monoceros, approach rate  = 56.7%, n = 97. We propose that the LDC echolocation strategy used by C. frithii is derived from HDC ancestors, that this species adjusts the harmonic contents of its echolocation calls, and that it may use both the narrowband component and the FM sweep of echolocations calls to detect fluttering targets.

19 CFR 181.53 - Collection and waiver or reduction of duty under duty-deferral programs.

Science.gov (United States)

2010-04-01

... Canada or Mexico as reflected on the applicable Canadian or Mexican entry document (see § 181.47(c) (1... or Mexico or for entry into a Canadian or Mexican duty-deferral program. Such measures govern... the case of a withdrawal of the goods from a warehouse, the person who has the right to withdraw the...

Fixed Costs and Hours Constraints

Science.gov (United States)

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…

Kant’s concept of indirect duties and environmental ethics

Directory of Open Access Journals (Sweden)

Milene Consenso Tonetto

2017-12-01

Full Text Available The aim of this paper is to assess whether Kant’s moral theory is suitable to deal with our obligations to take care of nonhuman animals and the environment. Kant’s ethics distinguishes persons, that is, rational beings with unconditional values who are considered as ends in themselves, from things, which have only relative worth. In relation to nature as a whole and to nonrational beings, Kant argues that we have only indirect duties or duties with regard to them. According to some philosophers, Kant’s ethics has anthropocentric starting points which lead to speciesist conclusions. This paper will argue that indirect duties can be in accordance with nonhuman interests, such as the suffering of nonhuman animals, the preservation of species and ecosystems, and so on. Thus Kant’s moral philosophy may contribute to environmental ethics because it justifies at least animal welfare and environmental protections as constraints on unrestricted human action.

25 CFR 122.6 - Duties of the Osage Tribal Education Committee.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Duties of the Osage Tribal Education Committee. 122.6 Section 122.6 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES MANAGEMENT OF OSAGE JUDGMENT FUNDS FOR EDUCATION § 122.6 Duties of the Osage Tribal Education Committee. (a) For...

40 CFR 1042.605 - Dressing engines already certified to other standards for nonroad or heavy-duty highway engines...

Science.gov (United States)

2010-07-01

... regulations during their useful life, we may require you to recall them under 40 CFR part 85, 89, 92, or 1068... regard to which company manufactures the vessel or equipment. Show this as follows: (i) If you are the... test data on the appropriate marine duty cycles. You can include the data in your application for...

Duties of care on the Internet

NARCIS (Netherlands)

van Eijk, N.; van Engers, T.; Wiersma, C.; Jasserand, C.; Abel, W.

2011-01-01

Internet Service Providers currently find themselves in the spotlight, both in a national and international context, with regard to their relationship both with governments and other private parties, on for example questions of (civil) liability. The paper focuses on duties of care as concerns the

CERN restaurants: opening hours during summer

CERN Document Server

2016-01-01

In the summer, the three CERN restaurants remain open during their usual hours. On Monday 1st August and Thursday 8 September, the Restaurant 1 will be open from 7:00 a.m. to 10:00 p.m.   The satellites will be open as follows: Building 6: normal hours Building 13: normal hours Building 30: normal hours Building 40: closing at 4:30 p.m. instead of 5:00 pm Building 54: normal hours in July, closed in August Building 864: normal hours Building 865: normal hours Building 774: normal hours

Kant’s concept of indirect duties and environmental ethics

OpenAIRE

Milene Consenso Tonetto

2017-01-01

The aim of this paper is to assess whether Kant’s moral theory is suitable to deal with our obligations to take care of nonhuman animals and the environment. Kant’s ethics distinguishes persons, that is, rational beings with unconditional values who are considered as ends in themselves, from things, which have only relative worth. In relation to nature as a whole and to nonrational beings, Kant argues that we have only indirect duties or duties with regard to them. According to some philosoph...

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

Science.gov (United States)

2012-07-26

... receive more frequent payments than every two weeks. The Contractor shall substantiate vouchers (including...] 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...

Corporate Moral Duties: Consequentialism, Collective Moral Agency and the “Ought” Implies “Can” Maxim

Directory of Open Access Journals (Sweden)

Leandro Martins Zanitelli

2013-12-01

Full Text Available The claim according to which corporations are morally responsible is a controversial one. At the same time, it is nowadays common to assign moral duties to companies, especially in work confronting the business and human rights issue. Can companies bear moral duties without being morally responsible? This article presents three different accounts of the duty to follow the course of action with the best consequences (consequentialist duty. The ascription of that duty to business is compatible with the claim that, by not being volitional agents, companies are not morally responsible for anything they do. The paper also addresses two possible objections against the claim that companies bear the duty of taking the course of action with the best consequences. These objections state that corporations are incapable of acting, be it in a general way (i.e. corporations do not possess the moral status of agents, be it regarding particular acts (the objection grounded on the “ought” implies “can” maxim.

77 FR 73424 - Steel Wire Garment Hangers From Taiwan: Antidumping Duty Order

Science.gov (United States)

2012-12-10

... materially injuring a U.S. industry, all unliquidated entries of such merchandise from Taiwan, entered or... From Taiwan: Antidumping Duty Order AGENCY: Import Administration, International Trade Administration... ``ITC''), the Department is issuing an antidumping duty order on steel wire garment hangers from Taiwan...

Motivations for Weight Loss Among Active Duty Military Personnel.

Science.gov (United States)

Maclin-Akinyemi, Courtney; Krukowski, Rebecca A; Kocak, Mehmet; Talcott, G Wayne; Beauvais, Alexis; Klesges, Robert C

2017-09-01

Rates of overweight and obesity among Active Duty Military Personnel remain high despite fitness test requirements, negative consequences of fitness test failure, and emphasis on weight and appearance standards. Specific motivating factors for weight loss influence weight loss program interest and often differ by gender, race, ethnicity, or age. This study investigates the weight loss motivations endorsed by a diverse population of Active Duty Military Personnel initiating a behavioral weight loss study, to inform the development of future recruitment efforts and program development. Active Duty Military Personnel (n = 248) completed a 16-item questionnaire of weight loss motivations before initiating a behavioral weight loss study. We evaluated endorsement patterns by demographic characteristics (body mass index [BMI], gender, race, ethnicity, age, and military rank). Data collection for this study was approved by the Institutional Review Board of Wilford Hall Ambulatory Surgical Center and acknowledged by the Institutional Review Board of the University of Tennessee Health Science Center. Results indicated that improved physical health, improved fitness, improved quality of life, and to live long were endorsed as "very important" motivations by at least three-fourths of the sample. "To pass the fitness test" was endorsed less frequently as a "very important" motivation, by 69% of the sample. A greater proportion of women as compared to men endorsed being very motivated by improving mood/well-being, quality of life, physical mobility, job performance, appearance, and sex life, as well as fitting into clothes. Participants categorized in the "Other" racial group and African Americans more frequently endorsed motivations to improve fitness and physical strength when compared to Caucasians. Moreover, participants in the "Other" race category were significantly more likely to rate their ability to physically defend themselves, improve physical mobility, and improve

PROHIBITION TO ENGAGE IN A DUTY OR PROFESSION IN CROATIAN CRIMINAL LAW

Directory of Open Access Journals (Sweden)

Igor Vuletić

2017-07-01

Full Text Available This paper deals with theoretical and practical issues concerning security measure of prohibition to engage in a duty or profession. Author discusses the purpose of this sanction, analyses legal requirements for imposing the sanction and suggests possible changes of the law de lege ferenda. Additionally, the author describes a few controversial questions concerning this sanction, such as the possibility of life imposing, its application in cases of tax evasion, the relationship with prohibition to operate a motor vehicle, and the question of supervision in practice. Finally, the author argues the quality of the existing provision.

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

Science.gov (United States)

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.

Influence of methane emissions and vehicle efficiency on the climate implications of heavy-duty natural gas trucks.

Science.gov (United States)

Camuzeaux, Jonathan R; Alvarez, Ramón A; Brooks, Susanne A; Browne, Joshua B; Sterner, Thomas

2015-06-02

While natural gas produces lower carbon dioxide emissions than diesel during combustion, if enough methane is emitted across the fuel cycle, then switching a heavy-duty truck fleet from diesel to natural gas can produce net climate damages (more radiative forcing) for decades. Using the Technology Warming Potential methodology, we assess the climate implications of a diesel to natural gas switch in heavy-duty trucks. We consider spark ignition (SI) and high-pressure direct injection (HPDI) natural gas engines and compressed and liquefied natural gas. Given uncertainty surrounding several key assumptions and the potential for technology to evolve, results are evaluated for a range of inputs for well-to-pump natural gas loss rates, vehicle efficiency, and pump-to-wheels (in-use) methane emissions. Using reference case assumptions reflecting currently available data, we find that converting heavy-duty truck fleets leads to damages to the climate for several decades: around 70-90 years for the SI cases, and 50 years for the more efficient HPDI. Our range of results indicates that these fuel switches have the potential to produce climate benefits on all time frames, but combinations of significant well-to-wheels methane emissions reductions and natural gas vehicle efficiency improvements would be required.

Determination of the duty cycle of WLAN for realistic radio frequency electromagnetic field exposure assessment.

Science.gov (United States)

Joseph, Wout; Pareit, Daan; Vermeeren, Günter; Naudts, Dries; Verloock, Leen; Martens, Luc; Moerman, Ingrid

2013-01-01

Wireless Local Area Networks (WLANs) are commonly deployed in various environments. The WLAN data packets are not transmitted continuously but often worst-case exposure of WLAN is assessed, assuming 100% activity and leading to huge overestimations. Actual duty cycles of WLAN are thus of importance for time-averaging of exposure when checking compliance with international guidelines on limiting adverse health effects. In this paper, duty cycles of WLAN using Wi-Fi technology are determined for exposure assessment on large scale at 179 locations for different environments and activities (file transfer, video streaming, audio, surfing on the internet, etc.). The median duty cycle equals 1.4% and the 95th percentile is 10.4% (standard deviation SD = 6.4%). Largest duty cycles are observed in urban and industrial environments. For actual applications, the theoretical upper limit for the WLAN duty cycle is 69.8% and 94.7% for maximum and minimum physical data rate, respectively. For lower data rates, higher duty cycles will occur. Although counterintuitive at first sight, poor WLAN connections result in higher possible exposures. File transfer at maximum data rate results in median duty cycles of 47.6% (SD = 16%), while it results in median values of 91.5% (SD = 18%) at minimum data rate. Surfing and audio streaming are less intensively using the wireless medium and therefore have median duty cycles lower than 3.2% (SD = 0.5-7.5%). For a specific example, overestimations up to a factor 8 for electric fields occur, when considering 100% activity compared to realistic duty cycles. Copyright © 2012 Elsevier Ltd. All rights reserved.

46 CFR 97.15-55 - Requirements for fuel oil.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Requirements for fuel oil. 97.15-55 Section 97.15-55... OPERATIONS Tests, Drills, and Inspections § 97.15-55 Requirements for fuel oil. (a) It shall be the duty of the chief engineer to cause an entry in the log to be made of each supply of fuel oil received on...

46 CFR 78.17-75 - Requirements for fuel oil.

Science.gov (United States)

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Requirements for fuel oil. 78.17-75 Section 78.17-75..., Drills, and Inspections § 78.17-75 Requirements for fuel oil. (a) It shall be the duty of the chief engineer to cause an entry in the log be made of each supply of fuel oil received on board, stating the...

Comparing cycling world hour records, 1967-1996: modeling with empirical data.

Science.gov (United States)

Bassett, D R; Kyle, C R; Passfield, L; Broker, J P; Burke, E R

1999-11-01

The world hour record in cycling has increased dramatically in recent years. The present study was designed to compare the performances of former/current record holders, after adjusting for differences in aerodynamic equipment and altitude. Additionally, we sought to determine the ideal elevation for future hour record attempts. The first step was constructing a mathematical model to predict power requirements of track cycling. The model was based on empirical data from wind-tunnel tests, the relationship of body size to frontal surface area, and field power measurements using a crank dynamometer (SRM). The model agreed reasonably well with actual measurements of power output on elite cyclists. Subsequently, the effects of altitude on maximal aerobic power were estimated from published research studies of elite athletes. This information was combined with the power requirement equation to predict what each cyclist's power output would have been at sea level. This allowed us to estimate the distance that each rider could have covered using state-of-the-art equipment at sea level. According to these calculations, when racing under equivalent conditions, Rominger would be first, Boardman second, Merckx third, and Indurain fourth. In addition, about 60% of the increase in hour record distances since Bracke's record (1967) have come from advances in technology and 40% from physiological improvements. To break the current world hour record, field measurements and the model indicate that a cyclist would have to deliver over 440 W for 1 h at sea level, or correspondingly less at altitude. The optimal elevation for future hour record attempts is predicted to be about 2500 m for acclimatized riders and 2000 m for unacclimatized riders.

Surface Weather Observations Hourly

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard hourly observations taken at Weather Bureau/National Weather Service offices and airports throughout the United States. Hourly observations began during the...

SMART Optimization of a Parenting Program for Active Duty Families

Science.gov (United States)

2017-10-01

child and caregiver outcomes over time, based on a sample of 200 military personnel and their co- parents who have recently or will soon separate from...AWARD NUMBER: W81XWH-16-1-0407 TITLE: SMART Optimization of a Parenting Program for Active Duty Families PRINCIPAL INVESTIGATOR: Abigail...Optimization of a Parenting Program for Active Duty 5a. CONTRACT NUMBER Families 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Abigail

Work Health & Safety legislation; the fire engineer’s neglected duty?

OpenAIRE

P.A. (Tony) Enright

2014-01-01

Fire engineers are in general, aware of their duties under Building legislation. However, they are often unfamiliar of separate duties under Work Health and Safety legislation. This paper describes an Australian case-study, but one that is presented generally so as to have applicability in those other jurisdictions where similar Work Health and Safety obligations exist. As society becomes safer, Work Health and Safety has evolved from being solely about the employer–employee relationshi...

Real-world NOx emissions of Euro V and Euro VI heavy duty vehicles

Energy Technology Data Exchange (ETDEWEB)

Vermeulen, R.; Dekker, H.; Vonk, W.

2012-04-15

TNO regularly performs measurements to determine the in-service performance and durability with respect to the pollutant emissions of heavy-duty vehicles under representative driving conditions. The 2011 measurement programme yields new insights regarding the emission performance of the upcoming Euro VI technology for heavy-duty vehicles, mandatory as of 31 December 2013 and, together with the results from earlier performed programmes, leads to conclusions on the emission performance of past and present generations of heavy-duty vehicles (Euro V, EEV)

Sports and Recreational Injuries in Relation to Lost Duty Time Among Deployed U.S. Marine Corps Personnel

Science.gov (United States)

2011-06-07

Lost Duty Time 6 standardized residuals of cells were examined to determine which cells had observed counts sizably different from expected counts...exploratory analysis) was used as the criterion to indicate that a cell had more (positive residual) or less (negative residual) observed events than...and supplies. These activities require lower body strength, stamina , and core strength that would be impaired by injuries to the lower extremities

Powers and Duties of Corporate Affairs Commission

African Journals Online (AJOL)

Mofasony

POWERS AND DUTIES OF THE CORPORATE AFFAIRS. COMMISSION ... The Registrar-General is the Chief Executive of the Commission and is saddled .... Federal Board of Inland Revenue Department of the Ministry of Finance v). Register ...

Going on holiday? Travelling on duty? Do you know what to do if your mobile phone is lost or stolen?

CERN Multimedia

2015-01-01

It’s summertime and many of us will be going on holiday, perhaps far away from Geneva. Duty travel also takes many of us far away from CERN from time to time. You probably know how to cancel your credit cards if they are lost or stolen, but do you know how to block your CERN mobile phone from use?   Recently, one user waited until returning to CERN to block theirs which was enough time for the thief to run up a substantial phone bill. Please make sure the same doesn’t happen to you! If your phone is lost or stolen: during working hours: call the Telecom Lab on +41 22 767 2480 or the CERN Switchboard on +41 22 767 6111 as soon as possible and provide: - your telephone number, - your name / first name / department. outside working hours: call the Swisscom hotline as soon as possible on: - +41 800 55 64 64 (in Switzerland) or, - +41 62 286 12 12 (outside Switzerland). You will also need to report the loss or theft in accordance with CERN’s offic...

Folding Proteins at 500 ns/hour with Work Queue.

Science.gov (United States)

Abdul-Wahid, Badi'; Yu, Li; Rajan, Dinesh; Feng, Haoyun; Darve, Eric; Thain, Douglas; Izaguirre, Jesús A

2012-10-01

Molecular modeling is a field that traditionally has large computational costs. Until recently, most simulation techniques relied on long trajectories, which inherently have poor scalability. A new class of methods is proposed that requires only a large number of short calculations, and for which minimal communication between computer nodes is required. We considered one of the more accurate variants called Accelerated Weighted Ensemble Dynamics (AWE) and for which distributed computing can be made efficient. We implemented AWE using the Work Queue framework for task management and applied it to an all atom protein model (Fip35 WW domain). We can run with excellent scalability by simultaneously utilizing heterogeneous resources from multiple computing platforms such as clouds (Amazon EC2, Microsoft Azure), dedicated clusters, grids, on multiple architectures (CPU/GPU, 32/64bit), and in a dynamic environment in which processes are regularly added or removed from the pool. This has allowed us to achieve an aggregate sampling rate of over 500 ns/hour. As a comparison, a single process typically achieves 0.1 ns/hour.

Duties, Oughts and Jesse Prinz’s Agent-Relativism

Directory of Open Access Journals (Sweden)

Marco Antônio Oliveira de Azevedo

2013-12-01

Full Text Available http://dx.doi.org/10.5007/1677-2954.2013v12n2p143 In The Emotional Construction of Morals (2007, Jesse Prinz offers a coherent naturalist approach on the foundations of human moral normativity. He classifies his view as a sensibility theory, a realist approach conspicuously opposed to the anti-realist bent of traditional emotivism. I sympathize with Prinz’s general approach; nevertheless, I have some specific disagreements. The first concerns the “is-ought” problem. I don’t think it is possible to build a realist, and a naturalist, approach in ethics without answering the famous problem with a positive stance. That is, without showing that it is actually possible to make the suspect transition—at least if we take “normativity” as a natural fact (as Hume, I think, actually thought. Here I will evaluate what I think are the main issues of Prinz’s approach. One issue that deserves to be commented on is the contrast between Prinz’s view and John Searle's well-known approach regarding the is-ought problem. Prinz thinks that Searle’s argument favouring the passage from an "is" to an "ought" is not cogent, but the correct understanding of Searle's argument requires assuming “obligations” (and duties as factual. Therefore, what a naturalist theory must explain is how it is possible to pass from the fact that one is under a particular obligation to the supposed required action (or, in more fashionable words, how duties can be “agent-relative reasons for action”. In effect, I will present my approach on the concept of “reason for action,” influenced by Judith Jarvis Thomson’s approach, and her distinction between “duties” and “oughts.” In the final section I will make some comments on the problem of relativism. I agree with Prinz that descriptive relativism is true; but Prinz is committed to a form of agent-relativism. I will present arguments against agent-relativism that depend on the acceptance of a clear

Light duty utility arm startup plan

International Nuclear Information System (INIS)

Barnes, G.A.

1998-01-01

This plan details the methods and procedures necessary to ensure a safe transition in the operation of the Light Duty Utility Arm (LDUA) System. The steps identified here outline the work scope and identify responsibilities to complete startup, and turnover of the LDUA to Characterization Project Operations (CPO)

Analysis of the Journal Bearing Friction Losses in a Heavy-Duty Diesel Engine

Directory of Open Access Journals (Sweden)

Christoph Knauder

2015-04-01

Full Text Available Internal combustion engines (ICE for the use in heavy-duty trucks and buses have to fulfil demanding requirements for both vehicle efficiency as well as for emission of greenhouse gases. Beside the piston assembly the journal bearings are among the largest contributors to friction in the ICE. Through a combination of measurements and validated simulation methods the journal bearing friction losses of a state-of-the-art heavy-duty Diesel engine are investigated for a large range of real world operating conditions. To this task recently developed and extensively validated simulation methods are used together with realistic lubricant models that consider the Non-Newtonian behaviour as well as the piezoviscous effect. In addition, the potential for further friction reduction with the use of ultra-low viscosity lubricants is explored. The results reveal a potential of about 8% friction reduction in the journal bearings using a 0W20 ultra-low viscosity oil with an HTHS-viscosity (The HTHS-viscosity is defined as the dynamic viscosity of the lubricant measured at 150 °C and at a shear rate of 106 s

29 CFR 541.700 - Primary duty.

Science.gov (United States)

2010-07-01

... other types of duties; the amount of time spent performing exempt work; the employee's relative freedom... employees for the kind of nonexempt work performed by the employee. (b) The amount of time spent performing.... Thus, employees who spend more than 50 percent of their time performing exempt work will generally...

Symptom Reporting Patterns of US Military Service Members with a History of Concussion According to Duty Status.

Science.gov (United States)

Lu, Lisa H; Cooper, Doug B; Reid, Matthew W; Khokhar, Bilal; Tsagaratos, Jennifer E; Kennedy, Jan E

2018-03-28

To compare symptom reporting patterns of service members with a history of concussion based on work status: full duty, limited duty, or in the Medical Evaluation Board (MEB)/disability process. Retrospective analysis of 181 service members with a history of concussion (MEB n = 56; limited duty n = 62; full duty n = 63). Neurobehavioral Symptom Inventory (NSI) Validity-10 cutoff (>22) and Mild Brain Injury Atypical Symptoms Scale (mBIAS) cutoffs (≥10 and ≥8) were used to evaluate potential over-reporting of symptoms. The MEB group displayed significantly higher NSI scores and significantly higher proportion scored above the mBIAS ≥10 cutoff (MEB = 15%; limited duty = 3%; full duty = 5%). Validity-10 cutoff did not distinguish between groups. MEB but not limited duty status was associated with increased risk of over-reporting symptoms in service members with a history of concussion. Results support the use of screening measures for over-reporting in the MEB/disability samples.

19 CFR 4.70 - Public Health Service requirements.

Science.gov (United States)

2010-04-01

... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service. [T.D. 00-4, 65 FR 2874, Jan. 19, 2000] ...

76 FR 7813 - Amended Final Results of the 2008-2009 Antidumping Duty Administrative Review: Pure Magnesium...

Science.gov (United States)

2011-02-11

... 2008-2009 Antidumping Duty Administrative Review: Pure Magnesium From the People's Republic of China... Final Results of the 2008-2009 administrative review of the antidumping duty order on pure magnesium... calculation of the antidumping duty margin for Tianjin Magnesium International Co., Ltd. (``TMI''), pursuant...

On-road heavy-duty diesel particulate matter emissions modeled using chassis dynamometer data.

Science.gov (United States)

Kear, Tom; Niemeier, D A

2006-12-15

This study presents a model, derived from chassis dynamometer test data, for factors (operational correction factors, or OCFs) that correct (g/mi) heavy-duty diesel particle emission rates measured on standard test cycles for real-world conditions. Using a random effects mixed regression model with data from 531 tests of 34 heavy-duty vehicles from the Coordinating Research Council's E55/E59 research project, we specify a model with covariates that characterize high power transient driving, time spent idling, and average speed. Gram per mile particle emissions rates were negatively correlated with high power transient driving, average speed, and time idling. The new model is capable of predicting relative changes in g/mi on-road heavy-duty diesel particle emission rates for real-world driving conditions that are not reflected in the driving cycles used to test heavy-duty vehicles.

78 FR 2868 - Draft Environmental Assessment for Rulemaking To Establish Minimum Sound Requirements for Hybrid...

Science.gov (United States)

2013-01-14

... require hybrid and electric passenger cars, light trucks, medium and heavy duty trucks and buses, low... Sound Requirements for Hybrid and Electric Vehicles AGENCY: National Highway Traffic Safety... minimum sound requirements for hybrid and electric vehicles. DATES: Comments must be received on or before...

Producing Daily and Embedded Hourly Rainfall Data Using a Novel Weather Generator

Directory of Open Access Journals (Sweden)

Ching-Pin Tung

2013-01-01

Full Text Available The number of worldwide extreme drought and flood events has risen significantly in recent years. Many studies confer that climate change may cause more intensive and extreme events. Simulating the impact of climate change often requires weather data as inputs to assessment models. Stochastic weather generators have been developed to produce weather data with the same temporal resolution based on the outputs of GCMs. Reservoir simulation normally uses operational rules in daily and hourly time steps for water supply and flood reduction, respectively. Simulating consecutive drought and flood events simultaneously requires a weather generator to produce different temporal resolution data. This work develops a continuous weather generator to generate daily and hourly precipitation data for regular wet days and severe storms, respectively. Daily rainfall data is generated for regular wet days using Exponential distribution or Weibull distribution, while the total rainfall data for severe storms is generated using the Pearson type III or Log Pearson type III distribution. Moreover, hourly rainfall is determined based on generated hyetographs. Simulation results indicate that the proposed continuous weather generator can generate daily and hourly rainfall reasonably. The proposed weather generator is thus highly promising for use in evaluating how climate change impacts reservoir operations that are significantly influenced by more frequent and intensive consecutive drought and flood events.

78 FR 57129 - Certain Pasta From Italy and Turkey: Continuation of Antidumping and Countervailing Duty Orders

Science.gov (United States)

2013-09-17

...-806] Certain Pasta From Italy and Turkey: Continuation of Antidumping and Countervailing Duty Orders... antidumping duty (AD) orders on certain pasta from Italy and Turkey would likely lead to continuation or recurrence of dumping, that revocation of the countervailing duty (CVD) orders on certain pasta from Italy...

8 CFR 208.5 - Special duties toward aliens in custody of DHS.

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Special duties toward aliens in custody of DHS. 208.5 Section 208.5 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION... duties toward aliens in custody of DHS. (a) General. When an alien in the custody of DHS requests asylum...

Breach of duty: Power of shareholders to ratify directors fraudulent dealings

Directory of Open Access Journals (Sweden)

Anthony O. Nwafor

2014-07-01

Full Text Available Company directors owe duty of loyalty to the company which prohibits them from fraudulent dealings in the course of conducting the affairs of the company. Although the shareholders could, in the exercise of their voting powers, grant relieves to the directors from liabilities arising from a breach of duty that amounts to fraud, the extent and capacity in which the shareholders could exercise such powers is confounded by the elusive attempts by the courts in defining fraud. The paper argues that without a definite meaning ascribed to fraud, the power and capacity in which the shareholders could ratify a breach of duty arising from self-dealing and expropriation of corporate opportunities by directors cannot be predetermined, but that each case would be based on the peculiarities of its own facts.

Learning to be a midwife in the clinical environment; tasks, clinical practicum hours or midwifery relationships.

Science.gov (United States)

Ebert, Lyn; Tierney, Olivia; Jones, Donovan

2016-01-01

Discussions continue within the midwifery profession around the number of and type of clinical experiences required to ensure competent midwifery graduates. Introduction of the three year Bachelor of Midwifery in Australia, almost two decades ago, was intended to reduce the pressure students were under to complete their academic requirements whilst ensuring students developed midwifery practice that encapsulates the philosophical values of midwifery. Currently, midwifery students are mandated to achieve a minimum number of clinical skills and Continuity of Care Experience (CCE) relationships in order to register upon completion of their degree. To achieve these experiences, universities require students to complete a number of clinical practicum hours. Furthermore students are required to demonstrate competent clinical performance of a number of clinical skills. However, there is no evidence to date that a set number of experiences or hours ensures professional competence in the clinical environment. The aim of this paper is to promote discussion regarding the mandated requirements for allocated clinical practicum hours, specified numbers of clinical-based skills and CCE relationships in the context of learning to be a midwife in Australia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Hourly distributions of the diffuse fraction of global solar irradiation in Cordoba (Spain)