WorldWideScience

Sample records for providing hourly values

  1. Resolving issues concerning Eskdalemuir geomagnetic hourly values

    Directory of Open Access Journals (Sweden)

    S. Macmillan

    2011-02-01

    Full Text Available The hourly values of the geomagnetic field from 1911 to 1931 derived from measurements made at Eskdalemuir observatory in the UK, and available online from the World Data Centre for Geomagnetism at http://www.wdc.bgs.ac.uk/, have now been corrected. Previously they were 2-point averaged and transformed from the original north, east and vertical down values in the tables in the observatory yearbooks. This paper documents the course of events from discovering the post-processing done to the data to the final resolution of the problem. As it was through the development of a new index, the Inter-Hour Variability index, that this post-processing came to light, we provide a revised series of this index for Eskdalemuir and compare it with that from another European observatory. Conclusions of studies concerning long-term magnetic field variability and inferred solar variability, whilst not necessarily consistent with one another, are not obviously invalidated by the incorrect hourly values from Eskdalemuir. This series of events illustrates the challenges that lie ahead in removing any remaining errors and inconsistencies in the data holdings of different World Data Centres.

  2. Duty Hour Reporting: Conflicting Values in Professionalism.

    Science.gov (United States)

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

    2015-09-01

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

  3. Determination of maximum physiologic thyroid uptake and correlation with 24-hour RAI uptake value

    International Nuclear Information System (INIS)

    Duldulao, M.; Obaldo, J.

    2007-01-01

    Full text: In hyperthyroid patients, thyroid uptake values are overestimated, sometimes approaching or exceeding 100%. This is physiologically and mathematically impossible. This study was undertaken to determine the maximum physiologic thyroid uptake value through a proposed simple method using a gamma camera. Methodology: Twenty-two patients (17 females and 5 males), with ages ranging from 19-61 y/o (mean age ± SD; 41 ± 12), with 24-hour uptake value of >50%, clinically hyperthyroid and referred for subsequent radioactive iodine therapy were studied. The computed maximum physiologic thyroid uptake was compared with the 24-hour uptake using the paired Student t-test and evaluated using linear regression analysis. Results: The computed physiologic uptake correlated poorly with the 24-hour uptake value. However, in the male subgroup, there was no statistically significant difference between the two (p=0.77). Linear regression analysis gives the following relationship: physiologic uptake (%) = 77.76 - 0.284 (24-hour RAI uptake value). Conclusion: Provided that proper regions of interest are applied with correct attenuation and background subtraction, determination of physiologic thyroid uptake may be obtained using the proposed method. This simple method may be useful prior to I-131 therapy for hyperthyroidism especially when a single uptake determination is performed. (author)

  4. Forecasting Kp from solar wind data: input parameter study using 3-hour averages and 3-hour range values

    Science.gov (United States)

    Wintoft, Peter; Wik, Magnus; Matzka, Jürgen; Shprits, Yuri

    2017-11-01

    We have developed neural network models that predict Kp from upstream solar wind data. We study the importance of various input parameters, starting with the magnetic component Bz, particle density n, and velocity V and then adding total field B and the By component. As we also notice a seasonal and UT variation in average Kp we include functions of day-of-year and UT. Finally, as Kp is a global representation of the maximum range of geomagnetic variation over 3-hour UT intervals we conclude that sudden changes in the solar wind can have a big effect on Kp, even though it is a 3-hour value. Therefore, 3-hour solar wind averages will not always appropriately represent the solar wind condition, and we introduce 3-hour maxima and minima values to some degree address this problem. We find that introducing total field B and 3-hour maxima and minima, derived from 1-minute solar wind data, have a great influence on the performance. Due to the low number of samples for high Kp values there can be considerable variation in predicted Kp for different networks with similar validation errors. We address this issue by using an ensemble of networks from which we use the median predicted Kp. The models (ensemble of networks) provide prediction lead times in the range 20-90 min given by the time it takes a solar wind structure to travel from L1 to Earth. Two models are implemented that can be run with real time data: (1) IRF-Kp-2017-h3 uses the 3-hour averages of the solar wind data and (2) IRF-Kp-2017 uses in addition to the averages, also the minima and maxima values. The IRF-Kp-2017 model has RMS error of 0.55 and linear correlation of 0.92 based on an independent test set with final Kp covering 2 years using ACE Level 2 data. The IRF-Kp-2017-h3 model has RMSE = 0.63 and correlation = 0.89. We also explore the errors when tested on another two-year period with real-time ACE data which gives RMSE = 0.59 for IRF-Kp-2017 and RMSE = 0.73 for IRF-Kp-2017-h3. The errors as function

  5. 8 Hour Ozone Design Value for 1998-2000

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Ozone design value is based on the average of the annual 4th highest daily 8-hour maximum over a 3-year period (1998-2000) in this case. This is a human health...

  6. Geomagnetic Absolute Mean Values at Hourly Intervals from 220 Observatories Worldwide

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This file is comprised of absolute mean hourly values of the geomagnetic components D, H and Z or X, Y and Z. These values, on magnetic tape, are available from...

  7. 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.

  8. Work Hours, Social Value of Leisure and Globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Nielsen, Jørgen Ulff-Møller; Montagna, Catia

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure...... to be increasing in the leisure time taken by other workers. Coordination takes the form of internalising the leisure externality and other relevant constraints (e.g., labour demand). The extent of openness is measured by the degree of capital mobility. We find that: coordination lowers equilibrium work hours...... and raises the wage rate; there is a U-shaped (inverse-U-shaped) relationship between work hours (wages) and the degree of coordination; coordination is welfare improving; and, the gap between the coordinated and uncoordinated work hours (and the corresponding wage rates) is affected by the extent and nature...

  9. Work Hours, Social Value of Leisure and Globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Molana, Hassan; Montagna, Catia

    2010-01-01

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure...... to be increasing in the leisure time taken by other workers. Coordination takes the form of internalising the leisure externality and other relevant constraints (e.g., labour demand). The extent of openness is measured by the degree of capital mobility. We find that: coordination lowers equilibrium work hours...... and raises the wage rate; there is a U-shaped (inverse-U-shaped) relationship between work hours (wages) and the degree of coordination; coordination is welfare improving; and, the gap between the coordinated and uncoordinated work hours (and the corresponding wage rates) is affected by the extent and nature...

  10. Work hours, social value of leisure and globalisation

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Molana, Hassan; Montagna, Catia

    2012-01-01

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker’s marginal utility of leisure...... to be increasing in the leisure time taken by other workers. Coordination takes the form of internalising the leisure externality and other relevant constraints (e.g., labour demand). The extent of openness is measured by the degree of capital mobility. We find that: coordination lowers equilibrium work hours...... and raises the wage rate; there is a U-shaped (inverse-U-shaped) relationship between work hours (wages) and the degree of coordination; coordination is welfare improving; and, the gap between the coordinated and uncoordinated work hours (and the corresponding wage rates) is affected by the extent and nature...

  11. Low-Value Service Use in Provider Organizations.

    Science.gov (United States)

    Schwartz, Aaron L; Zaslavsky, Alan M; Landon, Bruce E; Chernew, Michael E; McWilliams, J Michael

    2018-02-01

    To assess whether provider organizations exhibit distinct profiles of low-value service provision. 2007-2011 Medicare fee-for-service claims and enrollment data. Use of 31 services that provide minimal clinical benefit was measured for 4,039,733 beneficiaries served by 3,137 provider organizations. Variation across organizations, persistence within organizations over time, and correlations in use of different types of low-value services within organizations were estimated via multilevel modeling, with adjustment for beneficiary sociodemographic and clinical characteristics. Organizations provided 45.6 low-value services per 100 beneficiaries on average, with considerable variation across organizations (90th/10th percentile ratio, 1.78; 95 percent CI, 1.72-1.84), including substantial between-organization variation within hospital referral regions (90th/10th percentile ratio, 1.66; 95 percent CI, 1.60-1.71). Low-value service use within organizations was highly correlated over time (r, 0.98; 95 percent CI, 0.97-0.99) and positively correlated between 13 of 15 pairs of service categories (average r, 0.26; 95 percent CI, 0.24-0.28), with the greatest correlation between low-value imaging and low-value cardiovascular testing and procedures (r, 0.54). Use of low-value services in provider organizations exhibited substantial variation, high persistence, and modest consistency across service types. These findings are consistent with organizations shaping the practice patterns of affiliated physicians. © Health Research and Educational Trust.

  12. Value of travel time.

    Science.gov (United States)

    2016-08-01

    Knowingly or not, people generally place economic value on their time. Wage workers are paid a rate per hour, and service providers may charge per hour of their time. In the transportation realm, travelers place a value on their travel time and have ...

  13. Comparing Color Change Value of Three Types of Composite Resins in Distilled Water during the First 24 Hours after Exposure to Light

    Directory of Open Access Journals (Sweden)

    S Afkhami

    2016-09-01

    Full Text Available BACKGROUND AND OBJECTIVE: Color change of composite resin restorations is one the most common causes for replacing these restorations, which might occur due to internal and external factors. This research was carried out to study and compare color change value of three types of composite resins in distilled water during the first 24 hours after exposure to light. METHODS: In this laboratory research, 120 samples were prepared from three types of composites (Z350, Z250 and Heliomolar and were divided into 3 groups of 40. Samples with 2 mm thickness and 7 mm diameter were prepared. After assessing the initial color by spectrophotometer, samples were exposed to distilled water for 1, 6, 12 and 24 hours, respectively. Then, the final color was assessed by EasyShade device and the color change value (ΔE was calculated for all samples. Moreover, ΔE<3.3 was clinically acceptable. FINDINGS: In 12h group, Heliomolar composite showed lowest color change value compared with two other composites (Z350=1.385, Z250=1.179 and Heliomolar=0.854 (p<0.05, while no significant difference was observed in other groups. Furthermore, lowest color change value in each composite was observed 1 hour after curing (Z350=0.352, Z250=0.641 and Heliomolar=0.298 and color change value increased 24 hours after curing (Z350=1.888, Z250=1.903 and Heliomolar=1.929. CONCLUSION: Results of the study revealed that color change value of all three composites in distilled water was less than 3.3 after 24 hours and it was clinically acceptable

  14. Averaging and sampling for magnetic-observatory hourly data

    Directory of Open Access Journals (Sweden)

    J. J. Love

    2010-11-01

    Full Text Available A time and frequency-domain analysis is made of the effects of averaging and sampling methods used for constructing magnetic-observatory hourly data values. Using 1-min data as a proxy for continuous, geomagnetic variation, we construct synthetic hourly values of two standard types: instantaneous "spot" measurements and simple 1-h "boxcar" averages. We compare these average-sample types with others: 2-h average, Gaussian, and "brick-wall" low-frequency-pass. Hourly spot measurements provide a statistically unbiased representation of the amplitude range of geomagnetic-field variation, but as a representation of continuous field variation over time, they are significantly affected by aliasing, especially at high latitudes. The 1-h, 2-h, and Gaussian average-samples are affected by a combination of amplitude distortion and aliasing. Brick-wall values are not affected by either amplitude distortion or aliasing, but constructing them is, in an operational setting, relatively more difficult than it is for other average-sample types. It is noteworthy that 1-h average-samples, the present standard for observatory hourly data, have properties similar to Gaussian average-samples that have been optimized for a minimum residual sum of amplitude distortion and aliasing. For 1-h average-samples from medium and low-latitude observatories, the average of the combination of amplitude distortion and aliasing is less than the 5.0 nT accuracy standard established by Intermagnet for modern 1-min data. For medium and low-latitude observatories, average differences between monthly means constructed from 1-min data and monthly means constructed from any of the hourly average-sample types considered here are less than the 1.0 nT resolution of standard databases. We recommend that observatories and World Data Centers continue the standard practice of reporting simple 1-h-average hourly values.

  15. Studies on the T sub 3 suppression test with reference to the thyrodial sup 123 I uptake in Graves' disease; Comparison of 24-hour and 3-hour uptake

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Takahiko; Kobayashi, Isao; Yamaguchi, Yoshiyuki; Iwashita, Akira; Inukai, Toshihiko; Ohshima, Kihachi; Shimomura, Yohnosuke; Kobayashi, Setsuo (Gunma Univ., Maebashi (Japan). School of Medicine)

    1990-06-01

    Eighty-three patients with Graves' disease had been treated with methylmercaptoimidazole (MMI). They were prescribed a maintenance dose of antithyroid drug (MMI, 5 mg/day) at the time of a T{sub 3} suppression test. The 3-hour and 24-hour thyroidal {sup 123}I uptake after T{sub 3} administration (75 {mu}g/day, 2 weeks) were measured (post T{sub 3} uptake). In 38 patients whose post T{sub 3} uptake was below 35% in post T{sub 3} 24-hour uptake, treatment was stopped. The T{sub 3} suppression test was then repeated 1 and 3 months later. During a one-year follow up, 26 remained well, while 12 relapsed within 6 to 12 months. We have observed a good correlation between 3-hour uptake and 24-hour uptake of {sup 123}I after T{sub 3} administration (r=0.847, p<0.001). In 38 patients who showed positive T{sub 3} suppression, most patients with MMI withdrawal produced a marked overshoot of post T{sub 3} 3-hour and 24-hour uptake at one month. Retrospective analysis indicated that there was no significant difference in circulating thyroid hormone levels between remission and relapse groups. The present study provides evidence that 3-hour uptake values are able to be substituted for 24-hour uptake values during a T{sub 3} suppression test. In addition, overshoot of thyroidal uptake after antithyroid drug withdrawal was observed in 3-hour values, similar to 24-hour values. (author).

  16. 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

  17. Value management program: performance, quantification, and presentation of imaging value-added actions.

    Science.gov (United States)

    Patel, Samir

    2015-03-01

    Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  18. How Academic Libraries Provide Value through Course Readings

    Science.gov (United States)

    Tabacaru, Simona; Hartnett, Eric

    2017-01-01

    Academic libraries are continually being asked to demonstrate their value. Showing benefits that provide financial value to the user community is one approach to meeting this challenge. With a focus on journal articles and monographs, the authors have analyzed course syllabi to determine the cost savings graduate students in psychology receive…

  19. 24-hour whole-body retention of sup(99m)Tc-diphosphonate

    International Nuclear Information System (INIS)

    Kapitola, J.

    1985-01-01

    A new method is described for the examination of bone tissue metabolism; a 24-hour retention of diphosphonate labelled with radioactive sup(99m)Tc (assessed using a whole-body counter or by estimation of the amount of labelled substance excreted in the course of 24 hours via the urine). The values are elevated in primary hyperparathyroidism, osteomalacia, generalized Paget's disease, multiple bone metastases; the values are not uniform in osteoporosis. The method is simple, sensitive and reliable (provided renal function is normal), suited for screening, as part of specialized osteological diagnosis as well as for repeated longitudinal investigations. (author)

  20. Work Hours, Social Value of Leisure and Globalisation

    OpenAIRE

    Hansen, Jørgen Drud; Molana, Hassan; Montagna, Catia; Ulff-Møller Nielsen, Jørgen

    2010-01-01

    We examine how openness interacts with the coordination of consumption-leisure decisions in determining the equilibrium working hours and wage rate when there are leisure externalities (e.g., due to social interactions). The latter are modelled by allowing a worker's marginal utility of leisure to be increasing in the leisure time taken by other workers. Coordination takes the form of internalising the leisure externality and other relevant constraints (e.g., labour demand). The extent of ope...

  1. Economic influences on GPs' decisions to provide out-of-hours care.

    Science.gov (United States)

    Geue, Claudia; Skåtun, Diane; Sutton, Matt

    2009-01-01

    Introduction of the new general medical services contract offered UK general practices the option to discontinue providing out-of-hours (OOH) care. This aimed to improve GP recruitment and retention by offering a better work-life balance, but put primary care organisations under pressure to ensure sustainable delivery of these services. Many organisations arranged this by re-purchasing provision from individual GPs. To analyse which factors influence an individual GP's decision to re-provide OOH care when their practice has opted out. Cross-sectional questionnaire survey. Rural and urban general practices in Scotland, UK. A postal survey was sent to all GPs working in Scotland in 2006, with analyses weighted for differential response rates. Analysis included logistic regression of individuals' decisions to re-provide OOH care based on personal characteristics, work and non-work time commitments, income from other sources, and contracting primary care organisation. Of the 1707 GPs in Scotland whose practice had opted out, 40.6% participated in OOH provision. Participation rates of GPs within primary care organisations varied from 16.7% to 74.7%. Males with young children were substantially more likely to participate than males without children (odds ratio [OR] 2.44, 95% confidence interval [CI] = 1.36 to 4.40). GPs with higher-earning spouses were less likely to participate. This effect was reinforced if GPs had spouses who were also GPs (OR 0.52, 95% CI = 0.37 to 0.74). GPs with training responsibilities (OR 1.36, 95% CI = 1.09 to 1.71) and other medical posts (OR 1.38, 95% CI = 1.09 to 1.75) were more likely to re-provide OOH services. The opportunity to opt out of OOH care has provided flexibility for GPs to raise additional income, although primary care organisations vary in the extent to which they offer these opportunities. Examining intrinsic motivation is an area for future study.

  2. Normal values of iodine - 131 uptake in 24 hours, in Rio Grande do Norte, Brazil

    International Nuclear Information System (INIS)

    Oliveira Filho, T.F. de; Oliveira, C.F.F. de

    Thorough clinical exams on all patients come to the radioisotope Laboratory at UFRN, where carried out attempting to select those patients with thyroids considered to be clinically normal. After wayne tests for hypo and hyperthyroidism were carried out, 100 patients were considered to be fit for the research. All of them had an impalpable and asympitomatic thyroid. Waynes clinical indices were precisely revealed in 93% of cases. It was concluded that the normal values of uptake of 131 I during the 24 hours in RGN varied between 14% and 44% [pt

  3. 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...

  4. Health Care Provider Value Chain

    OpenAIRE

    Kawczynski , Lukasz; Taisch , Marco

    2009-01-01

    International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...

  5. 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.

  6. 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.

  7. Supply and demand determine the market value of food providers in wild vervet monkeys.

    Science.gov (United States)

    Fruteau, Cécile; Voelkl, Bernhard; van Damme, Eric; Noë, Ronald

    2009-07-21

    Animals neither negotiate verbally nor conclude binding contracts, but nevertheless regularly exchange goods and services without overt coercion and manage to arrive at agreements over exchange rates. Biological market theory predicts that such exchange rates fluctuate according to the law of supply and demand. Previous studies showed that primates pay more when commodities become scarcer: subordinates groomed dominants longer before being tolerated at food sites in periods of shortage; females groomed mothers longer before obtaining permission to handle their infants when there were fewer newborns and males groomed fertile females longer before obtaining their compliance when fewer such females were present. We further substantiated these results by conducting a 2-step experiment in 2 groups of free-ranging vervet monkeys in the Loskop Dam Nature Reserve, South Africa. We first allowed a single low-ranking female to repeatedly provide food to her entire group by triggering the opening of a container and measured grooming bouts involving this female in the hour after she made the reward available. We then measured the shifts in grooming patterns after we added a second food container that could be opened by another low-ranking female, the second provider. All 4 providers received more grooming, relative to the amount of grooming they provided themselves. As biological market theory predicts, the initial gain of first providers was partially lost again after the introduction of a second provider in both groups. We conclude that grooming was fine-tuned to changes in the value of these females as social partners.

  8. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey.

    Science.gov (United States)

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-04-29

    To investigate the experience of users of out of hours general practitioner services in England, UK. Population based cross sectional postal questionnaire survey. General Practice Patient Survey 2012-13. Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial) and service users' experience of out of hours care (timeliness, confidence and trust in the out of hours clinician, and overall experience of the service), rated on a scale of 0-100. Which sociodemographic/provider characteristics were associated with service users' experience, the extent to which any observed differences could be because of clustering of service users of a particular sociodemographic group within poorer scoring providers, and the extent to which observed differences in experience varied across types of provider. The overall response rate was 35%; 971,232/2,750,000 patients returned surveys. Data from 902,170 individual service users were mapped through their registered practice to one of 86 providers of out of hours GP care with known organisation type. Commercial providers of out of hours GP care were associated with poorer reports of overall experience of care, with a mean difference of -3.13 (95% confidence interval -4.96 to -1.30) compared with not for profit providers. Asian service users reported lower scores for all three experience outcomes than white service users (mean difference for overall experience of care -3.62, -4.36 to -2.89), as did service users who were unable to take time away from work compared with service users who did not work (mean difference for overall experience of care -4.73, -5.29 to -4.17). Commercial providers of out of hours GP care were associated with poorer experience of care. Targeted interventions aimed at improving experience for patients from ethnic minorities and

  9. Analysis of death in major trauma: value of prompt post mortem computed tomography (pmCT) in comparison to office hour autopsy.

    Science.gov (United States)

    Schmitt-Sody, Markus; Kurz, Stefanie; Reiser, Maximilian; Kanz, Karl Georg; Kirchhoff, Chlodwig; Peschel, Oliver; Kirchhoff, Sonja

    2016-03-29

    To analyze diagnostic accuracy of prompt post mortem Computed Tomography (pmCT) in determining causes of death in patients who died during trauma room management and to compare the results to gold standard autopsy during office hours. Multiple injured patients who died during trauma room care were enrolled. PmCT was performed immediately followed by autopsy during office hours. PmCT and autopsy were analyzed primarily regarding pmCT ability to find causes of death and secondarily to define exact causes of death including accurate anatomic localizations. For the secondary analysis data was divided in group-I with equal results of pmCT and autopsy, group-II with autopsy providing superior results and group-III with pmCT providing superior information contributing to but not majorly causing death. Seventeen multiple trauma patients were enrolled. Since multiple trauma patients were enrolled more injuries than patients are provided. Eight patients sustained deadly head injuries (47.1%), 11 chest (64.7%), 4 skeletal system (23.5%) injuries and one patient drowned (5.8%). Primary analysis revealed in 16/17 patients (94.1%) causes of death in accordance with autopsy. Secondary analysis revealed in 9/17 cases (group-I) good agreement of autopsy and pmCT. In seven cases autopsy provided superior results (group-II) whereas in 1 case pmCT found more information (group-III). The presented work studied the diagnostic value of pmCT in defining causes of death in comparison to standard autopsy. Primary analysis revealed that in 94.1% of cases pmCT was able to define causes of death even if only indirect signs were present. Secondary analysis showed that pmCT and autopsy showed equal results regarding causes of death in 52.9%. PmCT is useful in traumatic death allowing for an immediate identification of causes of death and providing detailed information on bony lesions, brain injuries and gas formations. It is advisable to conduct pmCT especially in cases without consent to

  10. Month-hour distributions of zenith luminance and diffuse illuminance in Madrid

    International Nuclear Information System (INIS)

    Soler, Alfonso; Gopinathan, Kannam K.; Robledo, Luis; Ruiz, Enrique

    2004-01-01

    Month-hour equal mean zenith luminance contours are obtained from one year of data of zenith luminance measurements for cloudless, overcast and partly cloudy skies and also when the combined data for all sky types are considered. For many hours in different months, the overcast sky luminance values are roughly about three times the cloudless sky luminance values and one and a half times the partly cloudy sky values. The dependence of month-hour equal mean zenith luminance contours on the ratio of global to extraterrestrial illuminance on a horizontal surface is also given. From equal mean zenith luminance contours, the approximate values of the mean zenith luminance for different sky conditions and different hours and months of the year can be easily obtained. Month-hour equal mean diffuse illuminance contours are obtained from diffuse illuminance measurements performed during the period 1992-1998. The dependence on solar altitude of the monthly average hourly values of diffuse illuminance is given and compared to the corresponding one obtained from data for Bet Dagan (Israel)

  11. 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.

  12. Optimising Refined Bleached Deodorized Palm Stearin For Its Crude Stearic Acid Iodine Value To Provide The Stable Specification Of Blended Stearic Acid Distillate Iodine Value

    OpenAIRE

    Ritonga, Muhammad Yusuf

    2015-01-01

    On the commercial scale, the quality standard of Blended Stearic Acid Distilled (BSAD) couldn’t be achieved by normal distillation. BSAD iodine value is mostly higher than maximum quality standard (0.2 mg/100 g), with the same iodine value (0.80 g/100 g) of feed Hydrogenated Splitted RBDPS Fatty Acid or HSRBDPSFA, feed capacity 5.5 ton/hour with bottom flash distiller temperature reaching 213oC. The separation and reduction of chemical impurities (so sensitive to oxidation/temperature/heat ch...

  13. Determination of the 24-hours survival of stored red cells beyond the legal duration (42 and 49 days). Value of a double labelling

    International Nuclear Information System (INIS)

    Messian, O.; Noel, L.; Saint-Paul, B.; Fabre, G.; Saint-Blancard, J.

    1985-01-01

    Red cell double labelling using chromium 51 and Tc 99m proved to be the good method for the measurement of 24-hour post-transfusion survival values of red cells stored at 4 0 C. Satisfactory results were obtained with the preservative solution PAGGSS (Phosphate Adenine Guanosine Glucose Sorbitol Saline) for 42 and 49 days, and with ADSOL (Adenine Dextrose Saline Mannital) for 42 days. But for 49 days ADSOL does not maintain 24-hour post-transfusion survival of the cells at an acceptable level, 70 per cent, for this length of time [fr

  14. Living hours under pressure

    DEFF Research Database (Denmark)

    Ilsøe, Anna; Larsen, Trine Pernille; Felbo-Kolding, Jonas

    2017-01-01

    Purpose The purpose of this paper is to investigate the effect of part-time work on absolute wages. The empirical focus is wages and working hours in three selected sectors within private services in the Danish labour market – industrial cleaning, retail, hotels and restaurants – and their agreem......Purpose The purpose of this paper is to investigate the effect of part-time work on absolute wages. The empirical focus is wages and working hours in three selected sectors within private services in the Danish labour market – industrial cleaning, retail, hotels and restaurants...... in industrial cleaning includes a minimum floor of 15 weekly working hours – this is not the case in retail, hotels and restaurants. This creates a loophole in the latter two sectors that can be exploited by employers to gain wage flexibility through part-time work. Originality/value The living wage literature...

  15. The Persistence of Long Work Hours

    OpenAIRE

    Robert Drago; David Black; Mark Wooden

    2005-01-01

    Previous research hypothesizes that long working hours are related to consumerism, the ideal worker norm, high levels of human capital, and a high cost-of-job-loss. The authors test these hypotheses using panel data on working hours for an Australian sample of full-time employed workers. Analyses include a static cross-sectional model and a persistence model for long hours over time. The results suggest that long hours (50 or more hours in a usual week) are often persistent, and provide stron...

  16. Valuing environmental services provided by local stormwater management

    Science.gov (United States)

    Brent, Daniel A.; Gangadharan, Lata; Lassiter, Allison; Leroux, Anke; Raschky, Paul A.

    2017-06-01

    The management of stormwater runoff via distributed green infrastructures delivers a number of environmental services that go beyond the reduction of flood risk, which has been the focus of conventional stormwater systems. Not all of these services may be equally valued by the public, however. This paper estimates households' willingness to pay (WTP) for improvements in water security, stream health, recreational and amenity values, as well as reduction in flood risk and urban heat island effect. We use data from nearly 1000 personal interviews with residential homeowners in Melbourne and Sydney, Australia. Our results suggest that the WTP for the highest levels of all environmental services is A799 per household per year. WTP is mainly driven by residents valuing improvements in local stream health, exemptions in water restrictions, the prevention of flash flooding, and decreased peak urban temperatures respectively at A297, A244, A104 and A$65 per year. We further conduct a benefit transfer analysis and find that the WTP and compensating surplus are not significantly different between the study areas. Our findings provide additional support that stormwater management via green infrastructures have large nonmarket benefits and that, under certain conditions, benefit values can be transferred to different locations.

  17. 75 FR 285 - Hours of Service

    Science.gov (United States)

    2010-01-05

    ... flexibility would not increase safety risks or adversely impact driver health? 3. How many hours per day and... period long enough to provide restorative sleep regardless of the number of hours worked prior to the... No. FMCSA-2004-19608] RIN 2126-AB26 Hours of Service AGENCY: Federal Motor Carrier Safety...

  18. Standard deviation of wind direction as a function of time; three hours to five hundred seventy-six hours

    International Nuclear Information System (INIS)

    Culkowski, W.M.

    1976-01-01

    The standard deviation of horizontal wind direction sigma/sub theta/ increases with time of averaging up to a maximum value of 104 0 . The average standard deviation of horizontal wind directions averaged over periods of 3, 5, 10, 16, 24, 36, 48, 72, 144, 288, and 576 hours were calculated from wind data obtained from a 100 meter tower in the Oak Ridge area. For periods up to 100 hours, sigma/sub theta/ varies as t/sup .28/; after 100 hours sigma/sub theta/ varies as 6.5 ln t

  19. Predictive values of early rest/24 hour delay Tl-201 perfusion SPECT for wall motion improvement in patients with acute myocardial infarction after reperfusion

    International Nuclear Information System (INIS)

    Hyun, In Young; Kwan, June

    1998-01-01

    We studied early rest/24 hour delay Tl-201 perfusion SPECT for prediction of wall motion improvement after reperfusion in patients with acute myocardial infarction. Among 17 patients (male/female=11/6, age: 59±13) with acute myocardial infarction, 15 patients were treated with percutaneous transcoronary angioplasty (direct:2, delay:11) and intravenous urokinase (2). Spontaneous resolution occurred in infarct related arteries of 2 patients. We confirmed TIMI 3 flow of infarct-related artery after reperfusion in all patients with coronary angiography. We performed rest Tl-201 perfusion SPECT less then 6 hours after reperfusion and delay Tl-201 perfusion SPECT next day. Tl-201 uptake was visually graded as 4 point score from normal (0) to severe defect (3). Rest Tl-201 uptake ≤2 or combination of rest Tl-201 uptake ≤2 or late reversibility were considered to be viable. Myocardial wall motion was graded as 5 point score from normal (1) to dyskinesia (5). Myocardial wall motion was considered to be improved when a segment showed an improvement ≥1 grade in follow up echo compared with the baseline values. Among 98 segments with wall motion abnormality, the severity of myocardial wall motion decrease was as follow: mild hypokinesia: 18/98 (18%), severe hypokinesia: 28/98 (29%), akinesia: 51/98 (52%), dyskinesia: 1/98 (1%). The wall motion improved in 85%. Redistribution (13%), and reverse redistribution (4%) were observed in 24 hour delay SPECT. Positive predictive value (PPV) and negative predictive value (NPV) of combination of late reversibility and rest Tl-201uptake were 99%, and 54%.PPV and NPV of rest Tl-201 uptake were 100% and 52% respectively. Predictive values of comibination of rest Tl-201 uptake and late reversibility were not significantly different compared with predictive values of rest Tl-201 uptake only. We conclude that early Tl-201 perfusion SPECT predict myocardial wall motion improvement with excellent positive but relatively low negative

  20. Twenty-four hour care for schizophrenia.

    Science.gov (United States)

    Macpherson, Rob; Edwards, Thomas Rhys; Chilvers, Rupatharshini; David, Chris; Elliott, Helen J

    2009-04-15

    Despite modern treatment approaches and a focus on community care, there remains a group of people who cannot easily be discharged from psychiatric hospital directly into the community. Twenty-four hour residential rehabilitation (a 'ward-in-a-house') is one model of care that has evolved in association with psychiatric hospital closure programmes. To determine the effects of 24 hour residential rehabilitation compared with standard treatment within a hospital setting. We searched the Cochrane Schizophrenia Group Trials Register (May 2002 and February 2004). We included all randomised or quasi-randomised trials that compared 24 hour residential rehabilitation with standard care for people with severe mental illness. Studies were reliably selected, quality assessed and data extracted. Data were excluded where more than 50% of participants in any group were lost to follow-up. For binary outcomes we calculated the relative risk and its 95% confidence interval. We identified and included one study with 22 participants with important methodological shortcomings and limitations of reporting. The two-year controlled study evaluated "new long stay patients" in a hostel ward in the UK. One outcome 'unable to manage in the placement' provided usable data (n=22, RR 7.0 CI 0.4 to 121.4). The trial reported that hostel ward residents developed superior domestic skills, used more facilities in the community and were more likely to engage in constructive activities than those in hospital - although usable numerical data were not reported. These potential advantages were not purchased at a price. The limited economic data was not good but the cost of providing 24 hour care did not seem clearly different from the standard care provided by the hospital - and it may have been less. From the single, small and ill-reported, included study, the hostel ward type of facility appeared cheaper and positively effective. Currently, the value of this way of supporting people - which could be

  1. The Value of a Checklist for Child Abuse in Out-of-Hours Primary Care: To Screen or Not to Screen.

    Directory of Open Access Journals (Sweden)

    Maartje Cm Schouten

    Full Text Available To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions for child abuse at Out-of-hours Primary Care locations (OPC, by comparing the test outcome with information from Child Protection Services (CPS. Secondary, to determine whether reducing the length of the checklist compromises diagnostic value.All children (<18 years attending one of the participating OPCs in the region of Utrecht, the Netherlands, in a year time, were included. The checklist is an obligatory field in the electronic patient file. CPS provided data on all checklist positives and a sample of 5500 checklist negatives (dataset. The checklist outcome was compared with a report to CPS in 10 months follow up after the OPC visit.The checklist was filled in for 50671 children; 108 (0.2% checklists were positive. Within the dataset, 61 children were reported to CPS, with emotional neglect as the most frequent type of abuse (32.8%. The positive predictive value (PPV of the checklist for child abuse was 8.3 (95% CI 3.9-15.2. The negative predictive value (NPV was 99.1 (98.8-99.3, with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3, the PPV was 9.1 (3.7-17.8 and the NPV 99.1 (98.7-99.3. These two questions are on the injury in relation to the history, and the interaction between child and parents.The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument.

  2. Examination of why some community pharmacists do not provide 72-hour emergency prescription drugs to Medicaid patients when prior authorization is not available.

    Science.gov (United States)

    Shepherd, Marvin D

    2013-09-01

    independent pharmacy respondents (14.3%). A total of 77.7% of the respondents estimated that they make the decision of providing or not providing a 72-hour emergency supply of medication 6 or fewer times a month. A total of 14.6% indicated that they make the decision 6 to 11 times a month, and 7.7% make the decision more than 11 times a month. When asked how often respondents had seen a 72-hour emergency prescription not being dispensed for Texas Medicaid recipients when PA was not available, 49.1% answered "never"; however, 30.0% indicated once or twice a month, 16.5% indicated from 1 to 5 times a week, and another 4.5% indicated more than 5 times a week. The top 2 reasons for not dispensing a 72 hour-emergency drug supply were: "Reluctant to open a new 'unit-of-use' container (especially 30-day supply bottles)" and "The Rx will most likely be changed with the PA call, so why dispense a 72-hour supply of the originally prescribed drug?" The top categories of 72-hour emergency prescription drug products that respondents would "likely" dispense were antibiotics; inhaler canisters; products for nausea/vomiting, cough, and cold; antiseizure agents; and diabetic treatment products. The results show that there are many factors why pharmacists do not provide 72-hour emergency medications when PA is unavailable. The lack of awareness of the federal and state requirements was significantly related to the frequency of 72-hour medications not being dispensed. In addition, other factors inhibiting the process were the pharmacists' inability to reach physicians or the lack of cooperation with physicians, prescriptions for controlled substances, drug-packing limitations, and the financial risk involved with dispensing a 72-hour supply.

  3. Identifying Nonprovider Factors Affecting Pediatric Emergency Medicine Provider Efficiency.

    Science.gov (United States)

    Saleh, Fareed; Breslin, Kristen; Mullan, Paul C; Tillett, Zachary; Chamberlain, James M

    2017-10-31

    The aim of this study was to create a multivariable model of standardized relative value units per hour by adjusting for nonprovider factors that influence efficiency. We obtained productivity data based on billing records measured in emergency relative value units for (1) both evaluation and management of visits and (2) procedures for 16 pediatric emergency medicine providers with more than 750 hours worked per year. Eligible shifts were in an urban, academic pediatric emergency department (ED) with 2 sites: a tertiary care main campus and a satellite community site. We used multivariable linear regression to adjust for the impact of shift and pediatric ED characteristics on individual-provider efficiency and then removed variables from the model with minimal effect on productivity. There were 2998 eligible shifts for the 16 providers during a 3-year period. The resulting model included 4 variables when looking at both ED sites combined. These variables include the following: (1) number of procedures billed by provider, (2) season of the year, (3) shift start time, and (4) day of week. Results were improved when we separately modeled each ED location. A 3-variable model using procedures billed by provider, shift start time, and season explained 23% of the variation in provider efficiency at the academic ED site. A 3-variable model using procedures billed by provider, patient arrivals per hour, and shift start time explained 45% of the variation in provider efficiency at the satellite ED site. Several nonprovider factors affect provider efficiency. These factors should be considered when designing productivity-based incentives.

  4. Hourly wind speed analysis in Sicily

    Energy Technology Data Exchange (ETDEWEB)

    Bivona, S.; Leone, C. [Palermo Univ., Dip di Fisica e Technologie Relative, Palermo (Italy); Burlon, R. [Palermo Univ., Dip. di Ingegnaria Nucleare, Palermo (Italy)

    2003-07-01

    The hourly average wind speed data recorded by CNMCA (Centro Nazionale di Meteorologia e Climatologia Aeronautica) have been used to study the statistical properties of the wind speed at nine locations on Sicily. By grouping the observations month by month, we show that the hourly average wind speed, with calms omitted, is represented by a Weibull function. The suitability of the distribution is judged by the discrepancies between the observed and calculated values of the monthly average wind speed and of the standard deviation. (Author)

  5. Validation of an hourly resolved global aerosol model in answer to solar electricity generation information needs

    Directory of Open Access Journals (Sweden)

    M. Schroedter-Homscheidt

    2013-04-01

    Full Text Available Solar energy applications need global aerosol optical depth (AOD information to derive historic surface solar irradiance databases from geostationary meteorological satellites reaching back to the 1980's. This paper validates the MATCH/DLR model originating in the climate community against AERONET ground measurements. Hourly or daily mean AOD model output is evaluated individually for all stations in Europe, Africa and the Middle East – an area highly interesting for solar energy applications being partly dominated by high aerosol loads. Overall, a bias of 0.02 and a root-mean-square error (RMSE of 0.23 are found for daily mean AOD values, while the RMSE increases to 0.28 for hourly mean AOD values. Large differences between various regions and stations are found providing a feedback loop for the aerosol modelling community. The difference in using daily means versus hourly resolved modelling with respect to hourly resolved observations is evaluated. Nowadays state-of-the-art in solar resource assessment relies on monthly turbidity or AOD climatologies while at least hourly resolved irradiance time series are needed by the solar sector. Therefore, the contribution of higher temporally modelled AOD is evaluated.

  6. CORRELATION OF SPOT URINE ALBUMIN AND 12-HOUR URINE PROTEIN WITH 24-HOUR URINE PROTEIN IN PRE-ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    S. Vinayachandran

    2017-11-01

    Full Text Available BACKGROUND Pre-eclampsia is defined as the development of new-onset hypertension in the second half of pregnancy often accompanied by new-onset proteinuria with other signs and symptoms. Proteinuria is defined by the excretion of 300 mg or more of protein in a 24-hour urine collection. To avoid time consumed in collection of 24-hour urine specimens, efforts have been made to develop faster methods to determine concentration of urine protein. Preliminary studies have suggested that 12-hour urine protein collection maybe adequate for evaluation of pre-eclampsia with advantage of early diagnosis and treatment of pre-eclampsia as well as potential for early hospital discharge and increased compliance with specimen collection. The aim of the study is to evaluate and correlate spot urine albumin and 12-hour urine protein with 24-hour urine protein in pre-eclampsia. MATERIALS AND METHODS A diagnostic evaluation study- a 24-hour urine protein, 12-hour urine protein and spot urine albumin results are analysed. Correlation of 12-hour urine protein and spot urine albumin with 24-hour urine protein is analysed using SPSS software. The strength of correlation was measured by Pearson’s correlation coefficient (r. Student’s t-test and Chi-square tests were used to compare patients with and without 24-hour urine protein ≥300 mg. Probability value of 165 mg with 24-hour urine protein ≥300 mg suggest that this test has role in the evaluation of women with suspected pre-eclampsia and could be substituted for 24-hour urine protein as a simple, faster and cheaper method.

  7. Six-Hours-Rule - A Dogma for Military Surgery?

    National Research Council Canada - National Science Library

    Gerngross, Heinz; Kahle, Wilhelm

    2004-01-01

    Today, the six-hours-rule is a delicate item for military logistics and it is a great challenge for medical services to provide an adequate treatment during the first hours after wounding. DEFINITION: Six-hour-rule...

  8. The financial value of services provided by a rural community health fair.

    Science.gov (United States)

    Dulin, Mary Katherine; Olive, Kenneth E; Florence, Joseph A; Sliger, Carolyn

    2006-11-01

    There has been little discussion in the literature regarding the financial value of the services provided to the participants in health fairs. This article examines the financial value of preventive services provided through a community health fair in an economically depressed area of southwest Virginia. Current Procedural Terminology codes were assigned to the services provided in order to estimate costs participants might incur for such services. An average 50-year-old man would have paid up to $320 to obtain commonly recommended preventive services available free at the fair. An average 50-year-old woman would have paid up to $495. Overall, over $58,000 in services were provided through the health fair. This community health fair provided preventive services that many participants otherwise might have found to be cost-prohibitive.

  9. Relative value of clinical variables, bicycle ergometry, rest radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring at discharge to predict 1 year survival after myocardial infarction

    NARCIS (Netherlands)

    P.M. Fioretti (Paolo); R.W. Brower (Ronald); M.L. Simoons (Maarten); H.J. ten Katen (Harald); A. Beelen (Anita); T. Baardman (Taco); J. Lubsen (Jacob); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractThe relative value of predischarge clinical variables, bicycle ergometry, radionuclide ventriculography and 24 hour ambulatory electrocardiographic monitoring for predicting survival during the first year in 351 hospital survivors of acute myocardial infarction was assessed. Discriminant

  10. Sub-hour solar data for power system modeling from static spatial variability analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hummon, Marissa R.; Ibanez, Eduardo; Brinkman, Gregory; Lew, Debra [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2012-07-01

    High penetration renewable integration studies need high quality solar power data with spatial-temporal correlations that are representative of a real system. For instance, as additional solar power sites are added, the relative amount of variability should decrease due to spatial averaging of localized irradiance fluctuations. This presentation will summarize the research relating sequential point-source sub-hour global horizontal irradiance (GHI) values to static, spatially distributed GHI values. This research led to the development of an algorithm for generating coherent sub-hour datasets that span distances ranging from 10 km to 4,000 km. The algorithm, in brief, generates synthetic GHI values at an interval of one minute, for a specific location, using SUNY/Clean Power Research, satellite-derived, hourly irradiance values for the nearest grid cell to that location and grid cells within 40 km. During each hour, the observed GHI value for the grid cell of interest and the surrounding grid cells is related, via probability distributions, to one of live temporal cloud coverage classifications (class I, II, III, IV, V). Synthesis algorithms are used to select one-minute time step GHI values based on the classification of the grid cell of interest in a particular hour. Three primary statistical measures of the dataset are demonstrated: reduction in ramps as a function of aggregation; coherence of GHI values across sites ranging from 6 to 400 km apart over time scales from one minute to three hours; and ramp magnitude and duration distributions as a function of time of day and day of year. (orig.)

  11. The Value of a Checklist for Child Abuse in Out-of-Hours Primary Care: To Screen or Not to Screen.

    Science.gov (United States)

    Schouten, Maartje Cm; van Stel, Henk F; Verheij, Theo Jm; Houben, Michiel L; Russel, Ingrid Mb; Nieuwenhuis, Edward Es; van de Putte, Elise M

    2017-01-01

    To assess the diagnostic value of the screening instrument SPUTOVAMO-R2 (checklist, 5 questions) for child abuse at Out-of-hours Primary Care locations (OPC), by comparing the test outcome with information from Child Protection Services (CPS). Secondary, to determine whether reducing the length of the checklist compromises diagnostic value. All children (abuse (32.8%). The positive predictive value (PPV) of the checklist for child abuse was 8.3 (95% CI 3.9-15.2). The negative predictive value (NPV) was 99.1 (98.8-99.3), with 52 false negatives. When the length of the checklist was reduced to two questions closely related to the medical process (SPUTOVAMO-R3), the PPV was 9.1 (3.7-17.8) and the NPV 99.1 (98.7-99.3). These two questions are on the injury in relation to the history, and the interaction between child and parents. The checklist SPUTOVAMO-R2 has a low detection rate of child abuse within the OPC setting, and a high false positive rate. Therefore, we recommend to use the shortened checklist only as a tool to increase the awareness of child abuse and not as a diagnostic instrument.

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

    Science.gov (United States)

    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.

  13. Characteristics of service users and provider organisations associated with experience of out of hours general practitioner care in England: population based cross sectional postal questionnaire survey

    OpenAIRE

    Warren, Fiona C; Abel, Gary; Lyratzopoulos, Georgios; Elliott, Marc N; Richards, Suzanne; Barry, Heather E; Roland, Martin; Campbell, John L

    2015-01-01

    Objective: To investigate the experience of users of out of hours general practitioner services in England, UK. Design: Population based cross sectional postal questionnaire survey. Setting: General Practice Patient Survey 2012-13. Main outcome measures: Potential associations between sociodemographic factors (including ethnicity and ability to take time away from work during working hours to attend a healthcare consultation) and provider organisation type (not for profit, NHS, or commercial)...

  14. The existence and persistence of long work hours

    OpenAIRE

    Drago, Robert William; Black, David; Wooden, Mark

    2005-01-01

    Previous research hypothesizes that long working hours are related to consumerism, the ideal worker norm, high levels of human capital, and a high cost-of-job-loss. The authors test these hypotheses using panel data on working hours for an Australian sample of full-time employed workers. Analyses include a static cross-sectional model and a persistence model for long hours over time. The results suggest that long hours (50 or more hours in a usual week) are often persistent, and provide stron...

  15. FEATURES OF PROVIDING THE VALUE OF PROJECTS FOR STAKEHOLDERS UNDER CONDITIONS OF UKRAINIAN BUSINESS

    Directory of Open Access Journals (Sweden)

    Anastasiia Liezina

    2017-09-01

    Full Text Available The purpose of the work is to determine the value characteristics for the stakeholders of the project, identify existing types of projects in the field of providing electricity services, and describe the features of providing value in the Ukrainian business environment. The system analysis method and analytical method allowed analysing the development of project management from the point of introduction and use of “value” category of the project in practice and considering the features of providing value characteristics for the main stakeholders of the project. Methodology. The analysis of the project management system is based on providing value expectations for the project stakeholders in theory and in practice. The development of the electricity supply in the country is of great importance in the economic development of the country during the crisis stages. For the analysis, 3 enterprises were selected, carrying out their economic activities in this area on the territory of the Kyiv region. In order to determine the specifics of providing value to project stakeholders at all phases of the life cycle of the project, the main types of projects were identified and their percentage was analysed among the implemented projects at enterprises between 2009 and 2017. The definition of the project product for this field of activity is presented and the main stakeholders of the project are described. The analysis of project implementation provides for the existence of four phases of the life cycle, with a partial provision of value on each of them for interested parties. This indicates that entrepreneurs are not consciously seeking to improve their management skills in order to increase the efficiency of project implementation. Relevance/originality. Analytical data provide further development of this science in the field of application of value characteristics in the analysis of the effectiveness of projects. In the future, the system analysis of

  16. The use of patient experience survey data by out-of-hours primary care services: a qualitative interview study.

    Science.gov (United States)

    Barry, Heather E; Campbell, John L; Asprey, Anthea; Richards, Suzanne H

    2016-11-01

    English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done. We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS). A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews. Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form. The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed. 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/.

  17. Flexible forms of working hours

    OpenAIRE

    Knapp, Viktor

    2017-01-01

    66 Abstract - Flexible forms of working hours This diploma thesis deals with the flexible forms of working hours and its goal is to describe this issue in intelligible and comprehensive way. It is being very interesting and current theme which is to a great extent not subject to direct legal regulations and provides its contracting parties with a big amount of freedom of contract. This fact assists in bigger flexibilization of labour market and represents a significant instrument in the fight...

  18. A Global Meta-Analysis of the Value of Ecosystem Services Provided by Lakes.

    Science.gov (United States)

    Reynaud, Arnaud; Lanzanova, Denis

    2017-07-01

    This study presents the first meta-analysis on the economic value of ecosystem services delivered by lakes. A worldwide data set of 699 observations drawn from 133 studies combines information reported in primary studies with geospatial data. The meta-analysis explores antagonisms and synergies between ecosystem services. This is the first meta-analysis to incorporate simultaneously external geospatial data and ecosystem service interactions. We first show that it is possible to reliably predict the value of ecosystem services provided by lakes based on their physical and geographic characteristics. Second, we demonstrate that interactions between ecosystem services appear to be significant for explaining lake ecosystem service values. Third, we provide an estimation of the average value of ecosystem services provided by lakes: between 106 and 140 USD$2010 per respondent per year for non-hedonic price studies and between 169 and 403 USD$2010 per property per year for hedonic price studies.

  19. Construction-man hour estimation for nuclear power plants

    International Nuclear Information System (INIS)

    Paek, J.H.

    1987-01-01

    This study centers on a statistical analysis of the preliminary construction time, main construction time, and total construction man hours of nuclear power plants. The use of these econometric techniques allows the major man hour driving variables to be identified through multivariate analysis of time-series data on over 80 United States nuclear power plants. The analysis made in this study provides a clearer picture of the dynamic changes that have occurred in the man hours of these plants when compared to engineering estimates of man hours, and produces a tool that can be used to project nuclear power plant man hours

  20. Measuring Nursing Value from the Electronic Health Record.

    Science.gov (United States)

    Welton, John M; Harper, Ellen M

    2016-01-01

    We report the findings of a big data nursing value expert group made up of 14 members of the nursing informatics, leadership, academic and research communities within the United States tasked with 1. Defining nursing value, 2. Developing a common data model and metrics for nursing care value, and 3. Developing nursing business intelligence tools using the nursing value data set. This work is a component of the Big Data and Nursing Knowledge Development conference series sponsored by the University Of Minnesota School Of Nursing. The panel met by conference calls for fourteen 1.5 hour sessions for a total of 21 total hours of interaction from August 2014 through May 2015. Primary deliverables from the bit data expert group were: development and publication of definitions and metrics for nursing value; construction of a common data model to extract key data from electronic health records; and measures of nursing costs and finance to provide a basis for developing nursing business intelligence and analysis systems.

  1. Rainforest pharmacopeia in Madagascar provides high value for current local and prospective global uses.

    Directory of Open Access Journals (Sweden)

    Christopher D Golden

    Full Text Available Botanical diversity provides value to humans through carbon sequestration, air and water purification, and the provisioning of wild foods and ethnomedicines. Here we calculate the value of botanical ethnomedicines in a rainforest region of Madagascar, the Makira Protected Area, using a substitution method that combines replacement costs and choice modeling. The Makira watershed may comprise approximately 0.8% of global botanical diversity and possesses enormous value both in its ability to provision botanical ethnomedicines to local people and as a source of potentially novel pharmaceutical drugs for society as a whole. Approximately 241 locally-recognized species are used as ethnomedicines, including 113 agricultural or weed species. We equated each ethnomedicinal treatment to the monetary value of a comparable pharmaceutical treatment adjusted by personal preferences in perceived efficacy (rather than from known or assumed medicinal equivalency. The benefit value of these botanical ethnomedicines per individual is $5.40-7.90 per year when using the value of highly subsidized Malagasy pharmaceuticals and $100.60-287.40 when using the value of American pharmaceuticals. Using local pharmaceuticals as substitutes, the value per household is $30.24-44.30 per year, equivalent to 43-63% of median annual household income, demonstrating their local importance. Using the value of American pharmaceuticals, the amount is equivalent to 22-63% of the median annual health care expenditures for American adults under 45 in 2006. The potential for developing novel biomedicines from the Makira watershed's unique flora ranges in untapped benefit value from $0.3-5.7 billion for American pharmaceutical companies, non-inclusive of the importance of providing novel medicines and improved healthcare to society. This study provides evidence of the tremendous current local and prospective global value of botanical ethnomedicines and furthers arguments for the

  2. 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

  3. Value-Added Electricity Services: New Roles for Utilities and Third-Party Providers

    Energy Technology Data Exchange (ETDEWEB)

    Blansfield, J. [Inst. for Electric Innovations, Washington, DC (United States); Wood, L. [Inst. for Electric Innovations, Washington, DC (United States); Katofsky, R. [Advanced Energy Economy, Washington, DC (United States); Stafford, B. [Advanced Energy Economy, Washington, DC (United States); Waggoner, D. [Advanced Energy Economy, Washington, DC (United States); Schwartz, L. C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-10-30

    New energy generation, storage, delivery, and end-use technologies support a broad range of value-added electricity services for retail electricity customers. Sophisticated energy management services, distributed generation coupled with storage, and electric vehicle charging are just a few examples of emerging offerings. Who should provide value-added services — utilities or third parties, or both, and under what conditions? What policy and regulatory changes may be needed to promote competition and innovation, to account for utility costs to enable these services, and to protect consumers? The report approaches the issues from three perspectives: utilities, third-party service providers, and consumers: -Jonathan Blansfield and Lisa Wood, Institute for Electric Innovation -Ryan Katofsky, Benjamin Stafford and Danny Waggoner, Advanced Energy Economy -National Association of State Utility Consumer Advocates

  4. The association between long work hours and leisure-time physical activity and obesity

    Directory of Open Access Journals (Sweden)

    Miranda A. Cook

    2018-06-01

    Full Text Available Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA, and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ2: 19.3; P-value: <0.01. Results of interaction assessment demonstrate that the effects of work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ2: 13.33; P-value: <0.001; χ2: 4.42; P-value: <0.05. Employees in intermediate activity occupations working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations. Keywords: Physical activity, Obesity, Occupation, Long work hours

  5. Resident duty hours in Canada: a survey and national statement.

    Science.gov (United States)

    Masterson, Mark F; Shrichand, Pankaj; Maniate, Jerry M

    2014-01-01

    Physicians in general, and residents in particular, are adapting to duty schedules in which they have fewer continuous work hours; however, there are no Canadian guidelines on duty hours restrictions. To better inform resident duty hour policy in Canada, we set out to prepare a set of recommendations that would draw upon evidence reported in the literature and reflect the experiences of resident members of the Canadian Association of Internes and Residents (CAIR). A survey was prepared and distributed electronically to all resident members of CAIR. A total of 1796 eligible residents participated in the survey. Of those who responded, 38% (601) reported that they felt they could safely provide care for up to 16 continuous hours, and 20% (315) said that 12 continuous hours was the maximum period during which they could safely provide care (n=1592). Eighty-two percent (1316) reported their perception that the quality of care they had provided suffered because of the number of consecutive hours worked (n=1598). Only 52% (830) had received training in handover (n=1594); those who had received such training reported that it was commonly provided through informal modelling. On the basis of these data and the existing literature, CAIR recommends that resident duty hours be managed in a way that does not endanger the health of residents or patients; does not impair education; is flexible; and does not violate ethical or legal standards. Further, residents should be formally trained in handover skills and alternative duty hour models.

  6. Missing data and the accuracy of magnetic-observatory hour means

    Directory of Open Access Journals (Sweden)

    J. J. Love

    2009-09-01

    Full Text Available Analysis is made of the accuracy of magnetic-observatory hourly means constructed from definitive minute data having missing values (gaps. Bootstrap sampling from different data-gap distributions is used to estimate average errors on hourly means as a function of the number of missing data. Absolute and relative error results are calculated for horizontal-intensity, declination, and vertical-component data collected at high, medium, and low magnetic latitudes. For 90% complete coverage (10% missing data, average (RMS absolute errors on hourly means are generally less than errors permitted by Intermagnet for minute data. As a rule of thumb, the average relative error for hourly means with 10% missing minute data is approximately equal to 10% of the hourly standard deviation of the source minute data.

  7. Excel VBA 24-hour trainer

    CERN Document Server

    Urtis, Tom

    2015-01-01

    Master VBA automation quickly and easily to get more out of Excel Excel VBA 24-Hour Trainer, 2nd Edition is the quick-start guide to getting more out of Excel, using Visual Basic for Applications. This unique book/video package has been updated with fifteen new advanced video lessons, providing a total of eleven hours of video training and 45 total lessons to teach you the basics and beyond. This self-paced tutorial explains Excel VBA from the ground up, demonstrating with each advancing lesson how you can increase your productivity. Clear, concise, step-by-step instructions are combined wit

  8. 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.

  9. 24-HOUR ARTERIAL STIFFNESS VALUES IN MEN WITH DIFFERENT PHENOTYPES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONCURRENT WITH HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. A. Karoli

    2015-01-01

    Full Text Available Objective: to study the specific features of the daily arterial stiffness (AS profile in men with different phenotypes of chronic obstructive pulmonary disease (COPD concurrent with hypertension. Subjects and methods. The investigation enrolled 78 male patients with COPD and hypertension. The patients were divided according to COPD phenotypes into 2 groups: 1 COPD patients with emphysema; 2 those with bronchitis. The exclusion criteria were less than 40 years and more than 80 years of age; diabetes mellitus; coronary heart disease; vascular diseases; an exacerbation of chronic diseases; bronchial and pulmonary diseases of another etiology. The patients underwent 24-hour blood pressure and AS monitoring, external respiratory function testing: spirography with a short-acting β2-agonist test, a six-minute walk test at baseline and after a hemoglobin oxygen saturation test, and a CAT test. Results. The patients of both groups were observed to have a statistically significant increase in (dP/dtmax as compared to those of the control group (p < 0.05; p < 0.01 in both the daytime and nighttime. In these periods, the COPD patients with emphysema had a higher AIx than those with bronchitis (p < 0.001. There was a statistically significantly (p < 0.001 higher AIx in the nighttime than in the daytime in Groups 1 and 2 patients. Conclusion. The patients with different COPD phenotypes were noted to have impaired arterial elastic properties, circadian AS changes with predominantly nocturnal impaired vascular stiffness. Relationships were found between 24-hour AS values and clinicoanamnestic findings. 

  10. 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.

  11. Hourly weather forecasts for gas turbine power generation

    Directory of Open Access Journals (Sweden)

    G. Giunta

    2017-06-01

    Full Text Available An hourly short-term weather forecast can optimize processes in Combined Cycle Gas Turbine (CCGT plants by helping to reduce imbalance charges on the national power grid. Consequently, a reliable meteorological prediction for a given power plant is crucial for obtaining competitive prices for the electric market, better planning and stock management, sales and supplies of energy sources. The paper discusses the short-term hourly temperature forecasts, at lead time day+1 and day+2, over a period of thirteen months in 2012 and 2013 for six Italian CCGT power plants of 390 MW each (260 MW from the gas turbine and 130 MW from the steam turbine. These CCGT plants are placed in three different Italian climate areas: the Po Valley, the Adriatic coast, and the North Tyrrhenian coast. The meteorological model applied in this study is the eni-Kassandra Meteo Forecast (e‑kmf™, a multi-model approach system to provide probabilistic forecasts with a Kalman filter used to improve accuracy of local temperature predictions. Performance skill scores, computed by the output data of the meteorological model, are compared with local observations, and used to evaluate forecast reliability. In the study, the approach has shown good overall scores encompassing more than 50,000 hourly temperature values. Some differences from one site to another, due to local meteorological phenomena, can affect the short-term forecast performance, with consequent impacts on gas-to-power production and related negative imbalances. For operational application of the methodology in CCGT power plant, the benefits and limits have been successfully identified.

  12. The future of work hours--the European view.

    Science.gov (United States)

    Akerstedt, Torbjörn; Kecklund, Göran

    2005-01-01

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

  13. Personal values and attitudes toward people living with HIV among health care providers in Kazakhstan.

    Science.gov (United States)

    Tartakovsky, Eugene; Hamama, Liat

    2013-01-01

    Our study investigates the relationship between health care providers' personal value preferences and their attitudes toward people living with HIV (PLWH). The study was conducted among nurses (n = 38) and physicians (n = 87) working in HIV Centers in Kazakhstan. Significant relationships were found between the providers' personal value preferences and their attitudes toward PLWH: higher preferences for tradition and power values and lower preferences for benevolence values were associated with more negative attitudes toward PLWH. In addition, more years of experience working with PLWH was associated with more positive attitudes toward this population. Age, gender, family status, religiosity, occupation, and number of years working in health care were not related to the health care providers' attitudes toward PLWH. Theoretical and practical implications of the results obtained are discussed. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  14. 168 Hours Salt Fog Test

    International Nuclear Information System (INIS)

    Nur Ubaidah Saidin; Muhamad Daud; Siti Radiah Mohd Kamarudin

    2011-01-01

    This report explained the test conducted in salt fog chamber to evaluate the effectiveness of mild steel, coated with rust converter, for 168 hours in artificial seawater exposure. The samples were compared with mild steel coated with commercial primer. The tests were conducted followed ASTM B117. Individual pictures were taken of each sample before the tests began, at 24, 48, 72, 96, 120, 144 and 168 hours to see the progression of the corrosion. Results showed that the samples coated with rust converter provide a good significant protection against corrosion phenomenon than the samples coated with commercial primer that available in the market. (author)

  15. Estimation of Rainfall Erosivity via 1-Minute to Hourly Rainfall Data from Taipei, Taiwan

    Science.gov (United States)

    Huang, Ting-Yin; Yang, Ssu-Yao; Jan, Chyan-Deng

    2017-04-01

    Soil erosion is a natural process on hillslopes that threats people's life and properties, having a considerable environmental and economic implications for soil degradation, agricultural activity and water quality. The rainfall erosivity factor (R-factor) in the Universal Soil Loss Equation (USLE), composed of total kinetic energy (E) and the maximum 30-min rainfall intensity (I30), is widely used as an indicator to measure the potential risks of soil loss caused by rainfall at a regional scale. This R factor can represent the detachment and entrainment involved in climate conditions on hillslopes, but lack of 30-min rainfall intensity data usually lead to apply this factor more difficult in many regions. In recent years, fixed-interval, hourly rainfall data is readily available and widely used due to the development of automatic weather stations. Here we assess the estimations of R, E, and I30 based on 1-, 5-, 10-, 15-, 30-, 60-minute rainfall data, and hourly rainfall data obtained from Taipei weather station during 2004 to 2010. Results show that there is a strong correlation among R-factors estimated from different interval rainfall data. Moreover, the shorter time-interval rainfall data (e.g., 1-min) yields larger value of R-factor. The conversion factors of rainfall erosivity (ratio of values estimated from the resolution lower than 30-min rainfall data to those estimated from 60-min and hourly rainfall data, respectively) range from 1.85 to 1.40 (resp. from 1.89 to 1.02) for 60-min (resp. hourly) rainfall data as the time resolution increasing from 30-min to 1-min. This paper provides useful information on estimating R-factor when hourly rainfall data is only available.

  16. General practice out-of-hours service in Ireland provides a new source of syndromic surveillance data on influenza.

    LENUS (Irish Health Repository)

    Brabazon, E D

    2010-01-01

    The use of routinely available electronic sources of healthcare data on the spread of influenza has the potential to enhance current surveillance activities. This study aimed to develop a method for identifying influenza-related records from general practitioner(GP) out-of-hours (OOH) services in Ireland. Data from one such service were interrogated for keywords relating to influenza-like illness (ILI) and a proxy measure of influenza activity in the community setting was developed. Comparison of this syndromic surveillance measure with national data on ILI consultation rates demonstrated a statistically significant temporal correlation.In five out of six influenza seasons investigated,peaks in the GP OOH influenza-related calls appeared at least one week ahead of peaks in the national ILI consultation rates. The method described in this paper has been extended to nine OOH services in Ireland (covering 70% of the Irish population) to provide weekly figures on self-reported illness for influenza in the community and its data have been incorporated into the national weekly influenza reports produced by the Health Protection Surveillance Centre. These data should provide early warnings of both seasonal and pandemic influenza in Ireland.

  17. Flexibility of working hours in the 24-hour society.

    Science.gov (United States)

    Costa, G

    2006-01-01

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

  18. 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...

  19. Valuing blue carbon: carbon sequestration benefits provided by the marine protected areas in Colombia.

    Directory of Open Access Journals (Sweden)

    Tatiana G Zarate-Barrera

    Full Text Available Marine protected areas are aimed to protect and conserve key ecosystems for the provision of a number of ecosystem services that are the basis for numerous economic activities. Among the several services that these areas provide, the capacity of sequestering (capturing and storing organic carbon is a regulating service, provided mainly by mangroves and seagrasses, that gains importance as alternatives for mitigating global warming become a priority in the international agenda. The objective of this study is to value the services associated with the capture and storage of oceanic carbon, known as Blue Carbon, provided by a new network of marine protected areas in Colombia. We approach the monetary value associated to these services through the simulation of a hypothetical market for oceanic carbon. To do that, we construct a benefit function that considers the capacity of mangroves and seagrasses for capturing and storing blue carbon, and simulate scenarios for the variation of key variables such as the market carbon price, the discount rate, the natural rate of loss of the ecosystems, and the expectations about the post-Kyoto negotiations. The results indicate that the expected benefits associated to carbon capture and storage provided by these ecosystems are substantial but highly dependent on the expectations in terms of the negotiations surrounding the extension of the Kyoto Protocol and the dynamics of the carbon credit's demand and supply. We also find that the natural loss rate of these ecosystems does not seem to have a significant effect on the annual value of the benefits. This approach constitutes one of the first attempts to value blue carbon as one of the services provided by conservation.

  20. 29 CFR 785.22 - Duty of 24 hours or more.

    Science.gov (United States)

    2010-07-01

    ... employee is required to be on duty for 24 hours or more, the employer and the employee may agree to exclude... from hours worked, provided adequate sleeping facilities are furnished by the employer and the employee... of sleeping time and lunch periods constitute hours worked. (Armour v. Wantock, 323 U.S. 126 (1944...

  1. The Conceptualization of Value in the Value Proposition of New Health Technologies Comment on "Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies".

    Science.gov (United States)

    Buttigieg, Sandra C; Hoof, Joost van

    2017-07-03

    Lehoux et al provide a highly valid contribution in conceptualizing value in value propositions for new health technologies and developing an analytic framework that illustrates the interplay between health innovation supply-side logic (the logic of emergence) and demand-side logic (embedding in the healthcare system). This commentary brings forth several considerations on this article. First, a detailed stakeholder analysis provides the necessary premonition of potential hurdles in the development, implementation and dissemination of a new technology. This can be achieved by categorizing potential stakeholder groups on the basis of the potential impact of future technology. Secondly, the conceptualization of value in value propositions of new technologies should not only embrace business/economic and clinical values but also ethical, professional and cultural values, as well as factoring in the notion of usability and acceptance of new technology. As a final note, the commentary emphasises the point that technology should facilitate delivery of care without negatively affecting doctor-patient communications, physical examination skills, and development of clinical knowledge. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  2. Hourly temporal distribution of wind

    Science.gov (United States)

    Deligiannis, Ilias; Dimitriadis, Panayiotis; Koutsoyiannis, Demetris

    2016-04-01

    The wind process is essential for hydrometeorology and additionally, is one of the basic renewable energy resources. Most stochastic forecast models are limited up to daily scales disregarding the hourly scale which is significant for renewable energy management. Here, we analyze hourly wind timeseries giving emphasis on the temporal distribution of wind within the day. We finally present a periodic model based on statistical as well as hydrometeorological reasoning that shows good agreement with data. Acknowledgement: This research is conducted within the frame of the undergraduate course "Stochastic Methods in Water Resources" of the National Technical University of Athens (NTUA). The School of Civil Engineering of NTUA provided moral support for the participation of the students in the Assembly.

  3. The association between long work hours and leisure-time physical activity and obesity.

    Science.gov (United States)

    Cook, Miranda A; Gazmararian, Julie

    2018-06-01

    Obesity affects approximately one-third of all U.S. adults, presenting a large economic and public health burden. Long work hours may be contributing to the rising obesity problem by reducing time for physical activity, particularly for individuals working in sedentary occupations. This study sought to investigate the association between long work hours, leisure-time physical activity (LTPA), and obesity across levels of occupational activity in order to identify potentially vulnerable groups. Cross sectional analysis was performed in 2017 using data from the 2015 Georgia Behavioral Risk Factor Surveillance System and prevalence ratios were estimated across work hour and occupational activity groups. Ability to meet guidelines for LTPA did not differ significantly across work hour categories overall. Those working in low activity occupations were more likely to meet aerobic guidelines for LTPA compared to those in intermediate and high activity occupations (χ 2 : 19.3; P -value: work hours on obesity risk and meeting aerobic guidelines are significantly different across OA categories, indicating OA to be an effect modifier of the relationship between long work hours and obesity (χ 2 : 13.33; P -value: working long hours were found to be at the greatest risk for obesity. Further research is required to better understand the mechanisms impacting the relationship between long work hours, domains of physical activity, and obesity risk as well as to identify effective intervention and prevention programs for employees in intermediate activity occupations.

  4. Value-added strategy models to provide quality services in senior health business.

    Science.gov (United States)

    Yang, Ya-Ting; Lin, Neng-Pai; Su, Shyi; Chen, Ya-Mei; Chang, Yao-Mao; Handa, Yujiro; Khan, Hafsah Arshed Ali; Elsa Hsu, Yi-Hsin

    2017-06-20

    The rapid population aging is now a global issue. The increase in the elderly population will impact the health care industry and health enterprises; various senior needs will promote the growth of the senior health industry. Most senior health studies are focused on the demand side and scarcely on supply. Our study selected quality enterprises focused on aging health and analyzed different strategies to provide excellent quality services to senior health enterprises. We selected 33 quality senior health enterprises in Taiwan and investigated their excellent quality services strategies by face-to-face semi-structured in-depth interviews with CEO and managers of each enterprise in 2013. A total of 33 senior health enterprises in Taiwan. Overall, 65 CEOs and managers of 33 enterprises were interviewed individually. None. Core values and vision, organization structure, quality services provided, strategies for quality services. This study's results indicated four type of value-added strategy models adopted by senior enterprises to offer quality services: (i) residential care and co-residence model, (ii) home care and living in place model, (iii) community e-business experience model and (iv) virtual and physical portable device model. The common part in these four strategy models is that the services provided are elderly centered. These models offer virtual and physical integrations, and also offer total solutions for the elderly and their caregivers. Through investigation of successful strategy models for providing quality services to seniors, we identified opportunities to develop innovative service models and successful characteristics, also policy implications were summarized. The observations from this study will serve as a primary evidenced base for enterprises developing their senior market and, also for promoting the value co-creation possibility through dialogue between customers and those that deliver service. © The Author 2017. Published by Oxford

  5. 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.

  6. 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.

  7. 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

  8. Out-of-hours MRI provision in the UK and models of service delivery

    International Nuclear Information System (INIS)

    Hauptfleisch, J.; Meagher, T.M.; King, D.; López de Heredia, L.; Hughes, R.J.

    2013-01-01

    Aim: To examine current out-of-hours magnetic resonance imaging (MRI) provision through a snapshot survey of National Health Service (NHS) trusts and to assay how radiographer staffing cover was provided for out-of-hours services. Materials and methods: A snapshot postal survey was mailed to heads of service of all 234 trusts in England and Wales. A literature search on the models of service delivery and correlation with the authors' internal MRI rota, which has provided a full on-call service for 20 years was undertaken. Results: The response rate was 45.7% (107 of 234); 14% of responders provided full access to MRI 24 h a day; 63% provided extended weekday service, typically to 20.00 h; and 81% provided a weekend daytime service. The radiographers running the service were typically from the core MRI team. Approximately one-third (29.9%) of trusts provided training in basic brain and spine MRI to non-core MRI team members, but they typically did not participate in out-of-hours provision. Conclusion: There is currently a paucity of information on the provision of out-of-hours MRI in the NHS. However, there is increasing pressure to provide complex imaging out of hours, and in the future, trauma centres may be required to provide MRI to assess spinal injury. The authors describe a system to provide access to MRI at no additional cost to the organization based on 20 years of experience. A minority of surveyed acute NHS trusts have full out-of-hours access to MRI. Demand for MRI provision out of core hours is likely to increase

  9. The 24-hour society between myth and reality.

    Science.gov (United States)

    Costa, G

    2001-12-01

    The 24-hour society appears to be an ineluctable process towards a social organisation where time constraints are no more "restricting" the human life. But, what kind of 24-hour society do we need? At what costs? Are they acceptable/sustainable? Shift work, night work, irregular and flexible working hours, together with new technologies, are the milestone of this epochal passage, of which shift workers are builders and victims at the same time. The borders between working and social times are no more fixed and rigidly determined: not only the link between work place and working hours is broken, but also the value of working time changes according to the different economic/productive/social effects it can make. What are the advantages and disadvantages for the individual, the companies, and the society? What is the cost/benefit ratio in terms of physical health; psychological well-being, family and social life? The research on irregular working hours and health shows us what can be the negative consequences of non-human-centered working times organisations. Coping properly with this process means avoiding a passive acceptance of it with consequent maladjustments at both individual and social level, but adopting effective preventive and compensative strategies aimed at building a more sustainable society, at acceptable costs and with the highest possible benefits.

  10. Efficacy and duration of benazepril plus amlodipine or hydrochlorothiazide on 24-hour ambulatory systolic blood pressure control.

    Science.gov (United States)

    Jamerson, Kenneth A; Devereux, Richard; Bakris, George L; Dahlöf, Björn; Pitt, Bertram; Velazquez, Eric J; Weir, Matthew; Kelly, Roxzana Y; Hua, Tsushung A; Hester, Allen; Weber, Michael A

    2011-02-01

    The combination of benazepril plus amlodipine was shown to be more effective than benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (benazepril plus amlodipine versus benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson's χ². At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure <130 mm Hg on ambulatory blood pressure monitoring) were greater than 80% in both groups. Nighttime systolic blood pressure provided additional risk prediction after adjusting for the effects of drugs. The 24-hour blood pressure control was similar in both treatment arms, supporting the interpretation that the difference in cardiovascular outcomes favoring a renin angiotensin system blocker combined with amlodipine rather than hydrochlorothiazide shown in the ACCOMPLISH trial was not caused by differences in blood pressure, but instead intrinsic properties (metabolic or hemodynamic) of the combination therapies.

  11. The Conceptualization of Value in the Value Proposition of New Health Technologies; Comment on “Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies”

    Directory of Open Access Journals (Sweden)

    Sandra C. Buttigieg

    2018-02-01

    Full Text Available Lehoux et al provide a highly valid contribution in conceptualizing value in value propositions for new health technologies and developing an analytic framework that illustrates the interplay between health innovation supply-side logic (the logic of emergence and demand-side logic (embedding in the healthcare system. This commentary brings forth several considerations on this article. First, a detailed stakeholder analysis provides the necessary premonition of potential hurdles in the development, implementation and dissemination of a new technology. This can be achieved by categorizing potential stakeholder groups on the basis of the potential impact of future technology. Secondly, the conceptualization of value in value propositions of new technologies should not only embrace business/economic and clinical values but also ethical, professional and cultural values, as well as factoring in the notion of usability and acceptance of new technology. As a final note, the commentary emphasises the point that technology should facilitate delivery of care without negatively affecting doctorpatient communications, physical examination skills, and development of clinical knowledge.

  12. 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...

  13. Hourly energy management for grid-connected wind-hydrogen systems

    International Nuclear Information System (INIS)

    Bernal-Agustin, Jose L.; Dufo-Lopez, Rodolfo

    2008-01-01

    This paper is a complete technical-economic analysis of the hourly energy management of the energy generated in wind-hydrogen systems. Wind power generation depends on the unpredictable nature of the wind. If the wind-power penetration becomes high in the Spanish electrical grid, energy management will be necessary for some wind farms. A method is proposed in this paper to adjust the generation curve to the demand curve, consisting of the generation of hydrogen and storing it in a hydrogen tank during off-peak (low demand) hours, while during the rest of the hours (peak hours, high demand) the stored hydrogen can be used to generate electricity. After revising the results obtained in this paper, for the current values of efficiency of the electricity-hydrogen-electricity conversion (approximately 30%) and due to the high cost of the hydrogen components, for a wind-hydrogen system to be economically viable the price of the sale of the energy generated by the fuel cell would be very high (approximately 171 cEUR/kWh). (author)

  14. Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies

    Science.gov (United States)

    Lehoux, Pascale; Miller, Fiona A.; Daudelin, Geneviève; Denis, Jean-Louis

    2017-01-01

    Background: New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Methods: Our 5-year qualitative research program examined the processes through which new health technologies were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec’s (Canada) publicly funded healthcare system. Results: Entrepreneurs have a direct influence over a new technology’s value proposition, but investors actively transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical practice or healthcare systems. Regulatory agencies reinforce the "double" value of a new technology—as a health intervention and as an economic commodity—and provide economic worth to the venture that is bringing the technology to market. Conclusion: Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of health policy issues in innovation policy. PMID:28949463

  15. Longer Opening Hours for the Library

    CERN Multimedia

    2001-01-01

    The scientific information service. The CERN library is open 24 hours a day, 365 days a year. So how, you might be wondering, can they improve on that? The answer is in the detail. Although you can already use the library whenever you want, items can only be checked out when the front desk is staffed. A decision taken last week by the Scientific Information Policy Board now means that there will someone at the desk through out CERN's official working hours, with an extra 90 minutes at the end of the day so that people can check out material on their way home. In other words, the library will be open from 8:30 to 19:00, Monday to Friday. The library continues, of course, to be open 24 hours a day, all year round, and services provided via the digital library remain at your disposal day and night: http://library.cern.ch

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

    Science.gov (United States)

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

    2016-11-01

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

  17. The 24-Hour Mathematical Modeling Challenge

    Science.gov (United States)

    Galluzzo, Benjamin J.; Wendt, Theodore J.

    2015-01-01

    Across the mathematics curriculum there is a renewed emphasis on applications of mathematics and on mathematical modeling. Providing students with modeling experiences beyond the ordinary classroom setting remains a challenge, however. In this article, we describe the 24-hour Mathematical Modeling Challenge, an extracurricular event that exposes…

  18. 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.

  19. I-131 attraction by thyroid during first hours following its oral administration

    International Nuclear Information System (INIS)

    Franquiz, J.M.; Cardenas, R.; Blanco, J.; Garcia, M.

    1982-01-01

    From radioisotopic investigations used to study thyroid function, that of I-131 attraction results to be one of the most known and used in medical practice. In the authors' laboratory measurement of I-131 activity upon the gland has been for long adopted at 24 hours after administration; however, current needs compel to look for an early time (within the first six hours) for measuring it. In the paper results of I-131 attraction by thyroid in a group with more than 200 patients at 2,4 and 24 hours following its administration are presented in order to assess a 24 hours attraction representativeness by an early attraction. Results demonstrate early attraction is representative of an attraction at 24 hours and with the same diagnostic usefulness. Normal and doubtful ranks for attraction in our medium are determined at 2 and 6 hours, being adopted as proceeding for those cases whose value should be found within doubtful rank, a measurement at 24 hours in order to determine functional condition of the gland. (author)

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Duty hours as viewed through a professionalism lens.

    Science.gov (United States)

    Ginsburg, Shiphra

    2014-01-01

    Understanding medical professionalism and its evaluation is essential to ensuring that physicians graduate with the requisite knowledge and skills in this domain. It is important to consider the context in which behaviours occur, along with tensions between competing values and the individual’s approach to resolving such conflicts. However, too much emphasis on behaviours can be misleading, as they may not reflect underlying attitudes or professionalism in general. The same behaviour can be viewed and evaluated quite differently, depending on the situation. These concepts are explored and illustrated in this paper in the context of duty hour regulations. The regulation of duty hours creates many conflicts that must be resolved, and yet their resolution is often hidden, especially when compliance with or violation of regulations carries significant consequences. This article challenges attending physicians and the medical education community to reflect on what we value in our trainees and the attributions we make regarding their behaviours. To fully support our trainees’ development as professionals, we must create opportunities to teach them the valuable skills they will need to achieve balance in their lives. [P]rofessionalism has no meaningful existence independent of the interactions that give it form and meaning. There is great folly in thinking otherwise. Hafferty and Levinson (2008)[1] Understanding and evaluating professionalism is essential to excellence in medical education and is mandated by organizations that oversee medical training [2]. Historically, attention has been focused largely on the professionalism of individual students or residents, at least for the purposes of evaluation. Yet there is now a growing appreciation that professionalism can be defined, understood, and evaluated from multiple perspectives [3]. Importantly, context has been recognized as critical to shaping trainees’ behaviours, and hence as important to our understanding of

  2. 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

  3. More than a device: today's medical technology companies provide value through service.

    Science.gov (United States)

    McCoy, Fred

    2003-01-01

    When physicians implant cardiac rhythm management devices, they establish a long-term relationship with those devices and with the manufacturers of those devices. The therapeutic value that each device will provide to its patient is enhanced throughout the life of the device by the services that the manufacturer provides. Services are provided prior to, during and long after implantation. Services include physician and allied health professional training, quality assurance programs, therapy outreach initiatives, on site technical support during device implantation and follow-up, technical service expertise and customer service support. The costs of these services are substantial. When assessed on a per device basis, the service costs may actually exceed the costs of manufacture. Further, the costs of these services are rising. Over the past five years, the number of implanted cardiac rhythm management devices has doubled. Industry field forces have tripled in size. Clearly, industry is dedicated to providing service as a critical element in achieving excellent patient outcomes.

  4. Job mobility and hours of work: the effect of Dutch legislation

    OpenAIRE

    Fouarge, D.; Baaijens, F P.

    2009-01-01

    Previous research has pointed to the existence of hours constraints on the labour market: not all employees’ preferences with respect to the length of the working week seem to be fulfilled, and changes in the number of working hours often coincide with job mobility. In this paper, we test whether or not a recently introduced Dutch legislation providing employees with the right to adjust working hours within their job has reduced the correlation between changes in working hours and job mobilit...

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

    Science.gov (United States)

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

    2015-05-01

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

  6. The crossover effect of spouses’ long working hours on depressive symptoms and suicidal ideation

    Science.gov (United States)

    YOON, Jin-Ha; KANG, Mo-Yeol

    2016-01-01

    To examine the association between spouses’ weekly working hours (SWWH) and psychological symptoms such as depressive symptom and suicidal ideation. We used data from the fourth and fifth Korean National Health and Nutrition Examination Survey (2007–2012). We collected information about general characteristics, depressive symptoms, suicidal ideation, and working hours. After inclusion and exclusion criteria were applied, a sample of 8,056 house units was used for analysis. A multiple logistic regression was conducted to investigate the association between SWWH and depressive symptoms, as well as suicidal ideation, to estimate the odds ratio (OR). The relationship between SWWH and psychological symptoms were linear in husbands, and J-shaped in wives. ORs for husbands’ depressive symptoms and suicidal ideation increased according to increase in SWWH (p-values for trend were 0.0045 and hours, but increased after SWWH of 40 to 49 hours (all p-values were below 0.01). Similar trends were observed after adjustment for age, obesity, household income, and one’s own weekly working hours, up to 1.33 and 1.57 in husbands, and 1.29 and 1.32 in wives, respectively. SWWH is negatively associated with mental health. PMID:27052574

  7. The crossover effect of spouses' long working hours on depressive symptoms and suicidal ideation.

    Science.gov (United States)

    Yoon, Jin-Ha; Kang, Mo-Yeol

    2016-10-08

    To examine the association between spouses' weekly working hours (SWWH) and psychological symptoms such as depressive symptom and suicidal ideation. We used data from the fourth and fifth Korean National Health and Nutrition Examination Survey (2007-2012). We collected information about general characteristics, depressive symptoms, suicidal ideation, and working hours. After inclusion and exclusion criteria were applied, a sample of 8,056 house units was used for analysis. A multiple logistic regression was conducted to investigate the association between SWWH and depressive symptoms, as well as suicidal ideation, to estimate the odds ratio (OR). The relationship between SWWH and psychological symptoms were linear in husbands, and J-shaped in wives. ORs for husbands' depressive symptoms and suicidal ideation increased according to increase in SWWH (p-values for trend were 0.0045 and hours, but increased after SWWH of 40 to 49 hours (all p-values were below 0.01). Similar trends were observed after adjustment for age, obesity, household income, and one's own weekly working hours, up to 1.33 and 1.57 in husbands, and 1.29 and 1.32 in wives, respectively. SWWH is negatively associated with mental health.

  8. Wage and Hour Farm Labor Laws.

    Science.gov (United States)

    Hertel, Catherine

    This paper, by a teacher of migrants, summarizes various farm labor laws and child labor laws pertaining to migrant and seasonal workers. The Migrant and Seasonal Agricultural Worker Protection Act of 1983 provides workers with assurances about pay, hours, and working conditions, including safety and health. This legislation permits anyone…

  9. Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

    International Nuclear Information System (INIS)

    Beraldo O, B.; Paixao, L.; Donato da S, S.; Araujo T, M. H.; Nogueira, M. S.

    2014-08-01

    Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D G ) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D G values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D G values were derived from the incident air kerma (K i ) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K i measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D G values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA). This work contributes to

  10. Validation of mean glandular dose values provided by a digital breast tomosynthesis system in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Beraldo O, B.; Paixao, L.; Donato da S, S. [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Post-graduation in Sciences and Technology of Radiations Minerals and Materials, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil); Araujo T, M. H. [Dr Maria Helena Araujo Teixeira Clinic, Guajajaras 40, 30180-100 Belo Horizonte (Brazil); Nogueira, M. S., E-mail: bbo@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear / CNEN, Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte (Brazil)

    2014-08-15

    Digital breast tomosynthesis (DBT) is an emerging imaging modality that provides quasi-three-dimensional structural information of the breast and has strong promise to improve the differentiation of normal tissue and suspicious masses reducing the tissue overlaps. DBT images are reconstructed from a sequence of low-dose X-ray projections of the breast acquired at a small number of angles over a limited angular range. The Ho logic Selen ia Dimensions system is equipped with an amorphous Selenium (a-Se) detector layer of 250 μm thickness and a 70 μm pixel pitch. Studies are needed to determine the radiation dose of patients that are undergoing this emerging procedure to compare with the results obtained in DBT images. The mean glandular dose (D{sub G}) is the dosimetric quantity used in quality control of the mammographic systems. The aim of this work is to validate D{sub G} values for different breast thicknesses provided by a Ho logic Selen ia Dimensions system using a DBT mode in comparison with the same results obtained by a calibrated 90 X 5-6M-model Radcal ionization chamber. D{sub G} values were derived from the incident air kerma (K{sub i}) measurements and tabulated conversion coefficients that are dependent on the half value layer (HVL) of the X-ray spectrum. Voltage and tube loading values were recorded in irradiations using W/Al anode/filter combination, automatic exposure control mode and polymethyl methacrylate (PMMA) slabs which simulate different breast thicknesses. For K{sub i} measurements, the ionization chamber was positioned at 655 mm from the focus and the same radiographic technique values were selected with the manual mode. D{sub G} values for a complete procedure ranged from 0.9 ± 0.1 to 3.7 ± 0.4 mGy. The results for different breast thicknesses are in accordance with values obtained by DBT images and with acceptable levels established by the Commission of the European Communities (Cec) and the International Atomic Energy Agency (IAEA

  11. Normal thyroid function values in Ethiopians

    International Nuclear Information System (INIS)

    Wassie, Emnetu; Abdulkadir, Jemal

    1990-01-01

    Thyroid function values were determined in 56 healthy nongoitrous adult Ethiopians. The mean triiodothyronine (T3) values for 20 males and 36 females were 1.42+-0.32 nmol/L and 1.51+-0.25 nmol/L, and thyroxine (T4) values were 119 22 nmol/L and 116+21 nmol/L respectively. The mean thyrotropin (TSH) values for males and females were identical at 1.86+-0.94 mu/L. Radioactive iodine uptake (RAIU) at 2 hours was 8.6+-4.4% in males and 11.3+-4.3% in females, and at 24 hours 31.7+-11.7% and 38.9+-11.1% respectively. The difference between males and females were significant at both 2 and 24 hours (P<0.05). The ranges for the 3 hormones derived from the mean 2SD values are close to these supplied with the kits but the Ethiopian RAIU values are higher than the values currently applicable in developed countries, probably indicative of the lower level of dietary iodine available to the population here. The values obtained in this study are offered to serve as normal reference for the interpretation of thyroid function results in Ethiopian patients. A strategy for the rational utilization of the available in vitro tests is suggested

  12. 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...

  13. Long work hours and adiposity among police officers in a US northeast city.

    Science.gov (United States)

    Gu, Ja K; Charles, Luenda E; Burchfiel, Cecil M; Fekedulegn, Desta; Sarkisian, Khachatur; Andrew, Michael E; Ma, Claudia; Violanti, John M

    2012-11-01

    To investigate the associations between long work hours and adiposity measures in police officers. Participants included 408 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study who were examined between 2004 and 2009. Total work hours were abstracted from payroll records and questionnaires. Analysis of variance and covariance models were used. Among male officers who worked the midnight shift, mean values of waist circumference and body mass index increased with longer work hours after adjustment for age, physical activity, energy intake, sleep duration, smoking status, police rank, activities after work (eg, child/family care, sports), and household income. Adiposity measures were not associated with work hours among women on any shift. Working longer hours was significantly associated with larger waist circumferences and higher body mass index among male police officers working the midnight shift.

  14. 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

  15. Implementation and Evaluation of a Values Clarification Activity for a Large Undergraduate Human Sexuality Course

    Science.gov (United States)

    Lederer, Alyssa M.

    2016-01-01

    Values clarification is an important tool that helps individuals to clarify their beliefs about sexuality-related issues. This lesson plan provides instructions for a 1-hour values clarification activity for a large undergraduate human sexuality course that serves as an introduction to course content and tone, stimulates students' initial thinking…

  16. How do migratory species add ecosystem service value to wilderness? Calculating the spatial subsidies provided by protected areas

    Science.gov (United States)

    Lopez-Hoffman, Laura; Semmens, Darius J.; Diffendorfer, Jay

    2013-01-01

    Species that migrate through protected and wilderness areas and utilize their resources, deliver ecosystem services to people in faraway locations. The mismatch between the areas that most support a species and those areas where the species provides most benefits to society can lead to underestimation of the true value of protected areas such as wilderness. We present a method to communicate the “off-site” value of wilderness and protected areas in providing habitat to migratory species that, in turn, provide benefits to people in distant locations. Using northern pintail ducks (Anas acuta) as an example, the article provides a method to estimate the amount of subsidy – the value of the ecosystem services provided by a migratory species in one area versus the cost to support the species and its habitat elsewhere.

  17. A Comparison of 4- and 24-Hour Urine Samples for the Diagnosis of Proteinuria in Pregnancy

    Directory of Open Access Journals (Sweden)

    Afsane Amirabi

    2011-09-01

    Full Text Available Background: Preeclampsia is a serious complication of pregnancy, and it is vital to diagnosis the condition as early as possible. Proteinuria is an important symptom of preeclampsia, and repeated urine analysis to screen for the condition is part of the standard antenatal care. The purpose of this study was to determine the correlation between 4- and 24-hour urine total protein values to examine whether the 4-hour urine samples could be used for the diagnosis of proteinuria in hypertensive disorders of pregnancy. Methods: A cross-sectional study was performed on 110 pregnant (after gestational week 20 of pregnancy patients who were hypertensive (blood pressure ≥140/90 mmHg and had proteinuria as defined by positive urinary protein of at least 1+ in dipstick. Patients' urine samples were collected over 24 hours; the first 4 hours were collected separately from the next 20-hours. Patients, who did not collect the 24-hour urine, were excluded from the study. One hundred patients met the criteria, and were included in the study. The urine volume, total protein and creatinine levels of 4- and 24-hours samples were measured. The correlation between 4-hour and 24-hour samples was examined using Pearson correlation test. Results: Of the 100 patients, 42 had no proteinuria, 44 had mild proteinuria, and 14 had severe proteinuria. The urine protein values of 4-hour samples correlated with those of the 24-hours samples for patients with mild and severe forms of the disease (P<0.001, r=0.86. Conclusion: This study showed there was a correlation between 4-hour and 24-hour urine proteins. The finding indicates that a random 4-hour sample might be used for the initial assessment of proteinuria

  18. 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...

  19. Working hours and health behaviour among nurses at public hospitals.

    Science.gov (United States)

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

    2013-01-01

    To analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. This is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). Men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  20. 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.

  1. Changes of glucose utilization by erythrocytes, lactic acid concentration in the serum and blood cells, and haematocrit value during one hour rest after maximal effort in individuals differing in physical efficiency.

    Science.gov (United States)

    Tomasik, M

    1982-01-01

    Glucose utilization by the erythrocytes, lactic acid concentration in the blood and erythrocytes, and haematocrit value were determined before exercise and during one hour rest following maximal exercise in 97 individuals of either sex differing in physical efficiency. In the investigations reported by the author individuals with strikingly high physical fitness performed maximal work one-third greater than that performed by individuals with medium fitness. The serum concentration of lactic acid was in all individuals above the resting value still after 60 minutes of rest. On the other hand, this concentration returned to the normal level in the erythrocytes but only in individuals with strikingly high efficiency. Glucose utilization by the erythrocytes during the restitution period was highest immediately after the exercise in all studied individuals and showed a tendency for more rapid return to resting values again in individuals with highest efficiency. The investigation of very efficient individuals repeated twice demonstrated greater utilization of glucose by the erythrocytes at the time of greater maximal exercise. This was associated with greater lactic acid concentration in the serum and erythrocytes throughout the whole one-hour rest period. The observed facts suggest an active participation of erythrocytes in the process of adaptation of the organism to exercise.

  2. 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...

  3. 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.

  4. Working Long Hours and Early Career Outcomes in the High-End Labor Market

    OpenAIRE

    Dora Gicheva

    2013-01-01

    This study establishes empirically a positive but nonlinear relationship between weekly hours and hourly wage growth. For workers who put in over 47 hours per week, 5 extra hours are associated with a 1% increase in annual wage growth. This correlation is not present when hours are lower. The relationship is especially strong for young professionals. Data on promotions provide evidence in support of a job-ladder model that combines higher skill sensitivity of output in higher-level jobs with ...

  5. 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…

  6. Working hours and health behaviour among nurses at public hospitals

    Directory of Open Access Journals (Sweden)

    Juliana da Costa Fernandes

    2013-09-01

    Full Text Available OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279. RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  7. Long working hours and sickness absence-a fixed effects design.

    Science.gov (United States)

    Bernstrøm, Vilde Hoff

    2018-05-02

    While long working hours seem to lead to impaired health, several studies have also shown that long working hours are related to lower levels of sickness absence. Previous studies on the relationship between long working hours and sickness absence have compared those who work long hours to those who do not, looking only at between-individual correlations. Those results might therefore reflect relatively stable differences between employees who typically work long hours and employees who typically do not. The aim of the present study is to examine within-individual correlations between long working hours and sickness absence. Records from the Human Resources department in a large Norwegian hospital from 2012 to 2015 provided objective data on both working hours and sickness absence. Two analyses were performed: a prospective cohort analysis to replicate the results from previous between-individual analyses and a second analysis of within-individual correlations using a fixed effect design. In line with existing research, both between-individual and within-individual analyses showed a negative relationship between long working hours (> 48 h/week) and short-term sickness absence (1-8 days) and no significant difference in incidence of long-term sickness absence (> 8 days). The results indicate that the negative relationship between long working hours and sickness absence is not due only to relatively stable individual differences between those who typically work long hours and those who do not. The results from both analyses therefore still contrast with previous research showing a negative relationship between long working hours and other health indicators.

  8. Evaluation of the performance of three diffuse hourly irradiation models on tilted surfaces according to the utilizability concept

    International Nuclear Information System (INIS)

    Posadillo, R.; Lopez Luque, R.

    2009-01-01

    The performance of three diffuse hourly irradiation models on tilted surfaces was evaluated by making a database of hourly global and diffuse solar irradiation on a horizontal surface, as well as global solar irradiation on a tilted surface, recorded in a solar radiation station located at Cordoba University (Spain). The method for a comparison of the performance of these models was developed from a study of the 'utilizable energy' statistics, a value representing, for a specific period of time, the mean monthly radiation that exceeded a critical level of radiation. This model comparison method seemed to us to be highly suitable since it provides a way of comparing the capacity of these models to estimate, however, much energy is incident on a tilted surface above a critical radiation level. Estimated and measured values were compared using the normalized RMBE and RRMSE statistics. According to the results of the method let us verify that, of the three models evaluated, one isotropic and two anisotropic, the Reindl et al. anisotropic model was the one giving the best results.

  9. 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

  10. Effect of travoprost on 24-hour intraocular pressure in normal tension glaucoma

    Directory of Open Access Journals (Sweden)

    Yuya Nomura

    2010-07-01

    Full Text Available Yuya Nomura1, Shunsuke Nakakura2, Mitsuyasu Moriwaki1, Yasuhiro Takahashi1, Kunihiko Shiraki11Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Osaka City University, Japan; 2Department of Ophthalmology, Saiseikai Gose Hospital, JapanPurpose: The effect of travoprost 0.004% on 24-hour intraocular pressure (IOP was examined in patients with normal tension glaucoma (NTG.Subjects and methods: This study included 17 patients with newly diagnosed unilateral NTG. IOP was measured at three-hour intervals over 24 hours by Goldman applanation tonometer in patients taking topical travoprost 0.004% and was compared retrospectively with 24-hour IOP data in untreated eyes.Results: IOP values were significantly reduced at individual time points after treatment (P < 0.01. Mean 24-hour IOP, maximum 24-hour IOP, minimum 24-hour IOP, and 24-hour IOP fluctuations at baseline (mean ± SD were 12.9 ± 2.2 mmHg, 15.4 ± 2.7 mmHg, 10.5 ± 2.2 mmHg, and 4.9 ± 1.2 mmHg, respectively, and were significantly reduced to 10.3 ± 2.0 mmHg, 12.4 ± 2.5 mmHg, 8.5 ± 1.9 mmHg (all P < 0.001, and 3.9 ± 1.5 mmHg (P < 0.05, respectively, after treatment. The rate of IOP reduction greater than 20% was 58.8% (10 eyes for maximum 24-hour IOP and 53.0% (nine eyes for mean 24-hour IOP.Conclusion: Travoprost reduced IOP throughout the 24-hour study period, with over half of the eyes examined showing IOP reduction exceeding 20%.Keywords: 24-hour intraocular pressure, fluctuation, normal tension glaucoma, travoprost, Travatan Z

  11. Working Hours, Promotion and the Gender Gap in the Workplace

    DEFF Research Database (Denmark)

    Kato, Takao; Owan, Hideo; Ogawa, Hiromasa

    thereof. The firm's decision to provide training also depends on its private information about the worker's OJT ability, which affects his/her future productivity if and when the worker gets promoted. Upon completion of training, the firm then promotes the worker. The model illuminates under what......This paper presents a novel model of promotion within the firm which sheds new light on the interplay between working hours and the odds of subsequent promotion. The model's key feature is the coexistence of two different sources of asymmetric information: (i) the worker's cost of long working....../her on the job. Long working hours signal the worker's commitment to the firm, which determines the surplus produced when the worker is promoted. Thus, the firm provides the worker with managerial training only after observing the employee's hours worked, a signal of his/her commitment to the firm or lack...

  12. 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...

  13. Long Working Hours and Work-related Cerebro-cardiovascular Disease in Korea

    Science.gov (United States)

    CHUNG, Yun Kyung; KWON, Young-jun

    2013-01-01

    The aim of the present study was to determine a good discriminatory cutoff for long working hours as a surrogate of chronic overload at work, which is associated with the approval of workers’ compensation claims for work-related cerebro-cardiovascular disease (WR-CVD) in Korea. We evaluated weekly working hours for four weeks prior to the onset of disease for all manufacturing industry claimants (N=319) of WR-CVD in 2010. The discrimination of long working hours in predicting approval of worker’s compensation pertaining to WR-CVD was compared across cases. The cutoff was calculated with sensitivity, specificity, and the area under the curve with 95% CI using the receiver operating curve (ROC) method. The cutoff point was thus calculated to be 60.75 h (AUC=0.89, 95% CI [0.84–0.93]), showing a sensitivity value of 65% and specificity of 94%. This is the first study to report that long working hours could be a predictor with good discrimination and high specificity of approval of WR-CVD cases. In Korea, long working hours and widespread chronic overload at work are recognized as a social problem. Our study results suggest an appropriate cutoff for working hours as an indicator of chronic overload for the purpose of approving claims of WR-CVD. Furthermore, these results could contribute to improving the consistency of evaluation. PMID:23892901

  14. Long working hours and work-related cerebro-cardiovascular disease in Korea.

    Science.gov (United States)

    Chung, Yun Kyung; Kwon, Young-jun

    2013-01-01

    The aim of the present study was to determine a good discriminatory cutoff for long working hours as a surrogate of chronic overload at work, which is associated with the approval of workers' compensation claims for work-related cerebro-cardiovascular disease (WR-CVD) in Korea. We evaluated weekly working hours for four weeks prior to the onset of disease for all manufacturing industry claimants (N=319) of WR-CVD in 2010. The discrimination of long working hours in predicting approval of worker's compensation pertaining to WR-CVD was compared across cases. The cutoff was calculated with sensitivity, specificity, and the area under the curve with 95% CI using the receiver operating curve (ROC) method. The cutoff point was thus calculated to be 60.75 h (AUC=0.89, 95% CI [0.84-0.93]), showing a sensitivity value of 65% and specificity of 94%. This is the first study to report that long working hours could be a predictor with good discrimination and high specificity of approval of WR-CVD cases. In Korea, long working hours and widespread chronic overload at work are recognized as a social problem. Our study results suggest an appropriate cutoff for working hours as an indicator of chronic overload for the purpose of approving claims of WR-CVD. Furthermore, these results could contribute to improving the consistency of evaluation.

  15. Safe working hours--doctors in training a best practice issue.

    Science.gov (United States)

    Lewis, Andrew

    2002-01-01

    In 1995, the Australian Medical Association launched its Safe Working Hours campaign. By 1998, this had been developed into a National Code of Conduct that continues to resonate in the Australian public health system. However, and particularly in respect of Doctors in Training (DITs) who continue to work long hours, there are levels of resistance to proposals that seek to re-organise work or change prevailing professional and cultural expectations. Long working hours have substantial impacts on a DIT's capacity to consistently deliver high quality patient care, dilute the effectiveness of their training regime and have negative consequences on their health, social life and family responsibilities. While public hospitals often maintain the view that minimal budget flexibility restricts their capacity to affect change in a positive way, in fact devisable productivity and efficiency gains can be achieved by reducing working hours. Further, the medical profession needs to consider whether long hours provide an optimal environment for quality learning and performance.

  16. Hours of work and rest in the rail industry.

    Science.gov (United States)

    Anderson, C; Grunstein, R R; Rajaratnam, S M W

    2013-06-01

    Currently, the National Transport Commission is considering four options to form the regulatory framework for rail safety within Australia with respect to fatigue. While the National Transport Commission currently recommends no limitations around hours of work or rest, we provide evidence which suggests regulatory frameworks should incorporate a traditional hours of service regulation over more flexible policies. Our review highlights: Shift durations >12 h are associated with a doubling of risk for accident and injury. Fatigue builds cumulatively with each successive shift where rest in between is inadequate (hours of work and rest, including maximum shift duration and successive number of shifts. Appropriately, validated biomathematical models and technologies may be used as a part of a fatigue management system, to augment the protection afforded by limits on hours of work and rest. A comprehensive sleep disorder screening and management programme should form an essential component of any regulatory framework. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  17. Developing personal values: trainees' attitudes toward strikes by health care providers.

    Science.gov (United States)

    Li, Su-Ting T; Srinivasan, Malathi; Der-Martirosian, Claudia; Kravitz, Richard L; Wilkes, Michael S

    2011-05-01

    Worldwide, health care providers use strikes and job actions to influence policy. For health care providers, especially physicians, strikes create an ethical tension between an obligation to care for current patients (e.g., to provide care and avoid abandonment) and an obligation to better care for future patients by seeking system improvements (e.g., improvements in safety, to access, and in the composition and strength of the health care workforce). This tension is further intensified when the potential benefit of a strike involves professional self-interest and the potential risk involves patient harm or death. By definition, trainees are still forming their professional identities and values, including their opinions on fair wages, health policy, employee benefits, professionalism, and strikes. In this article, the authors explore these ethical tensions, beginning with a discussion of reactions to a potential 2005 nursing strike at the University of California, Davis, Medical Center. The authors then propose a conceptual model describing factors that may influence health care providers' decisions to strike (including personal ethics, personal agency, and strike-related context). In particular, the authors explore the relationship between training level and attitudes toward taking a job action, such as going on strike. Because trainees' attitudes toward strikes continue to evolve during training, the authors maintain that open discussion around the ethics of health care professionals' strikes and other methods of conflict resolution should be included in medical education to enhance professionalism and systems-based practice training. The authors include sample case vignettes to help initiate these important discussions. Copyright © by the Association of American medical Colleges.

  18. Assessing the nutritive value of waterweeds to livestock production ...

    African Journals Online (AJOL)

    Paspalum scrobiculatum and Dicksonia antartica recorded the least value at 24 and 48 hours incubation while Nymphaea lotus and Dicksonia antartica had the least value at 72 and 96 hours incubation. Heteranthera callifolia had the highest organic matter digestibility (%) while the least short chain fatty acid (μmol) was ...

  19. Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues.

    Science.gov (United States)

    Taubert, Mark; Nelson, Annmarie

    2010-08-12

    Out-of-hours general practitioners (GPs) cover the community over a significant proportion of a given week, and palliative care patients are seen as a priority. Little is known about how well these GPs feel supported in their line of work and whether communication exchanges work well for the proportion of their patients who have palliative care needs. For this study, GPs who provide out-of-hours care were interviewed in order to explore factors that they identified as detrimental or beneficial for good communication between themselves, patients, relatives and other professionals, specifically to palliative care encounters. Nine GPs were interviewed using face-to-face semi-structured interviews. All nine GPs worked regular out-of-hours sessions. Data from transcripts was analysed using Interpretative Phenomenological Analysis. A predominant theme expressed by GPs related to constraints within the system provided by the local private company owned out-of-hours provider. A strong feeling of 'being alone out there' emerged, with some GPs more willing to call for help than others, and others expressing their concern at access to pharmacies and medication being very inconsistent.Out-of-hours GPs felt left alone on occasion, unable to access daytime services and not knowing who to call for advice. Information hand-over systems from in-hours to out-of-hours with regard to palliative care were felt to be inadequate. Out-of-hours doctors interviewed felt left out of the care loop; handover sheets from specialist palliative care providers were a rarity. Out-of-hours services need to be mindful of the needs of the GPs they employ, in particular relating to the palliative care they provide in this setting. Other healthcare professionals should aim to keep their local out-of-hours service informed about palliative care patients they may be called to see.

  20. Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues

    Directory of Open Access Journals (Sweden)

    Taubert Mark

    2010-08-01

    Full Text Available Abstract Background Out-of-hours general practitioners (GPs cover the community over a significant proportion of a given week, and palliative care patients are seen as a priority. Little is known about how well these GPs feel supported in their line of work and whether communication exchanges work well for the proportion of their patients who have palliative care needs. For this study, GPs who provide out-of-hours care were interviewed in order to explore factors that they identified as detrimental or beneficial for good communication between themselves, patients, relatives and other professionals, specifically to palliative care encounters. Methods Nine GPs were interviewed using face-to-face semi-structured interviews. All nine GPs worked regular out-of-hours sessions. Data from transcripts was analysed using Interpretative Phenomenological Analysis. Results A predominant theme expressed by GPs related to constraints within the system provided by the local private company owned out-of-hours provider. A strong feeling of 'being alone out there' emerged, with some GPs more willing to call for help than others, and others expressing their concern at access to pharmacies and medication being very inconsistent. Out-of-hours GPs felt left alone on occasion, unable to access daytime services and not knowing who to call for advice. Information hand-over systems from in-hours to out-of-hours with regard to palliative care were felt to be inadequate. Out-of-hours doctors interviewed felt left out of the care loop; handover sheets from specialist palliative care providers were a rarity. Conclusions Out-of-hours services need to be mindful of the needs of the GPs they employ, in particular relating to the palliative care they provide in this setting. Other healthcare professionals should aim to keep their local out-of-hours service informed about palliative care patients they may be called to see.

  1. 29 CFR 778.202 - Premium pay for hours in excess of a daily or weekly standard.

    Science.gov (United States)

    2010-07-01

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

  2. Deregulating Overtime Hours Restrictions on Women and its Effects on Female Employment

    DEFF Research Database (Denmark)

    Kato, Takao; Kodama, Naomi

    2017-01-01

    This paper provides novel evidence on the effect of deregulating overtime hours restrictions on women by using the 1985 Amendments to the Labour Standards Act (LSA) in Japan as a natural experiment. The original LSA of 1947 prohibited women from working overtime exceeding two hours a day; six hours...... a week; and 150 hours a year. The 1985 Amendments exempted a variety of occupations and industries from such an overtime restriction on women. Applying a difference-in-difference model to census data, we find causal evidence pointing to the positive effect of this particular piece of labour market...

  3. Did liberalising bar hours decrease traffic accidents?

    Science.gov (United States)

    Green, Colin P; Heywood, John S; Navarro, Maria

    2014-05-01

    Legal bar closing times in England and Wales have historically been early and uniform. Recent legislation liberalised closing times with the object of reducing social problems thought associated with drinking to "beat the clock." Indeed, using both difference in difference and synthetic control approaches we show that one consequence of this liberalisation was a decrease in traffic accidents. This decrease is heavily concentrated among younger drivers. Moreover, we provide evidence that the effect was most pronounced in the hours of the week directly affected by the liberalisation: late nights and early mornings on weekends. This evidence survives a series of robustness checks and suggests at least one socially positive consequence of extending bar hours. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Quality-control of an hourly rainfall dataset and climatology of extremes for the UK.

    Science.gov (United States)

    Blenkinsop, Stephen; Lewis, Elizabeth; Chan, Steven C; Fowler, Hayley J

    2017-02-01

    Sub-daily rainfall extremes may be associated with flash flooding, particularly in urban areas but, compared with extremes on daily timescales, have been relatively little studied in many regions. This paper describes a new, hourly rainfall dataset for the UK based on ∼1600 rain gauges from three different data sources. This includes tipping bucket rain gauge data from the UK Environment Agency (EA), which has been collected for operational purposes, principally flood forecasting. Significant problems in the use of such data for the analysis of extreme events include the recording of accumulated totals, high frequency bucket tips, rain gauge recording errors and the non-operation of gauges. Given the prospect of an intensification of short-duration rainfall in a warming climate, the identification of such errors is essential if sub-daily datasets are to be used to better understand extreme events. We therefore first describe a series of procedures developed to quality control this new dataset. We then analyse ∼380 gauges with near-complete hourly records for 1992-2011 and map the seasonal climatology of intense rainfall based on UK hourly extremes using annual maxima, n-largest events and fixed threshold approaches. We find that the highest frequencies and intensities of hourly extreme rainfall occur during summer when the usual orographically defined pattern of extreme rainfall is replaced by a weaker, north-south pattern. A strong diurnal cycle in hourly extremes, peaking in late afternoon to early evening, is also identified in summer and, for some areas, in spring. This likely reflects the different mechanisms that generate sub-daily rainfall, with convection dominating during summer. The resulting quality-controlled hourly rainfall dataset will provide considerable value in several contexts, including the development of standard, globally applicable quality-control procedures for sub-daily data, the validation of the new generation of very high

  5. 50 CFR 20.106 - Seasons, limits, and shooting hours for sandhill cranes.

    Science.gov (United States)

    2010-10-01

    ... sandhill cranes. 20.106 Section 20.106 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., and Shooting Hours Schedules § 20.106 Seasons, limits, and shooting hours for sandhill cranes. This section provides for the annual hunting of sandhill cranes in designated portions of the 48 contiguous...

  6. The generation of hourly diffuse irradiation: A model from the analysis of the fluctuation of global irradiance series

    International Nuclear Information System (INIS)

    Posadillo, R.; Lopez Luque, R.

    2010-01-01

    An analysis of models for the estimation of hourly diffuse irradiation based on the interrelations between the hourly diffuse fraction k d and the hourly clearness index k t , has concluded that k t is not a sufficient variable for parametrizing the effect of clouds on diffuse irradiation. A detailed study of the dispersion recorded by this diffuse component for a specific clearness index under partly cloudy sky conditions has led to analyzing how the variability in the instantaneous clearness index influences this dispersion. The data sets correspond to 10 years of hourly and instantaneous value records of global and diffuse radiation collected in Cordoba, Spain. In addition to the inclusion of the sine of solar elevation as a variable into the k d -k t correlations, this model propose the inclusion of others parameters related to the variability in the normalized clearness index within an hour and with the fluctuations presented by the time series of the instantaneous values of that index. Also presented is the implementation of an algorithm permitting both the determination of the hourly diffuse irradiation and the discrimination between the different sky conditions in those situations known by the designation partly cloudy sky.

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

    Science.gov (United States)

    Ejiri, A.

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

  8. The declining demand for hospital care as a rationale for duty hour reform.

    Science.gov (United States)

    Jena, Anupam B; DePasse, Jacqueline W; Prasad, Vinay

    2014-10-01

    The regulation of duty hours of physicians in training remains among the most hotly debated subjects in medical education. Although recent duty hour reforms have been chiefly motivated by concerns about resident well-being and medical errors attributable to resident fatigue, the debate surrounding duty hour reform has infrequently involved discussion of one of the most important secular changes in hospital care that has affected nearly all developed countries over the last 3 decades: the declining demand for hospital care. For example, in 1980, we show that resident physicians in US teaching hospitals provided, on average, 1,302 inpatient days of care per resident physician compared to 593 inpatient days in 2011, a decline of 54%. This decline in the demand for hospital care by residents provides an under-recognized economic rationale for reducing residency duty hours, a rationale based solely on supply and demand considerations. Work hour reductions and growing requirements for outpatient training can be seen as an appropriate response to the shrinking demand for hospital care across the health-care sector.

  9. A COMPARATIVE STUDY OF PREEMPTIVE USE OF 0.2% ROPIVACAINE AND 0.125% BUPIVACAINE ALONG WITH FENTANYL AND FENTANYL INCREMENTS TO PROVIDE POSTOPERATIVE EPIDURAL ANALGESIA UP TO 24 HOURS

    Directory of Open Access Journals (Sweden)

    Chiranji Lal Khedia

    2016-06-01

    Full Text Available BACKGROUND AND OBJECTIVES The present study was carried out to compare duration of analgesia, haemodynamic changes (Systolic and Diastolic Blood Pressure, Pulse Rate, Respiratory Rate, total incremental doses of epidural fentanyl required to maintain VAS 3 up to 24 hours in each group and total required incremental fentanyl doses were compared between both the groups. Once the data were collected from all the patients, they were compared using, chi-square test, two sample t-test. The p-value was calculated and P <0.05 was considered statistically significant. RESULTS The duration of analgesia was more with Group BF (245+17.58 min. than Group RF (217.6+22.41 min., thus it is concluded that difference in duration of analgesia was statistically significant between the groups (P<0.05. In this study, it was noticed that patients of Group RF required much more incremental doses of epidural fentanyl (218+31.88 μg to maintain VAS<3 up to 24 hours than group BF (170+32.27 μg, and difference was statistically significant (P<0.05. Haemodynamic parameters like SBP, DBP, HR and RR were comparable in both the groups. Hypotension and bradycardia were noted in two patients of group BF. CONCLUSION Duration of analgesia was longer and comparatively better in group BF and less incremental doses were required to maintain VAS <3 up to 24 hours as compared to group RF, but haemodynamic stability was more in group RF as compared to group BF.

  10. 10 CFR 26.205 - Work hours.

    Science.gov (United States)

    2010-01-01

    ... an 8-hour break between successive work periods when a break of less than 10 hours is necessary to...) Individuals who are working 8-hour shift schedules shall have at least 1 day off per week, averaged over the shift cycle; (ii) Individuals who are working 10-hour shift schedules shall have at least 2 days off per...

  11. Short-Term Reproducibility of Twenty-Four-Hour Intraocular Pressure Curves in Untreated Patients with Primary Open-Angle Glaucoma and Ocular Hypertension.

    Directory of Open Access Journals (Sweden)

    Shuo Xu

    Full Text Available To assess the short-term day-to-day reproducibility of 24-hour intraocular pressure (IOP curves in various respects in untreated primary open-angle glaucoma (POAG and ocular hypertension (OHT patients.47 subjects with POAG and 34 subjects with OHT underwent IOP measurements every 2 hours in both eyes for consecutive 48 hours by a non-contact tonometer (NCT. IOP values at each time point were recorded. Mean IOP, peak IOP, time difference of peak IOP between two days and IOP fluctuation were also calculated. Intraclass correlation coefficients (ICCs and Bland-Altman plots were used to evaluate reproducibility.ICCs of the entire IOP values for a complete 24-hour curve were 0.577 and 0.561 in POAG and OHT patients, respectively. ICCs of IOP values at different time points ranged from 0.384 (10am to 0.686 (4am in POAG patients and from 0.347 (6am to 0.760 (4am in OHT patients. ICCs of mean IOP, peak IOP and IOP fluctuation were respectively 0.832, 0.704, 0.367 in POAG patients and 0.867, 0.816 0.633 in OHT patients. Only 37.23% and 35.29% of the peak IOP time points appeared within the time difference of 2 hours in POAG and OHT patients, respectively, while 53.19% and 48.53% appeared within 4 hours in POAG and OHT patients, respectively.A 24-hour IOP curve in a single day is not highly reproducible in short-term and has limited use for evaluating individual IOP condition. Mean IOP and peak IOP for a 24-hour IOP curve are useful parameters in clinical follow-up, while IOP value at a certain time point, IOP fluctuation and peak IOP time point should be interpreted with caution.

  12. Effectiveness of 2-hour Troponin in High-risk Patients With Suspected Acute Coronary Syndrome.

    Science.gov (United States)

    Bove, Joseph; Hochman, Steven; Miller, Jacob; Artim, Stephen

    2017-06-01

    Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome. Patients were defined as high risk if the attending physician planned to admit or transfer the patient to the observation unit. History, Electrocardiography, Age, Risk factors, Troponin scores were calculated on all patients to provide verification that the individuals were high risk. The primary outcome was a composite of 30-day myocardial infarction, death, cardiac arrest with return of spontaneous circulation, or dysrhythmia. The secondary outcome was 30-day revascularization. We included a total of 122 patients with an average follow-up of 112 days (minimum 30 days). A total of 86% of cases had History, Electrocardiography, Age, Risk factors, Troponin scores ≥4. The primary outcome was met in 22 (18%) patients, and the secondary outcome occurred in 7 (5.7%) patients. The negative predictive value of negative 2-hour troponins along with no significant delta troponin rise was 98.7%. Discharging patients thought to be high risk who have negative troponins at 0 and 2 hours and no delta troponin rise appears safe. No deaths occurred in follow-up. Larger studies are warranted.

  13. Using probabilistic finite automata to simulate hourly series of global radiation

    Energy Technology Data Exchange (ETDEWEB)

    Mora-Lopez, L. [Universidad de Malaga (Spain). Dpto. Lenguajes y Computacion; Sidrach-de-Cardona, M. [Universidad de Malaga (Spain). Dpto. Fisica Aplicada II

    2003-03-01

    A model to generate synthetic series of hourly exposure of global radiation is proposed. This model has been constructed using a machine learning approach. It is based on the use of a subclass of probabilistic finite automata which can be used for variable-order Markov processes. This model allows us to represent the different relationships and the representative information observed in the hourly series of global radiation; the variable-order Markov process can be used as a natural way to represent different types of days, and to take into account the ''variable memory'' of cloudiness. A method to generate new series of hourly global radiation, which incorporates the randomness observed in recorded series, is also proposed. As input data this method only uses the mean monthly value of the daily solar global radiation. We examine if the recorded and simulated series are similar. It can be concluded that both series have the same statistical properties. (author)

  14. Three Mile Island - The hour-by-hour account of what really happened

    International Nuclear Information System (INIS)

    Stephens, M.

    1980-01-01

    An hour-by-hour account is given of the progression of events leading up to and during the accident at the Three Mile Island Unit 2 reactor. The emergency procedures followed, the evacuation of local residents and the decisions taken as the possibility of a meltdown became apparent are recorded in detail together with aspects of the media coverage and the problems of communication. (U.K.)

  15. Systematic screening of child abuse in out-of-hours primary care

    NARCIS (Netherlands)

    Schouten, MCM

    2017-01-01

    Child abuse is a serious global health problem. This thesis focused on – improving – the detection of child abuse in the out-of-hours primary care (OOH-PC). The main aim was to assess the diagnostic value of the screening instrument SPUTOVAMO-R2 for child abuse. We found that the detection rate of

  16. 24-Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Mena, Luis J; Felix, Vanessa G; Melgarejo, Jesus D; Maestre, Gladys E

    2017-10-19

    Although 24-hour blood pressure (BP) variability (BPV) is predictive of cardiovascular outcomes independent of absolute BP levels, it is not regularly assessed in clinical practice. One possible limitation to routine BPV assessment is the lack of standardized methods for accurately estimating 24-hour BPV. We conducted a systematic review to assess the predictive power of reported BPV indexes to address appropriate quantification of 24-hour BPV, including the average real variability (ARV) index. Studies chosen for review were those that presented data for 24-hour BPV in adults from meta-analysis, longitudinal or cross-sectional design, and examined BPV in terms of the following issues: (1) methods used to calculate and evaluate ARV; (2) assessment of 24-hour BPV determined using noninvasive ambulatory BP monitoring; (3) multivariate analysis adjusted for covariates, including some measure of BP; (4) association of 24-hour BPV with subclinical organ damage; and (5) the predictive value of 24-hour BPV on target organ damage and rate of cardiovascular events. Of the 19 assessed studies, 17 reported significant associations between high ARV and the presence and progression of subclinical organ damage, as well as the incidence of hard end points, such as cardiovascular events. In all these cases, ARV remained a significant independent predictor ( P <0.05) after adjustment for BP and other clinical factors. In addition, increased ARV in systolic BP was associated with risk of all cardiovascular events (hazard ratio, 1.18; 95% confidence interval, 1.09-1.27). Only 2 cross-sectional studies did not find that high ARV was a significant risk factor. Current evidence suggests that ARV index adds significant prognostic information to 24-hour ambulatory BP monitoring and is a useful approach for studying the clinical value of BPV. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  17. Work hours and cortisol variation from non-working to working days.

    Science.gov (United States)

    Marchand, Alain; Durand, Pierre; Lupien, Sonia

    2013-07-01

    This study aims at modelling the relationship between the number of work hours per week and cortisol variation across 3 days by comparing non-working day to working day in a population of day-shift workers. Questionnaire data and saliva samples for cortisol analysis were collected on 132 day-shift workers employed in 13 workplaces in Canada. Consenting workers provided 5 saliva samples a day (awaking, 30 min after awaking, 2 p.m., 4 p.m., bedtime) repeated 3 times (Saturday, Tuesday, Thursday) over a week, to provide measures at work and non-work times and settings. Multilevel regression models were estimated from cortisol measurements at each occasion within a day at level-1, days at level-2 and workers at level-3. Controlling for gender and age, results revealed significant variations in salivary cortisol concentration between sample, day and worker levels. Cortisol increases linearly from non-working day to work days and work hours per week interacted with days, revealing a positive association between the number of work hours per week and cortisol concentrations during these days. Work hours per week did not interact with awaking, 30 min after awaking, 2 p.m., 4 p.m., and bedtime cortisol concentrations. Gender and age had neither main effects nor interaction effects. No significant cortisol variations were found between workplaces. These results suggest that work hours act as a stressor that is associated with significant variations in cortisol concentrations over working days. Non-working days may contribute to stress reduction in workers who experience longer work hours.

  18. Safe and tolerable one-hour pamidronate infusion for multiple myeloma patients

    Directory of Open Access Journals (Sweden)

    Dimitrios Chantzichristos

    2008-09-01

    Full Text Available Dimitrios Chantzichristos, Andréasson Björn, Johansson PeterDepartment of Internal Medicine, Uddevalla Hospital, Uddevalla, SwedenBackground: Once a month, patients with multiple myeloma received an infusion of bisphosphonates, principally to reduce osteoclastic bone resorption. Recommended infusion time for pamidronate is 2 hours in the US and 4 hours in Europe because of its potential nephrotoxicity. From 2003, a 90 mg infusion of pamidronate was provided over 1 hour to patients with no pre-existing renal impairment, in the Daily Care Unit at Uddevalla Hospital.Method: Retrospective analysis of the renal deterioration, serum calcium, and adverse effects in patients with multiple myeloma treated with 1-hour pamidronate 90 mg infusion from January 2003 to April 2007.Results: Seventy-nine patients provided valuable data. A total number of 846 infusions were given and the median number of infusion to each patient was 11. Significant creatinine elevation was seen in 7 patients (8.9%, after 19 infusions (2.2%. Renal deterioration occurred in 5 of these 7 patients, which was related to progress of the myeloma or opportunistic infections. Prevalence of infusion-related events was 0.8% and the mean total S-Ca was 0.05 mmol/L lower than the baseline.Conclusion: Few events of renal deterioration, hypocalcemia, or other adverse effects resulted from a 1-hour pamidronate 90 mg infusion for multiple myeloma patients with no pre-existing renal impairment.Keywords: bisphosphonates, pamidronate, multiple myeloma, infusion time

  19. Four-hour quantitative real-time polymerase chain reaction-based comprehensive chromosome screening and accumulating evidence of accuracy, safety, predictive value, and clinical efficacy.

    Science.gov (United States)

    Treff, Nathan R; Scott, Richard T

    2013-03-15

    Embryonic comprehensive chromosomal euploidy may represent a powerful biomarker to improve the success of IVF. However, there are a number of aneuploidy screening strategies to consider, including different technologic platforms with which to interrogate the embryonic DNA, and different embryonic developmental stages from which DNA can be analyzed. Although there are advantages and disadvantages associated with each strategy, a series of experiments producing evidence of accuracy, safety, clinical predictive value, and clinical efficacy indicate that trophectoderm biopsy and quantitative real-time polymerase chain reaction (qPCR)-based comprehensive chromosome screening (CCS) may represent a useful strategy to improve the success of IVF. This Biomarkers in Reproductive Medicine special issue review summarizes the accumulated experience with the development and clinical application of a 4-hour blastocyst qPCR-based CCS technology. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. The generation of hourly diffuse irradiation: A model from the analysis of the fluctuation of global irradiance series

    Energy Technology Data Exchange (ETDEWEB)

    Posadillo, R.; Lopez Luque, R. [Grupo de Investigacion de Fisica para las Energias y Recursos Renovables, Dpto. de Fisica Aplicada, UCO, Edificio C2 Campus de Rabanales, 14071 Cordoba (Spain)

    2010-04-15

    An analysis of models for the estimation of hourly diffuse irradiation based on the interrelations between the hourly diffuse fraction k{sub d} and the hourly clearness index k{sub t}, has concluded that k{sub t} is not a sufficient variable for parametrizing the effect of clouds on diffuse irradiation. A detailed study of the dispersion recorded by this diffuse component for a specific clearness index under partly cloudy sky conditions has led to analyzing how the variability in the instantaneous clearness index influences this dispersion. The data sets correspond to 10 years of hourly and instantaneous value records of global and diffuse radiation collected in Cordoba, Spain. In addition to the inclusion of the sine of solar elevation as a variable into the k{sub d}-k{sub t} correlations, this model propose the inclusion of others parameters related to the variability in the normalized clearness index within an hour and with the fluctuations presented by the time series of the instantaneous values of that index. Also presented is the implementation of an algorithm permitting both the determination of the hourly diffuse irradiation and the discrimination between the different sky conditions in those situations known by the designation partly cloudy sky. (author)

  1. The spatial return level of aggregated hourly extreme rainfall in Peninsular Malaysia

    Science.gov (United States)

    Shaffie, Mardhiyyah; Eli, Annazirin; Wan Zin, Wan Zawiah; Jemain, Abdul Aziz

    2015-07-01

    This paper is intended to ascertain the spatial pattern of extreme rainfall distribution in Peninsular Malaysia at several short time intervals, i.e., on hourly basis. Motivation of this research is due to historical records of extreme rainfall in Peninsular Malaysia, whereby many hydrological disasters at this region occur within a short time period. The hourly periods considered are 1, 2, 3, 6, 12, and 24 h. Many previous hydrological studies dealt with daily rainfall data; thus, this study enables comparison to be made on the estimated performances between daily and hourly rainfall data analyses so as to identify the impact of extreme rainfall at a shorter time scale. Return levels based on the time aggregate considered are also computed. Parameter estimation using L-moment method for four probability distributions, namely, the generalized extreme value (GEV), generalized logistic (GLO), generalized Pareto (GPA), and Pearson type III (PE3) distributions were conducted. Aided with the L-moment diagram test and mean square error (MSE) test, GLO was found to be the most appropriate distribution to represent the extreme rainfall data. At most time intervals (10, 50, and 100 years), the spatial patterns revealed that the rainfall distribution across the peninsula differ for 1- and 24-h extreme rainfalls. The outcomes of this study would provide additional information regarding patterns of extreme rainfall in Malaysia which may not be detected when considering only a higher time scale such as daily; thus, appropriate measures for shorter time scales of extreme rainfall can be planned. The implementation of such measures would be beneficial to the authorities to reduce the impact of any disastrous natural event.

  2. The Other 17 Hours: Valuing Out-of-School Time. Occasional Papers 30

    Science.gov (United States)

    Teitle, Jennifer, Ed.

    2015-01-01

    This issue of "Bank Street Occasional Papers" explores the value of time outside of school. Educators have given relatively little scholarly attention to young people's nonschool lives. Ignored or valorized, nonschool spaces show up in educational research only as a backdrop, implying that school learning is the yardstick by which to…

  3. Hourly Precipitation Data (HPD) Publication

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly Precipitation Data (HPD) Publication is archived and available from the National Climatic Data Center (NCDC). This publication contains hourly precipitation...

  4. Long working hours and cancer risk

    DEFF Research Database (Denmark)

    Heikkila, Katriina; Nyberg, Solja T.; Madsen, Ida E. H.

    2016-01-01

    in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported. Results: During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393......Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk......; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working greater than or equal to55 h...

  5. A methodology for the stochastic generation of hourly synthetic direct normal irradiation time series

    Science.gov (United States)

    Larrañeta, M.; Moreno-Tejera, S.; Lillo-Bravo, I.; Silva-Pérez, M. A.

    2018-02-01

    Many of the available solar radiation databases only provide global horizontal irradiance (GHI) while there is a growing need of extensive databases of direct normal radiation (DNI) mainly for the development of concentrated solar power and concentrated photovoltaic technologies. In the present work, we propose a methodology for the generation of synthetic DNI hourly data from the hourly average GHI values by dividing the irradiance into a deterministic and stochastic component intending to emulate the dynamics of the solar radiation. The deterministic component is modeled through a simple classical model. The stochastic component is fitted to measured data in order to maintain the consistency of the synthetic data with the state of the sky, generating statistically significant DNI data with a cumulative frequency distribution very similar to the measured data. The adaptation and application of the model to the location of Seville shows significant improvements in terms of frequency distribution over the classical models. The proposed methodology applied to other locations with different climatological characteristics better results than the classical models in terms of frequency distribution reaching a reduction of the 50% in the Finkelstein-Schafer (FS) and Kolmogorov-Smirnov test integral (KSI) statistics.

  6. 30 CFR 48.25 - Training of new miners; minimum courses of instruction; hours of instruction.

    Science.gov (United States)

    2010-07-01

    ...; minimum courses of instruction; hours of instruction. (a) Each new miner shall receive no less than 24...: Provided, That no less than 8 hours of training shall in all cases be given to new miners before they are... instruction; hours of instruction. 48.25 Section 48.25 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION...

  7. [Effect of maximum blood pressure fluctuation on prognosis of patients with acute ischemic stroke within 24 hours after hospital admission].

    Science.gov (United States)

    Wang, H; Tang, Y; Zhang, Y; Xu, K; Zhao, J B

    2018-05-10

    Objective: To investigate the relationship between the maximum blood pressure fluctuation within 24 hours after admission and the prognosis at discharge. Methods: The patients with ischemic stroke admitted in Department of Neurology of the First Affiliated Hospital of Harbin Medical University within 24 hours after onset were consecutively selected from April 2016 to March 2017. The patients were grouped according to the diagnostic criteria of hypertension. Ambulatory blood pressure of the patients within 24 hours after admission were measured with bedside monitors and baseline data were collected. The patients were scored by NIHSS at discharge. The relationships between the maximum values of systolic blood pressure (SBP) or diastolic blood pressure (DBP) and the prognosis at discharge were analyzed. Results: A total of 521 patients with acute ischemic stroke were enrolled. They were divided into normal blood pressure group (82 cases) and hypertension group(439 cases). In normal blood pressure group, the maximum values of SBP and DBP were all in normal distribution ( P >0.05). The maximum value of SBP fluctuation was set at 146.6 mmHg. After adjustment for potential confounders, the OR for poor prognosis at discharge in patients with SBP fluctuation ≥146.6 mmHg was 2.669 (95 %CI : 0.594-11.992) compared with those with SBP fluctuation blood pressure at admission, the maximum values of SBP and DBP within 24 hours after admission had no relationship with prognosis at discharge. In acute ischemic stroke patients with hypertension at admission, the maximum values of SBP and DBP within 24 hours after admission were associated with poor prognosis at discharge.

  8. Clinical value of ambulatory blood pressure: evidence and limits.

    Science.gov (United States)

    Mancia, Giuseppe; Verdecchia, Paolo

    2015-03-13

    This article reviews the clinical value of ambulatory blood pressure (BP) vis-à-vis the traditional BP measurements taken in the physician's office or in the hospital. Mention is initially made that longitudinal studies conducted in the general population or in hypertensive cohorts have shown that ambulatory BP provides a more accurate prediction of outcome than office BP. Namely, that (1) the risk of cardiovascular events increases in a less steep fashion with office than with 24-hour mean BP, (2) the 24-hour BP-dependent prediction is maintained after adjustment for office BP values, and (3) among individuals with normal office BP, those with increased ambulatory BP (masked hypertension) have an increased prevalence of organ damage, a more frequent unfavorable metabolic profile and a higher risk of new onset sustained hypertension, diabetes mellitus, and cardiovascular events than those with normal ambulatory BP. It is further mentioned, however, that more recently similar observations have been made for individuals with high office but normal ambulatory BP (white coat hypertension) suggesting a complementary role of out-of-office and office BP values in the determination of patients' prognosis. The evidence in favor of an independent prognostic value also of some within 24-hour BP phenomena (night BP reduction or absolute values, short-term BP variations, and morning BP surge) is then critically appraised for its elements of strength and weakness. Finally, whether the clinical advantages of ambulatory BP make this approach necessary for all patients with hypertension is discussed. The conclusion is that this is at present still premature because crucial evidence pro or against routine use of this approach in untreated and treated hypertensives is not yet available. It will be crucial for future studies to determine whether, compared with a treatment guided by office BP, a treatment tailored on ambulatory BP allows to improve prevention or regression of organ

  9. US Naval Observatory Hourly Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly observations journal from the National Observatory in Washington DC. The observatory is the first station in the United States to produce hourly observations...

  10. Hours Constraints Within and Between Jobs

    OpenAIRE

    Euwals, R.W.

    1997-01-01

    In the empirical literature on labour supply, several models are developed to incorporate constraints on working hours. These models do not address the question to which extent working hours are constrained within and between jobs. In this paper I investigate the effect of individual changes in labour supply preferences on actual working hours. The availability of subjective information on the individual’s preferred working hours gives direct measures on the degree of adjustment of working ho...

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

    Science.gov (United States)

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

    2006-09-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  13. Forecasting hourly patient visits in the emergency department to counteract crowding

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2017-01-01

    visits. The data for 2012-2014 were used to create linear regression models, autoregressive integrated moving average (ARIMA) models, and – for purposes of comparison – naïve models of hourly patient arrivals and ED occupancy. Using the models, patient arrivals and ED occupancy were forecasted for every...... hour of January 2015. Results: Hourly patient arrivals were forecasted with a mean percentage error of 47-58% (regression), 49-58% (ARIMA), and 60-76% (naïve). Increasing the forecasting interval decreased the mean percentage error. ED occupancy was forecasted with better accuracy by ARIMA than...... regression models. With ARIMA the mean percentage error of the forecasts of the hourly ED occupancy was 69-73% for three of the EDs and 101% for the last ED. Factors beyond calendar variables might possibly have improved the models of ED occupancy, provided that information about these factors had been...

  14. Estimation of clear sky hourly global solar radiation in Iraq

    Energy Technology Data Exchange (ETDEWEB)

    Al-Jumaily, Kais J.; Al-Zuhairi, Munya F.; Mahdi, Zahraa S. [Department of Atmospheric Sciences, College of Science, Al-Mustansiriyah University, Baghdad (Iraq)

    2012-07-01

    The availability of hourly solar radiation data is very important for applications utilizing solar energy and for climate and environmental aspects. The aim of this work is to use a simple model for estimating hourly global solar radiation under clear sky condition in Iraq. Calculations were compared with measurements obtained from local station in Baghdad city and from Meteosat satellite data for different locations in Iraq. The statistical test methods of the mean bias error (MBE), root mean square error (RMSE) and t-test were used to evaluate the performance of the model. Results indicated that a fairly good agreement exists between calculated and measured values for all locations in Iraq. Since the model is independent of any meteorological variable, it would be of a practical use for rural areas where no meteorological data are available.

  15. 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

    Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled "Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?" was held at Harvard Medical School on June 17-18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine's recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. RESIDENT PHYSICIAN WORKLOAD AND SUPERVISION: By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians' time is dominated by tasks with little

  16. Design Values, U.S., 2015, EPA/OAR/OAQPS/AQAD

    Data.gov (United States)

    U.S. Environmental Protection Agency — This web service contains layers which depict design values for all NAAQS for through 2015 for the following: CO 8-hour, CO 1-hour, Lead 3-month, NO2 Annual, NO2...

  17. 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...

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

    Science.gov (United States)

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

    2012-10-01

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

  19. [A systematic review of working hours and mental health burden].

    Science.gov (United States)

    Fujino, Yoshihisa; Horie, Seichi; Hoshuyama, Tsutomu; Tsutsui, Takao; Tanaka, Yayoi

    2006-07-01

    There is growing concern over the possible increase in mental health problems among Japanese workers. This trend is generally regarded as a reflection of Japan's prolonged economic depression and changes in working environment. In fact, claims for compensation for industrial accidents related to mental health diseases have been rapidly increasing in recent years. Working hours, personal-relationships, support from supervisors/co-workers, job demand, job control, and payment are known to affect workers mental health. In 2004, the Government announced a guideline to combat overwork and mental health problems at work places. This guideline articulates that long overtime working is a major indicator, and workers who work over 100 h overtime in a month should be encouraged to see an occupational physician. This guideline takes into account the practicalities of occupational health at work places and the empiric knowledge that long working hours might associate with workers mental health status. It may be reasonable to assume that long working hours affect workers health status both psychologically and physiologically, interacting with a variety of occupational factors, particularly job stress. However, the association between working hours and workers mental health status has not been fully clarified. The present article aimed to provide a systematic review of the association between working hours and mental health problems. The authors conducted a systematic review of the published literature on the association between working hours and mental health problems using PubMed. Of 131 abstracts and citations reviewed, 17 studies met the predefined criteria. Ten of these are longitudinal studies, and the others are cross-sectional studies. Seven of the 17 studies report statistically significant associations between working hours and mental health problems, while the others report no association. In addition, comparison among these studies is difficult because a variety of

  20. GPs' experiences with out-of-hours GP cooperatives: a survey study from the Netherlands.

    Science.gov (United States)

    Smits, Marleen; Keizer, Ellen; Huibers, Linda; Giesen, Paul

    2014-09-01

    Out-of-hours primary care has been provided by general practitioner (GP) cooperatives since the year 2000 in the Netherlands. Early studies in countries with similar organizational structures showed positive GP experiences. However, nowadays it is said that GPs experience a high workload at the cooperative and that they outsource a considerable part of their shifts. To examine positive and negative experiences of GPs providing out-of-hours primary care, and the frequency and reasons for outsourcing shifts. A cross-sectional observational survey among 688 GPs connected to six GP cooperatives in the Netherlands, using a web-based questionnaire. The response was 55% (n = 378). The main reasons for working in GP cooperatives were to retain registration as GP (79%) and remain experienced in acute care (74%). GPs considered the peak hours (81%) and the high number of patients (73%) as the most negative aspects. Most GPs chose to provide the out-of-hours shifts themselves: 85% outsourced maximally 25% of their shifts. The percentage of outsourced shifts increased with age. Main reasons for outsourcing were the desire to have more private time (76%); the high workload in daytime practice (71%); and less the workload during out-of-hours (46%). GPs are motivated to work in out-of-hours GP cooperatives, and they outsource few shifts. GPs consider the peak load and the large number of (non-urgent) help requests as the most negative aspects. To motivate and involve GPs for 7 × 24-h primary care, it is important to set limits on their workload.

  1. Poorer Health – Shorter Hours? Health and Flexibility of Hours of Work

    OpenAIRE

    Geyer, Johannes; Myck, Michal

    2010-01-01

    We analyse the role of health in determining the difference between desired and actual hours of work in a sample of German men using the Socio-Economic Panel Data for years 1996-2007. The effects of both self-assessed health and legal disability status are examined. About 60% of employees report working more than they would wish with the mean difference of -3.9 hours/week. We estimate static and dynamic model specifications allowing for auto-regressive nature of the dependent variable and tes...

  2. Potential of energy-oriented network optimisation: Switching off over-capacity in off-peak hours

    NARCIS (Netherlands)

    Litjens, R.; Jorguseski, L.

    2010-01-01

    Mobile communication networks are usually planned to provide some minimum service quality level during peak traffic hours. Consequently, in off-peak hours, when traffic loads are lower, the network is characterised by over-capacity, in the sense that same service quality targets can typically be

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

    Science.gov (United States)

    Seki, N

    2001-07-01

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

  4. IAS telecommunication infrastructure and value added network services provided by IASNET

    Science.gov (United States)

    Smirnov, Oleg L.; Marchenko, Sergei

    The topology of a packet switching network for the Soviet National Centre for Automated Data Exchange with Foreign Computer Networks and Databanks (NCADE) based on a design by the Institute for Automated Systems (IAS) is discussed. NCADE has partners all over the world: it is linked to East European countries via telephone lines while satellites are used for communication with remote partners, such as Cuba, Mongolia, and Vietnam. Moreover, there is a connection to the Austrian, British, Canadian, Finnish, French, U.S. and other western networks through which users can have access to databases on each network. At the same time, NCADE provides western customers with access to more than 70 Soviet databases. Software and hardware of IASNET use data exchange recommendations agreed with the International Standard Organization (ISO) and International Telegraph and Telephone Consultative Committee (CCITT). Technical parameters of IASNET are compatible with the majority of foreign networks such as DATAPAK, TRANSPAC, TELENET, and others. By means of IASNET, the NCADE provides connection of Soviet and foreign users to information and computer centers around the world on the basis of the CCITT X.25 and X.75 recommendations. Any information resources of IASNET and value added network services, such as computer teleconferences, E-mail, information retrieval system, intelligent support of access to databanks and databases, and others are discussed. The topology of the ACADEMNET connected to IASNET over an X.25 gateway is also discussed.

  5. 5C.07: A METHOD TO ESTIMATE 24-HOUR SODIUM EXCRETION THROUGH SPOT URINE SAMPLES AND ITS APPLICATION VALUE FOR TARGET-ORGAN DAMAGE ASSESSMENT.

    Science.gov (United States)

    Wang, H; Zhao, L; Xi, Y; Sun, N

    2015-06-01

    24-h urine sodium excretion is considered the most reliable method to evaluate the salt intakes. However, this method is cumbersome. So we want to develop formulas to estimate 24-h urinary sodium excretion using spot urinary samples in Chinese hypertensive population and explore the application value of this method in salt intake assessment and target organ damage. 1. We enrolled 510 cases of hospitalized patients with hypertension, 2/3 of them were arranged randomly to formula group to develop a new formula and the remainings were used to test the performance of the formula. All participants were instructed to collect a 24-h urine sample, a second morning voiding urine sample (SMU), and a post-meridiem urine sample in the late afternoon or early evening, prior to the evening meal (PMU). All samples were sent to measure sodium and creatinine concentration.2. We compared the differences of office blood pressure, 24-hour ambulatory blood pressure and left ventricular hypertrophy, vascular stiffness and urine protein among groups of different sodium intake. 24hour sodium excretion formulas was obtained using SMU and PMU respectively, which have good cosistency. The difference between the estimated and measured values in sodium excretion is 12.66mmol/day (SMU) and 9.41mmol/day (PM), to be equal to 0.7 g (SMU) and 0.6 g (PM) salt intake. Comparing with Kawasaki and Tanaka method, the new formula shows the lower degree of deviation, and higher accuracy and precision. Blood pressure of high urinary sodium group is higher than that in low urinary sodium group (P < 0.05). Left ventricular hypertrophy and urinary albumin/creatinine aggravated with the salt intake increase, this has eliminated the influence of other factors. All of morphologies of the relationship between ambulatory arterial stiffness index, pulse wave velocity and carotid intima-media thickness with quartiles of sodium intake resembled a J-shaped curve. In Chinese hypertensive population, the

  6. Providing value in ambulatory anesthesia.

    Science.gov (United States)

    Fosnot, Caroline D; Fleisher, Lee A; Keogh, John

    2015-12-01

    colonoscopies. With this projected increase in the demand for anesthesia services nationwide comes the analysis of its financial feasibility. Some early data looking at endoscopist-administered sedation conclude that it offers higher patient satisfaction, there were less adverse effects than anesthesiologist-administered sedation, and is economically advantageous. This and future retrospective studies will help to guide healthcare policymakers and physicians to come to a conclusion about providing ambulatory services for these millions of patients. Ambulatory anesthesia's popularity continues to rise and anesthetic techniques will continue to morph and adapt to the needs of patients seeking ambulatory surgery. Alterations in already existing medications are promising as these modifications allow for quicker recovery from anesthesia or minimization of the already known undesirable side-effects. PONV, pain, obstructive sleep apnea, and chronic comorbidities (hypertension, cardiac disease, and diabetes mellitus) are perioperative concerns in ambulatory settings as more patients are safely being treated in ambulatory settings. Regional anesthesia stands out as a modality that has multiple advantages to general anesthesia, providing a minimal recovery period and a decrease in postanesthesia care unit stay. The implementation of the Affordable Healthcare Act specifically affects ambulatory settings as the demand and need for patients to have screening procedures with anesthesia. The question remains what the best strategy is to meet the needs of our future patients while preserving economically feasibility within an already strained healthcare system.

  7. Raman spectroscopic assessment of degree of conversion of bulk-fill resin composites--changes at 24 hours post cure.

    Science.gov (United States)

    Par, M; Gamulin, O; Marovic, D; Klaric, E; Tarle, Z

    2015-01-01

    The aim of this study was to determine degree of conversion (DC) of solid and flowable bulk-fill composites immediately and after 24 hours and investigate the variations of DC at surface and depths up to 4 mm. Eight bulk-fill composites (Tetric EvoCeram Bulk Fill [shades IVA and IVB], Quixfil, X-tra fil, Venus Bulk Fill, X-tra Base, SDR, Filtek Bulk Fill) were investigated, and two conventional composites (GrandioSO, X-Flow) were used as controls. The samples (n = 5) were cured for 20 seconds with irradiance of 1090 mW/cm(2). Raman spectroscopic measurements were made immediately after curing on sample surfaces and after 24 hours of dark storage at surface and at incremental depths up to 4 mm. Mean DC values were compared using repeated measures analysis of variance (ANOVA) and t-test for dependent samples. Surface DC values immediately after curing ranged from 59.1%-71.8%, while the 24-hour postcure values ranged from 71.3%-86.1%. A significant increase of DC was observed 24 hours post cure for all bulk-fill composites, which amounted from 11.3% to 16.9%. Decrease of DC through depths up to 4 mm varied widely among bulk-fill composites and ranged from 2.9% to 19.7%. All bulk-fill composites presented a considerable 24-hour postcure DC increase and clinically acceptable DC at depths up to 4 mm. Conventional control composites were sufficiently cured only up to 2 mm, despite significant postcure polymerization.

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

    Science.gov (United States)

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

    2018-07-01

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

  9. The value of Web-based library services at Cedars-Sinai Health System.

    Science.gov (United States)

    Halub, L P

    1999-07-01

    Cedars-Sinai Medical Library/Information Center has maintained Web-based services since 1995 on the Cedars-Sinai Health System network. In that time, the librarians have found the provision of Web-based services to be a very worthwhile endeavor. Library users value the services that they access from their desktops because the services save time. They also appreciate being able to access services at their convenience, without restriction by the library's hours of operation. The library values its Web site because it brings increased visibility within the health system, and it enables library staff to expand services when budget restrictions have forced reduced hours of operation. In creating and maintaining the information center Web site, the librarians have learned the following lessons: consider the design carefully; offer what services you can, but weigh the advantages of providing the services against the time required to maintain them; make the content as accessible as possible; promote your Web site; and make friends in other departments, especially information services.

  10. Generalised extreme value distributions provide a natural hypothesis for the shape of seed mass distributions.

    Directory of Open Access Journals (Sweden)

    Will Edwards

    Full Text Available Among co-occurring species, values for functionally important plant traits span orders of magnitude, are uni-modal, and generally positively skewed. Such data are usually log-transformed "for normality" but no convincing mechanistic explanation for a log-normal expectation exists. Here we propose a hypothesis for the distribution of seed masses based on generalised extreme value distributions (GEVs, a class of probability distributions used in climatology to characterise the impact of event magnitudes and frequencies; events that impose strong directional selection on biological traits. In tests involving datasets from 34 locations across the globe, GEVs described log10 seed mass distributions as well or better than conventional normalising statistics in 79% of cases, and revealed a systematic tendency for an overabundance of small seed sizes associated with low latitudes. GEVs characterise disturbance events experienced in a location to which individual species' life histories could respond, providing a natural, biological explanation for trait expression that is lacking from all previous hypotheses attempting to describe trait distributions in multispecies assemblages. We suggest that GEVs could provide a mechanistic explanation for plant trait distributions and potentially link biology and climatology under a single paradigm.

  11. Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level

    Directory of Open Access Journals (Sweden)

    Guilherme Brasil Grezzana

    Full Text Available Abstract Background: Hypertension is an important risk factor for cardiovascular outcomes. Primary health care (PHC physicians should be prepared to act appropriately in the prevention of cardiovascular risk factors. However, the rates of patients with control of blood pressure (BP remain low. The impact of the reclassification of high BP by 24-hour ambulatory BP monitoring (ABPM can lead to different medical decisions in PHC. Objective: To evaluate the agreement between the BP measured by a conventional method by PHC physicians and by 24-hour ABPM, considering different BP normal thresholds for the 24-hour ABPM according to the V Brazilian ABPM Guidelines and the European Society of Hypertension Guidelines. Methods: A cross-sectional study including 569 hypertensive patients. The BP was initially measured by the PHC physicians and, later, by 24-hour ABPM. The BP measurements were obtained independently between the two methods. The therapeutic targets for the conventional BP followed the guidelines by the Eighth Joint National Committee (JNC 8, the V ABPM Brazilian Guidelines, and the 2013 European Hypertension Guidelines. Results: There was an accuracy of 54.8% (95% confidence interval [95%CI] 0.51 - 0.58% for the BP measured with the conventional method when compared with the 24-hour ABPM, with a sensitivity of 85% (95%CI 80.8 - 88.6%, specificity of 31.9% (95%CI 28.7 - 34.7%, and kappa value of 0.155, when considering the European Hypertension Guidelines. When using more stringent thresholds to characterize the BP as "normal" by ABPM, the accuracy was 45% (95%CI 0.41 - 0.47% for conventional measurement when compared with 24-hour ABPM, with a sensitivity of 86.7% (95%CI 0.81 - 0.91%, specificity of 29% (95%CI 0.26 - 0.30%, and kappa value of 0.103. Conclusion: The BP measurements obtained by PHC physicians showed low accuracy when compared with those obtained by 24-hour ABPM, regardless of the threshold set by the different guidelines.

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

    Science.gov (United States)

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

    2017-10-18

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

  13. 48 CFR 552.236-74 - Working Hours.

    Science.gov (United States)

    2010-10-01

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

  14. Development and validation of a direct-comparison method for cardiac {sup 123}I-metaiodobenzylguanidine washout rates derived from late 3-hour and 4-hour imaging

    Energy Technology Data Exchange (ETDEWEB)

    Okuda, Koichi; Hashimoto, Mitsumasa [Kanazawa Medical University, Department of Physics, Kahoku, Ishikawa (Japan); Nakajima, Kenichi; Matsuo, Shinro; Taki, Junichi; Kinuya, Seigo [Kanazawa University Hospital, Department of Nuclear Medicine, Kanazawa, Ishikawa (Japan); Sugino, Shuichi [Okayama Kyokuto Hospital, Department of Radiology, Okayama, Okayama (Japan); Kirihara, Yumiko [FUJIFILM RI Pharma Co., Ltd., Chuo-Ku, Tokyo (Japan)

    2016-02-15

    The washout rate (WR) has been used in {sup 123}I-metaiodobenzylguanidine (MIBG) imaging to evaluate cardiac sympathetic innervation. However, WR varies depending on the time between the early and late MIBG scans. Late scans are performed at either 3 or 4 hours after injection of MIBG. The aim of this study was to directly compare the WR at 3 hours (WR{sub 3h}) with the WR at 4 hours (WR{sub 4h}). We hypothesized that the cardiac count would reduce linearly between the 3-hour and 4-hour scans. A linear regression model for cardiac counts at two time-points was generated. We enrolled a total of 96 patients who underwent planar {sup 123}I-MIBG scintigraphy early (15 min) and during the late phase at both 3 and 4 hours. Patients were randomly divided into two groups: a model-creation group (group 1) and a clinical validation group (group 2). Cardiac counts at 15 minutes (count{sub early}), 3 hours (count{sub 3h}) and 4 hours (count{sub 4h}) were measured. Cardiac count{sub 4h} was mathematically estimated using the linear regression model from count{sub early} and count{sub 3h}. In group 1, the actual cardiac count{sub 4h}/count{sub early} was highly significantly correlated with count{sub 3h}/count{sub early} (r = 0.979). In group 2, the average estimated count{sub 4h} was 92.8 ± 31.9, and there was no significant difference between this value and the actual count{sub 4h} (91.9 ± 31.9). Bland-Altman analysis revealed a small bias of -0.9 with 95 % limits of agreement of -6.2 and +4.3. WR{sub 4h} calculated using the estimated cardiac count{sub 4h} was comparable to the actual WR{sub 4h} (24.3 ± 9.6 % vs. 25.1 ± 9.7 %, p = ns). Bland-Altman analysis and the intraclass correlation coefficient showed that there was excellent agreement between the estimated and actual WR{sub 4h}. The linear regression model that we used accurately estimated cardiac count{sub 4h} using count{sub early} and count{sub 3h}. Moreover, WR{sub 4h} that was mathematically calculated using

  15. Extended working hours: Impacts on workers

    Science.gov (United States)

    D. Mitchell; T. Gallagher

    2010-01-01

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

  16. 8760-Based Method for Representing Variable Generation Capacity Value in Capacity Expansion Models: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Frew, Bethany A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Cole, Wesley J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Sun, Yinong [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mai, Trieu T [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Richards, James [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-08-01

    Capacity expansion models (CEMs) are widely used to evaluate the least-cost portfolio of electricity generators, transmission, and storage needed to reliably serve demand over the evolution of many years or decades. Various CEM formulations are used to evaluate systems ranging in scale from states or utility service territories to national or multi-national systems. CEMs can be computationally complex, and to achieve acceptable solve times, key parameters are often estimated using simplified methods. In this paper, we focus on two of these key parameters associated with the integration of variable generation (VG) resources: capacity value and curtailment. We first discuss common modeling simplifications used in CEMs to estimate capacity value and curtailment, many of which are based on a representative subset of hours that can miss important tail events or which require assumptions about the load and resource distributions that may not match actual distributions. We then present an alternate approach that captures key elements of chronological operation over all hours of the year without the computationally intensive economic dispatch optimization typically employed within more detailed operational models. The updated methodology characterizes the (1) contribution of VG to system capacity during high load and net load hours, (2) the curtailment level of VG, and (3) the potential reductions in curtailments enabled through deployment of storage and more flexible operation of select thermal generators. We apply this alternate methodology to an existing CEM, the Regional Energy Deployment System (ReEDS). Results demonstrate that this alternate approach provides more accurate estimates of capacity value and curtailments by explicitly capturing system interactions across all hours of the year. This approach could be applied more broadly to CEMs at many different scales where hourly resource and load data is available, greatly improving the representation of challenges

  17. 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.

  18. Long working hours and depressive symptoms

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Madsen, Ida Eh

    2018-01-01

    Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published....... In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence...... interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association...

  19. Long working hours and depressive symptoms

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Madsen, Ida Eh

    2018-01-01

    . In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence......Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published...... interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association...

  20. Payroll data based description of working hours in the Danish regions.

    Science.gov (United States)

    Garde, Anne Helene; Hansen, Johnni; Kolstad, Henrik A; Larsen, Ann Dyreborg; Pedersen, Jacob; Petersen, Jindong Ding; Hansen, Åse Marie

    2018-05-15

    The aim was to describe the organization of working hours in the Danish regions according to sex, age and calendar year. Based on the Danish Working Hour Database (DWHD), individuals were classified according to schedules: Permanent day (57.8%), evening (1.7%), or night (1.2%); day/evening (22.0%); day/night (6.6%); evening/night (0.6%); and day/evening/night (10.2%). More men (9.1%) than women (5.9%) worked day/night, whereas more women (10.9%) than men (7.4%) worked day/evening/night. More young than older employees worked day/evening/night, and fewer worked permanent day or night. From 2008 to 2015 we observed a trend towards more employees working permanent day and fewer employees working other schedules. Altogether DWHD provides a strong tool in research on working hours.

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

    Science.gov (United States)

    Seto, Masako; Morimoto, Kanehisa; Maruyama, Soichiro

    2006-05-01

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

  2. Normative values for a functional capacity evaluation.

    Science.gov (United States)

    Soer, Remko; van der Schans, Cees P; Geertzen, Jan H; Groothoff, Johan W; Brouwer, Sandra; Dijkstra, Pieter U; Reneman, Michiel F

    2009-10-01

    Soer R, van der Schans CP, Geertzen JH, Groothoff JW, Brouwer S, Dijkstra PU, Reneman MF. Normative values for a functional capacity evaluation. To establish normative values for a functional capacity evaluation (FCE) of healthy working subjects. Descriptive. Rehabilitation center. Healthy working subjects (N=701; 448 men, 253 women) between 20 and 60 years of age, working in more than 180 occupations. Subjects performed a 2-hour FCE consisting of 12 work-related tests. Subjects were classified into categories based on physical demands according to the Dictionary of Occupational Titles. Means, ranges, SDs, and percentiles were provided for normative values of FCE, and a regression analysis for outcome of the 12 tests was performed. Normative FCE values were established for 4 physical demand categories. The normative values enable comparison of patients' performances to these values. If a patient's performance exceeds the lowest scores in his/her corresponding demand category, then the patient's capacity is very likely to be sufficient to meet the workload. Further, clinicians can make more precise return-to-work recommendations and set goals for rehabilitation programs. A comparison of the normative values can be useful to the fields of rehabilitation, occupational, and insurance medicine. Further research is needed to test the validity of the normative values with respect to workplace assessments and return-to-work recommendations.

  3. The cost and value of pre-registration clinical placements for Project 2000 students.

    Science.gov (United States)

    Jones, M L; Akehurst, R

    1999-07-01

    The research outlined in this article was commissioned by the Sheffield and North Trent College of Nursing and Midwifery to explore the cost implications of pre-registration clinical placements in the context of Project 2000. The authors outline the methodology and findings of an exercise designed to collect relevant cost information which was not readily available. On the basis of these findings, they suggest that: at 1995/1996 pay and prices, clinical placements cost the education provider approximately pound 890 per student per annum; in terms of real resources, the value to service providers of the service contribution made by second- and third-year nursing and midwifery students on ward-based placements outweighs the value of the time spent by qualified staff on their supervision and education. Once the funding assumptions underlying the introduction of Project 2000 have been taken into account, second- and third-year nursing and midwifery students benefit the service provider by on average pound 3.46 for every hour they spend in an unrostered ward-based placement. The service contribution made by students in community-based clinical placements cannot free staff time in the same way as on the wards and, because qualified staff in these areas are generally more highly graded, the value of the time they spend on the supervision and education of students on placement is higher than in ward-based placements. Second- and third-year students therefore appear to cost the service provider on average pound 0.48 for each hour they spend in a community-based placement. It was not possible to determine whether this cost translates into a reduction in patient contacts.

  4. 75 FR 82170 - Hours of Service of Drivers

    Science.gov (United States)

    2010-12-29

    ... drivers to take breaks when needed and would reduce safety and health risks associated with long hours... long work hours, without significantly compromising their ability to do their jobs and earn a living... between hours 3.5 and 7 of an 11-hour driving period. Working beyond the 7th hour without a break is...

  5. Do Financial Incentives Influence GPs' Decisions to Do After-hours Work? A Discrete Choice Labour Supply Model.

    Science.gov (United States)

    Broadway, Barbara; Kalb, Guyonne; Li, Jinhu; Scott, Anthony

    2017-12-01

    This paper analyses doctors' supply of after-hours care (AHC), and how it is affected by personal and family circumstances as well as the earnings structure. We use detailed survey data from a large sample of Australian General Practitioners (GPs) to estimate a structural, discrete choice model of labour supply and AHC. This allows us to jointly model GPs' decisions on the number of daytime-weekday working hours and the probability of providing AHC. We simulate GPs' labour supply responses to an increase in hourly earnings, both in a daytime-weekday setting and for AHC. GPs increase their daytime-weekday working hours if their hourly earnings in this setting increase, but only to a very small extent. GPs are somewhat more likely to provide AHC if their hourly earnings in that setting increase, but again, the effect is very small and only evident in some subgroups. Moreover, higher earnings in weekday-daytime practice reduce the probability of providing AHC, particularly for men. Increasing GPs' earnings appears to be at best relatively ineffective in encouraging increased provision of AHC and may even prove harmful if incentives are not well targeted. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  6. Long Work Hours: Volunteers and Conscripts

    OpenAIRE

    Robert Drago; Mark Wooden; David Black

    2006-01-01

    Panel data from Australia are used to study the prevalence of work hours mismatch among long hours workers and, more importantly, how that mismatch persists and changes over time, and what factors are associated with these changes. Particular attention is paid to the roles played by household debt, ideal worker characteristics and gender. Both static and dynamic multinomial logit models are estimated, with the dependent variable distinguishing long hours workers from other workers, and within...

  7. Preferred vs Actual Working Hours in Couple Households

    OpenAIRE

    Yi-Ping Tseng; Mark Wooden

    2005-01-01

    Working hours in Australia are quite widely distributed around the population mean. That is, there are relatively many people working both relatively short hours and relatively long hours each week. From a welfare perspective, however, it is not the actual number of hours worked that is of importance, but whether the hours being worked are consistent with individual preferences. In this paper the question of how closely hours preferences are being met is examined using data collected in the f...

  8. Work Hours Constraints: Impacts and Policy Implications

    OpenAIRE

    Constant, Amelie F.; Otterbach, Steffen

    2011-01-01

    If individuals reveal their preference as consumers, then they are taken seriously. What happens if individuals, as employees, reveal their preferences in working hours? And what happens if there is a misalignment between actual hours worked and preferred hours, the so-called work hours constraints? How does this affect the productivity of workers, their health, and overall life satisfaction? Labor supply and corresponding demand are fundamental to production. Labor economists know for long t...

  9. Breaking the Long Hours Culture.

    Science.gov (United States)

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

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

  10. EMSC program manager survey on education of prehospital providers.

    Science.gov (United States)

    Ngo, Thuy L; Belli, Karen; Shah, Manish I

    2014-01-01

    Although pediatric-specific objectives for the initial education of prehospital providers have been established, uniform implementation of these objectives and guidelines for hours of required pediatric continuing education (CE) for prehospital providers have not been established. To examine the content and number of hours of pediatric-specific education that prehospital providers receive during initial certification and recertification. Second, to identify barriers to implementing specific requirements for pediatric education of prehospital providers. Electronic surveys were sent to 55 EMS for Children (EMSC) State Partnership grantee program managers inquiring about the certification and recertification processes of prehospital providers and barriers to receiving pediatric training in each jurisdiction. We had a 91% response rate for our survey. Specified pediatric education hours exist in more states and territories for recertification (63-67%) than initial certification (41%). Limitations in funding, time, instructors, and accessibility are barriers to enhancing pediatric education. Modifying statewide policies on prehospital education and increasing hands-on training may overcome identified barriers.

  11. Working hours: Past, present, and future

    OpenAIRE

    Dolton, Peter

    2017-01-01

    Working hours across the world are falling, but considerable variation remains. In some countries people work 70% more hours per year, on average, than in other countries. Much of this variation is due to differences in the prevalence of part-time work and patterns of female labor market participation. Looking ahead, the question of how reducing working hours will affect productivity is significant. In addition, how individuals divide up their leisure and work time and what the appropriate wo...

  12. Palliative Care Office Hours for Patients with Hematologic Malignancies: An Innovative Model for Symptom Management and Education.

    Science.gov (United States)

    Foxwell, Anessa M; Moyer, Mary E; Casarett, David J; O'Connor, Nina R

    2017-10-01

    Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress. A retrospective study looking at outcome measures after six months of office hour utilization and palliative care consults from the hematologic oncology services. Palliative care office hours had a mean duration of 16 minutes per day (range 5 to 55). A mean of 11 patients were discussed per week (range 4 to 20). Pain, nausea, and anxiety were the issues most frequently raised. Of 299 patients discussed during office hours, 44 (14.7%) subsequently required a full palliative care consult. Overall, palliative care consults from the hematologic oncology services decreased from 19.6% to 10.2% of admissions (87/445 vs. 61/594, p Office hours are an efficient way to address palliative care needs when demand for palliative care consults exceeds capacity. Office hours may serve an educational function as well, enabling primary teams to manage basic palliative care issues with increasing independence over time.

  13. 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.

  14. Making residency work hour rules work.

    Science.gov (United States)

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

    2013-01-01

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

  15. Is the Office Hour Obsolete?

    Science.gov (United States)

    Behrens, Susan

    2013-01-01

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

  16. The browning value changes and spectral analysis on the Maillard reaction product from glucose and methionine model system

    Science.gov (United States)

    Al-Baarri, A. N.; Legowo, A. M.; Widayat

    2018-01-01

    D-glucose has been understood to provide the various effect on the reactivity in Maillard reaction resulting in the changes in physical performance of food product. Therefore this research was done to analyse physical appearance of Maillard reaction product made of D-glucose and methionine as a model system. The changes in browning value and spectral analysis model system were determined. The glucose-methionine model system was produced through the heating treatment at 50°C and RH 70% for 24 hours. The data were collected for every three hour using spectrophotometer. As result, browning value was elevated with the increase of heating time and remarkably high if compare to the D-glucose only. Furthermore, the spectral analysis showed that methionine turned the pattern of peak appearance. As conclusion, methionine raised the browning value and changed the pattern of spectral analysis in Maillard reaction model system.

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

    Science.gov (United States)

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

    1998-01-01

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

  18. 48 CFR 536.570-5 - Working hours.

    Science.gov (United States)

    2010-10-01

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

  19. Working 40 Hours or Not Working 39: Lessons from the 1981 Mandatory Reduction of Weekly Working Hours

    OpenAIRE

    Crépon, Bruno; Kramarz, Francis

    1999-01-01

    We use longitudinal individual wage, hours, and employment data to investigate the effect of the 1981 mandatory reduction of weekly working hours in France. A few months after François Mitterrand's election of May 1981, the government, applying its programme decided first to increase the minimum wage by 5% and, second, to reduce weekly working hours - from 40 to 39 - together with mandatory stability of monthly earnings of minimum wage workers and strong recommendation for stability of monthl...

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

    Science.gov (United States)

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

    2010-07-01

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

  1. Hourly Electricity Prices in Day-Ahead Markets

    NARCIS (Netherlands)

    R. Huisman (Ronald); C. Huurman; R.J. Mahieu (Ronald)

    2007-01-01

    textabstractThis paper focuses on the characteristics of hourly electricity prices in day-ahead markets. In these markets, quotes for day-ahead delivery of electricity are submitted simultaneously for all hours in the next day. The same information set is used for quoting all hours of the day. The

  2. High historical values of foEs—Reality or artefact?

    Science.gov (United States)

    Laštovička, J.; Boška, J.; Burešová, D.; Kouba, D.

    2012-01-01

    Very high values of foEs had sometimes been reported in the past. These values, as well as all other ionogram-scaled values, had been derived from ionograms under the assumption of the vertical reflection of ordinary mode of sounding radio waves. In the past it was impossible to check the validity of this assumption. However, modern digisondes determine clearly the oblique or extraordinary mode reflections. To test the assumption of the vertical reflection of ordinary mode for high values of foEs, seven summers (June 2004-August 2010) from a midlatitude station Pruhonice are chosen. All hourly values of foEs≥6.0 MHz are selected from this data set, altogether 282 values. In 90% of cases the “classical” way of evaluation of foEs provides values higher than “true” values from modern digisonde (average difference about 1 MHz). 38% of “classical” foEs are oblique reflections, which however do not occur in direction perpendicular to geomagnetic field. The occurrence of high values of foEs varies very much from year to year between 0 and 130 events per year. As for diurnal variation, a pronounced maximum occurs at ˜10:00LT and 16:00LT (secondary), and a minimum after midnight.

  3. The impact of processing delay on the exposure index value

    Science.gov (United States)

    Butler, M. L.; Brennan, P. C.; Last, J.; Rainford, L.

    2010-04-01

    Digital radiography poses the risk of unnoticed increases in patient dose. Manufacturers responded to this by offering an exposure index (EI) value to clinicians. Use of the EI value in clinical practice is encouraged by the American College of Radiology and American Association of Physicists in Medicine. This study assesses the impact of processing delay on the EI value. An anthropormorphic phantom was used to simulate three radiographic examinations; skull, pelvis and chest. For each examination, the phantom was placed in the optimal position and exposures were chosen in accordance with international guidelines. A Carestream (previously Kodak) computed radiography system was used. The imaging plate was exposed, and processing was delayed in various increments from 30 seconds to 24 hours, representing common delays in clinical practice. The EI value was recorded for each exposure. The EI value decreased considerably with increasing processing delay. The EI value decreased by 100 within 25 minutes delay for the chest, and 20 minutes for the skull and pelvis. Within 1 hour, the EI value had fallen by 180, 160 and 100 for the chest, skull and pelvis respectively. After 24 hours, the value had decreased by 370, 350 and 340 for the chest, skull and pelvis respectively, representing to the clinician more then a halving of exposure to the detector in Carestream systems. The assessment of images using EI values should be approached with caution in clinical practice when delays in processing occur. The use of EI values as a feedback mechanism is questioned.

  4. How extreme is extreme hourly precipitation?

    Science.gov (United States)

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

    2016-04-01

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

  5. 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...

  6. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    .20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours......OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies......, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were...

  7. IDENTIFICATIONS PEAK HOURS ON INTERSECTIONS SET IN BIELSKO-BIAŁA CITY

    Directory of Open Access Journals (Sweden)

    Marcin KŁOS

    2016-03-01

    Full Text Available Traffic flow in cities is usually examined locally. This method is not effective for through traffic analysis. The paper discusses the problem of determining peak traffic hours taking into account vehicle distributions. Peak hours represent time periods of traffic flow which demand special treatment by traffic control systems. This is particularly important in the case of ITS. High values of traffic flow require relieving actions not only at the junctions but preferably along the transit routes. The north-south transit route in Bielsko-Biała was chosen for analysis. Instead of the usual two distinct peaks it is determined that the traffic flow is characterised by five peaks. This pattern is the result of specific location of the route, which links residential areas, industrial zones and shopping centres besides carrying through traffic. This multi peak graph more accurately models the traffic flow.

  8. Ability of a 5-minute electrocardiography (ECG) for predicting arrhythmias in Doberman Pinschers with cardiomyopathy in comparison with a 24-hour ambulatory ECG.

    Science.gov (United States)

    Wess, G; Schulze, A; Geraghty, N; Hartmann, K

    2010-01-01

    Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24-hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time-consuming and often not as readily available as common ECG. Comparison of 5-minute ECGs with Holter examinations. Eight hundred and seventy-five 5-minute ECGs and Holter examinations of 431 Doberman Pinschers. Each examination included a 5-minute ECG and Holter examination. A cut-off value of > 100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value. Holter examinations revealed > 100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5-minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5-minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5-minute ECG with at least 1 VPC as cut-off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of > 100 VPCs/24 hours. A 5-minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.

  9. 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...

  10. Employees' use of social media for private reasons during working hours

    Science.gov (United States)

    Gunnlaugsdottir, Johanna

    2015-02-01

    The objectives of the study were to find out: Whether Icelandic organizations allowed open access to social media (SM), whether the respondents used SM for private reasons during working hours, which SM they used, how much time they devoted to such use, and what was the attitude of managers and the employees themselves towards such use. The respondents were asked to disclose whether they worked in the private or the public sector and the type of organization that they worked for. This was a two-dimensional study: A questionnaire sent to an internet panel and a telephone survey both based on a random sample selected from the National Registry in February 2013. A similar study has not been performed in Iceland before. Foreign studies of the same nature are not known, only related research. The main findings were that about half of the organizations allowed open access to SM, just below 50% of respondents took advantage of SM for personal use during working hours and the great majority used Facebook. Employees used a considerable part of their working hours for personal use of SM. The majority of respondents were of the opinion that managers objected to the use of SM during working hours and a larger majority believed that such use of themselves was unacceptable. The survey adds valuable information for a better understanding of the status of SM at places of work. The results could be of value to organizations that want to evaluate the pros and cons of SM for the organization.

  11. Hourly cooling load prediction of a vehicle in the southern region of Turkey by Artificial Neural Network

    International Nuclear Information System (INIS)

    Solmaz, Ozgur; Ozgoren, Muammer; Aksoy, Muharrem Hilmi

    2014-01-01

    Highlights: • An ANN model was developed to predict hourly cooling load of a vehicle. • Hourly meteorological data of 5 different provinces was used. • The agreement of the cooling load values between the calculations and predictions was fairly promising. • The ANN model could be successfully used to design automotive air conditioning systems. - Abstract: In this study, Artificial Neural Networks (ANNs) method for prediction hourly cooling load of a vehicle was implemented. The cooling load of the vehicle was calculated along the cooling season (1 May–30 September) for Antalya, Konya, Mersin, Mugla and Sanliurfa provinces in Turkey. For ANN model, seven neurons determinated as input signals of latitude, longitude, altitude, day of the year, hour of the day, hourly mean ambient air temperature and hourly solar radiation were used for the input layer of the network. One neuron producing an output signal of the hourly cooling load was utilized in the output layer. All data were divided into two categories for training and testing of the ANN. The 80% of the data was reserved to training and the remaining was used for testing of the model. Neuron numbers in the hidden layer from 7 to 40 were tested step by step to find the best matching ANN structure. The obtained results for different numbers of neurons were compared in terms of root mean squared error (RMSE), coefficient of determination (R 2 ) and mean absolute error (MAE). The best matching results for the training and testing were obtained as 8 neurons for the minimum testing RMSE value for the prediction of cooling load by the ANN model on the 23rd day of each month along the cooling season. For the model with 8 neurons RMSE, R 2 and MAE (Training/Testing) were found to be 0.0128/0.0259, 0.9959/0.9818 and 78.81/174.71 W/m 2 , respectively. It is shown that the cooling load of a vehicle can be successfully predicted by means of the ANNs from geographical characteristics and meteorological data

  12. Just Checking In: The Effect of an Office Hour Meeting and Learning Reflection in an Introductory Statistics Course

    Science.gov (United States)

    McGrath, April L.

    2014-01-01

    Office hours provide time outside of class for students to consult with instructors about course material, progress, and evaluation. Yet office hours, at times, remain an untapped source of academic support. The current study examined whether office hour attendance in combination with a learning reflection would help students learn material in an…

  13. Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

    Science.gov (United States)

    Steele, Joseph R; Schomer, Don F

    2009-07-01

    Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

  14. Outcome of a four-hour smoking cessation counselling workshop for medical students

    Directory of Open Access Journals (Sweden)

    Kurosch Purkabiri

    2016-11-01

    Implementing a four-hour smoking intervention workshop into a medical curriculum was highly effective in improving students’ knowledge, skills and attitudes towards smoking counselling, as well as providing them with additional clinical competencies.

  15. Generation of global hourly radiation sequences using a Transition Markov matrix for Madrid. Generacion de secuencias horarias de radiacion global utilizando matrices de transicion de Markov, para la localidad de Madrid

    Energy Technology Data Exchange (ETDEWEB)

    Mora, Ll

    1989-11-01

    The aim of this work is the generation of sequences of hourly global radiation which have similar statistically characteristics of real sequences for the city of Madrid (Spain). For this generation, a first order Markov model has been proposed. The input parameters of simulation method are the following: The maximum value of hourly radiation and the average monthly value of the transparency normalized index. The maximum value of hourly radiation has been calculated as a function of the solar height by an empirical expression. The transparency normalized index has been defined as the ratio among the measured hourly global radiation to the maximum value for the corresponding solar height. The method is based on the following observations: -The transparency normalized index shows a significant correlation only for two consecutive hours. -The months with the same average transparency normalized indies have similar probability density function. Global solar radiation, time series, simulation, Markov transition matrix, solar energy.

  16. Value-based resource management: a model for best value nursing care.

    Science.gov (United States)

    Caspers, Barbara A; Pickard, Beth

    2013-01-01

    With the health care environment shifting to a value-based payment system, Catholic Health Initiatives nursing leadership spearheaded an initiative with 14 hospitals to establish best nursing care at a lower cost. The implementation of technology-enabled business processes at point of care led to a new model for best value nursing care: Value-Based Resource Management. The new model integrates clinical patient data from the electronic medical record and embeds the new information in care team workflows for actionable real-time decision support and predictive forecasting. The participating hospitals reported increased patient satisfaction and cost savings in the reduction of overtime and improvement in length of stay management. New data generated by the initiative on nursing hours and cost by patient and by population (Medicare severity diagnosis-related groups), and patient health status outcomes across the acute care continuum expanded business intelligence for a value-based population health system.

  17. Nutritional and energy values of sunflower cake for broilers

    Directory of Open Access Journals (Sweden)

    Eveline Berwanger

    2014-12-01

    Full Text Available The study aimed to determine the nutritional and energy values of sunflower cake for broilers through two experiments. The first study evaluated the energy values by the method of total excreta collection, using 100 broiler chicks 21–31 days old, divided into five treatments of 0%, 10%, 20%, 30% and 40% inclusion sunflower cake will reference a diet. The second experiment evaluated the influence of the period and the quantity supplied of sunflower cake on digestibility of amino acids by a forcedfeeding technique. Eighteen cockerels were used, divided into three treatments, which consisted of supplying 15 g of sunflower cake, 30 g of sunflower cake (15 g at intervals of 12 hours and 30 g of sunflower cake (15 g at intervals of 24 hours, and an additional six roosters were fasted for correction of metabolic and endogenous losses. The samples were sent for amino acid analysis by HPLC in the Evonik Laboratory (Germany, and chemical and energy analysis to Unioeste Laboratory. The values of apparent metabolizable energy (AME, metabolization coefficient (AMC, apparent metabolizable energy corrected for nitrogen balance (AMEn, metabolization coefficient corrected for nitrogen balance (AMCn for sunflower cake were 2211.68 kcal.kg-1, 2150.54 kcal.kg-1, 45.47% and 44.73%, respectively. The amount of food provided in the feeding method changed the assessment of true digestibility of amino acids (TDCA, and when only 15 g was used, the values of true digestibility coefficients were underestimated. The lysine, histidine and threonine amino acids were at lower TDCA, and arginine and methionine showed the highest TDCA for sunflower cake.

  18. Effectiveness of the Twelve-Hour Shift.

    Science.gov (United States)

    Brinton, Robert D.

    1983-01-01

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

  19. Diagnostic value and cost-benefit analysis of 24?hours ambulatory blood pressure monitoring in primary care in Portugal

    OpenAIRE

    Pessanha, Paulo; Viana, Manuel; Ferreira, Paula; Bertoquini, Susana; Pol?nia, Jorge

    2013-01-01

    Background Hypertensive patients (HTs) are usually attended in primary care (PC). We aimed to assess the diagnostic accuracy and cost-benefit ratio of 24-hour ambulatory blood pressure monitoring (ABPM) in all newly diagnosed hypertensive patients (HTs) attended in PC. Methods In a cross-sectional study ABPM was recorded in all 336 never treated HTs (Office BP ?140 and/or???90?mm Hg) that were admitted during 16?months. Since benefits from drug treatment in white-coat hypertension (WCH) remai...

  20. 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

  1. Improved Hourly and Sub-Hourly Gauge Data for Assessing Precipitation Extremes in the U.S.

    Science.gov (United States)

    Lawrimore, J. H.; Wuertz, D.; Palecki, M. A.; Kim, D.; Stevens, S. E.; Leeper, R.; Korzeniewski, B.

    2017-12-01

    The NOAA/National Weather Service (NWS) Fischer-Porter (F&P) weighing bucket precipitation gauge network consists of approximately 2000 stations that comprise a subset of the NWS Cooperative Observers Program network. This network has operated since the mid-20th century, providing one of the longest records of hourly and 15-minute precipitation observations in the U.S. The lengthy record of this dataset combined with its relatively high spatial density, provides an important source of data for many hydrological applications including understanding trends and variability in the frequency and intensity of extreme precipitation events. In recent years NOAA's National Centers for Environmental Information initiated an upgrade of its end-to-end processing and quality control system for these data. This involved a change from a largely manual review and edit process to a fully automated system that removes the subjectivity that was previously a necessary part of dataset quality control and processing. An overview of improvements to this dataset is provided along with the results of an analysis of observed variability and trends in U.S. precipitation extremes since the mid-20th century. Multi-decadal trends in many parts of the nation are consistent with model projections of an increase in the frequency and intensity of heavy precipitation in a warming world.

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

    Science.gov (United States)

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

    2017-02-01

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

  3. Hours Constraints Within and Between Jobs

    NARCIS (Netherlands)

    Euwals, R.W.

    1997-01-01

    In the empirical literature on labour supply, several models are developed to incorporate constraints on working hours. These models do not address the question to which extent working hours are constrained within and between jobs. In this paper I investigate the effect of individual changes in

  4. Employer Attitudes towards Peak Hour Avoidance

    NARCIS (Netherlands)

    Vonk Noordegraaf, D.M.; Annema, J.A.

    2012-01-01

    Peak Hour Avoidance is a relatively new Dutch mobility management measure. To reduce congestion frequent car drivers are given a financial reward for reducing the proportion of trips that they make during peak hours on a specific motorway section. Although previous studies show that employers are

  5. Employer attitudes towards peak hour avoidance

    NARCIS (Netherlands)

    Noordegraaf, D.M.V.; Annema, J.A.

    2012-01-01

    Peak Hour Avoidance is a relatively new Dutch mobility management measure. To reduce congestion frequent car drivers are given a financial reward for reducing the proportion of trips that they make during peak hours on a specific motorway section. Although previous studies show that employers are

  6. Cost-efficient staffing under annualized hours

    NARCIS (Netherlands)

    van der Veen, Egbert; Hans, Elias W.; Veltman, Bart; Berrevoets, Leo M.; Berden, Hubert J.J.M.

    2012-01-01

    We study how flexibility in workforce capacity can be used to efficiently match capacity and demand. Flexibility in workforce capacity is introduced by the annualized hours regime. Annualized hours allow organizations to measure working time per year, instead of per month or per week. An additional

  7. The Credit Hour and Public Budgeting.

    Science.gov (United States)

    Wellman, Jane V.

    2003-01-01

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

  8. Key-value store with internal key-value storage interface

    Science.gov (United States)

    Bent, John M.; Faibish, Sorin; Ting, Dennis P. J.; Tzelnic, Percy; Gupta, Uday; Grider, Gary; Bonnie, David J.

    2018-01-16

    A key-value store is provided having one or more key-value storage interfaces. A key-value store on at least one compute node comprises a memory for storing a plurality of key-value pairs; and an abstract storage interface comprising a software interface module that communicates with at least one persistent storage device providing a key-value interface for persistent storage of one or more of the plurality of key-value pairs, wherein the software interface module provides the one or more key-value pairs to the at least one persistent storage device in a key-value format. The abstract storage interface optionally processes one or more batch operations on the plurality of key-value pairs. A distributed embodiment for a partitioned key-value store is also provided.

  9. 5 CFR 610.408 - Use of credit hours.

    Science.gov (United States)

    2010-01-01

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

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

    Science.gov (United States)

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

    2007-02-01

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

  11. Transcutaneous Bilirubin Nomogram for Healthy Term and Late Preterm Neonates in First 96 Hours of Life.

    Science.gov (United States)

    Thakkar, Pareshkumar; Chavda, Hardas; Doshi, Vikas

    2017-05-15

    To develop nomogram of Transcutaneous Bilirubin among healthy term and late-preterm neonates during first 96 hours of age. Longitudinal observational study. Neonatal unit of a tertiary care Hospital of Central Gujarat, India. 1075 healthy term and late preterm neonates (≥35weeks). Six-hourly transcutaneous bilirubin was obtained from birth to 96 hour of life using Drager JM 103 Transcutaneous Bilirubinometer. Main outcome measures: Nomogram of Transcutaneous Bilirubin with percentile values was obtained, rate of rise of bilirubin was calculated and predictive ability of normative data was analyzed for subsequent need of phototherapy. The age-specific percentile curves and nomogram were developed from the transcutaneous bilirubin readings of 1,010 neonates. Rate of rise in first 12 hour was 0.2 mg/dL and was 0.17 mg/dL in 12 to 24 hour of life which decreased on second day of life. Neonates who required phototherapy had consistently higher readings of transcutaneous bilirubin and also higher rate of rise in first 48 hrs. Neonates whose transcutaneous bilirubin is above the 50th percentile should be monitored for the development of significant hyperbilirubinemia.

  12. 17 CFR 201.104 - Business hours.

    Science.gov (United States)

    2010-04-01

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

  13. Experience With Flexible Hours of Work

    Science.gov (United States)

    Hartley, Jo

    1976-01-01

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

  14. Change in working characteristics of the steam turbine metal with operating time of more than 330000 hours

    Science.gov (United States)

    Gladshteyn, V. I.; Troitskiy, A. I.

    2017-01-01

    Research of a metal of the stop valve case (SVC) of the K-300-23.5 LMZ turbine (steel grade 15Kh1M1FL), destroyed after operation for 331000 hours, is performed. It's chemical composition and properties are determined as follows: a short-term mechanical tensile stress at 20°C and at elevated temperature, critical temperature, fragility, critical crack opening at elevated temperature, and long-term strength. Furthermore, nature of the microstructure, packing density of carbide particles and their size, and chemical composition of carbide sediment are estimated. A manifestation of metal properties for the main case components by comparison with a forecast of the respective characteristics made for the operating time of 331000 hours is tested. Property-time relationships are built for the forecast using statistical treatment of the test results for the samples cut out from more than 300 parts. Representativeness of the research results is proved: the statistical treatment of their differences are within the range of ±5%. It has been found that, after 150000 hours of operation, only the tensile strength insignificantly depends on the operating time at 20°C, whereas indicators of strength at elevated temperature significantly reduce, depending on the operating time. A brittle-to-ductile transition temperature (BDTT) raises, a critical notch opening changes in a complicated way, a long-term strength reduces. It has been found empirically that the limit of a long-term strength of the SVC metal at 540°C and the operating time of 105 hours is almost 1.6 times less than the required value in the as-delivered state. It is possible to evaluate a service life of the operating valves with the operating time of more than 330000 hours with respect to the long-term strength of the metal taking into account the actual temperature and stress. Guidelines for the control of similar parts are provided.

  15. 7 CFR 226.19 - Outside-school-hours care center provisions.

    Science.gov (United States)

    2010-01-01

    ..., snacks and suppers. In addition, outside-school-hours care centers shall be eligible to serve lunches to... claimed for more than two meals and one snack provided daily to each child or for meals served to children... licensed capacity, whichever is less) were eligible for free or reduced price meals or were title XX...

  16. 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.

  17. "Hour of Code": A Case Study

    Science.gov (United States)

    Du, Jie; Wimmer, Hayden; Rada, Roy

    2018-01-01

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

  18. 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

  19. Prediction of outcome in neurogenic oropharyngeal dysphagia within 72 hours of acute stroke.

    Science.gov (United States)

    Ickenstein, Guntram W; Höhlig, Carolin; Prosiegel, Mario; Koch, Horst; Dziewas, Rainer; Bodechtel, Ulf; Müller, Rainer; Reichmann, Heinz; Riecker, Axel

    2012-10-01

    Stroke is the most frequent cause of neurogenic oropharyngeal dysphagia (NOD). In the acute phase of stroke, the frequency of NOD is greater than 50% and, half of this patient population return to good swallowing within 14 days while the other half develop chronic dysphagia. Because dysphagia leads to aspiration pneumonia, malnutrition, and in-hospital mortality, it is important to pay attention to swallowing problems. The question arises if a prediction of severe chronic dysphagia is possible within the first 72 hours of acute stroke. On admission to the stroke unit, all stroke patients were screened for swallowing problems by the nursing staff within 2 hours. Patients showing signs of aspiration were included in the study (n = 114) and were given a clinical swallowing examination (CSE) by the swallowing/speech therapist within 24 hours and a swallowing endoscopy within 72 hours by the physician. The primary outcome of the study was the functional communication measure (FCM) of swallowing (score 1-3, tube feeding dependency) on day 90. The grading system with the FCM swallowing and the penetration-aspiration scale (PAS) in the first 72 hours was tested in a multivariate analysis for its predictive value for tube feeding-dependency on day 90. For the FCM level 1 to 3 (P dysphagia scales to prevent aspiration pneumonia and malnutrition. A dysphagia program can lead to better communication within the stroke unit team to initiate the appropriate diagnostics and swallowing therapy as soon as possible. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Disaggregation of Rainy Hours: Compared Performance of Various Models.

    Science.gov (United States)

    Ben Haha, M.; Hingray, B.; Musy, A.

    In the urban environment, the response times of catchments are usually short. To de- sign or to diagnose waterworks in that context, it is necessary to describe rainfall events with a good time resolution: a 10mn time step is often necessary. Such in- formation is not always available. Rainfall disaggregation models have thus to be applied to produce from rough rainfall data that short time resolution information. The communication will present the performance obtained with several rainfall dis- aggregation models that allow for the disaggregation of rainy hours into six 10mn rainfall amounts. The ability of the models to reproduce some statistical character- istics of rainfall (mean, variance, overall distribution of 10mn-rainfall amounts; ex- treme values of maximal rainfall amounts over different durations) is evaluated thanks to different graphical and numerical criteria. The performance of simple models pre- sented in some scientific papers or developed in the Hydram laboratory as well as the performance of more sophisticated ones is compared with the performance of the basic constant disaggregation model. The compared models are either deterministic or stochastic; for some of them the disaggregation is based on scaling properties of rainfall. The compared models are in increasing complexity order: constant model, linear model (Ben Haha, 2001), Ormsbee Deterministic model (Ormsbee, 1989), Ar- tificial Neuronal Network based model (Burian et al. 2000), Hydram Stochastic 1 and Hydram Stochastic 2 (Ben Haha, 2001), Multiplicative Cascade based model (Olsson and Berndtsson, 1998), Ormsbee Stochastic model (Ormsbee, 1989). The 625 rainy hours used for that evaluation (with a hourly rainfall amount greater than 5mm) were extracted from the 21 years chronological rainfall series (10mn time step) observed at the Pully meteorological station, Switzerland. The models were also evaluated when applied to different rainfall classes depending on the season first and on the

  1. CHIS – Opening hours of UNIQA offices during end-of-year closure

    CERN Multimedia

    2013-01-01

    The office of UNIQA at CERN (Main Building) will be closed during the end-of-year closure.   During that period, the Geneva offices of UNIQA will be open on 23, 26, 27 and 30 December as well as on 2 and 3 January. Opening hours: 8 a.m. to 12.30 p.m. and 1.30 p.m. to 5 p.m. During these hours, you can also call 022 718 63 00. Mail sent to uniqa.assurances@cern.ch will be handled only during these opening hours. For urgent medical assistance, you may call +43 512 224 22, 24h/day.  Please note that this service only provides medical advice and is not in a position to inform you on your administrative situation nor on the coverage by CHIS of medical expenses. HR Department Tel.: 74125

  2. Effects of worksite health interventions involving reduced work hours and physical exercise on sickness absence costs.

    Science.gov (United States)

    von Thiele Schwarz, Ulrica; Hasson, Henna

    2012-05-01

    To investigate the effects of physical exercise during work hours (PE) and reduced work hours (RWH) on direct and indirect costs associated with sickness absence (SA). Sickness absence and related costs at six workplaces, matched and randomized to three conditions (PE, RWH, and referents), were retrieved from company records and/or estimated using salary conversion methods or value-added equations on the basis of interview data. Although SA days decreased in all conditions (PE, 11.4%; RWH, 4.9%; referents, 15.9%), costs were reduced in the PE (22.2%) and RWH (4.9%) conditions but not among referents (10.2% increase). Worksite health interventions may generate savings in SA costs. Costs may not be linear to changes in SA days. Combing the friction method with indirect cost estimates on the basis of value-added productivity may help illuminate both direct and indirect SA costs.

  3. 20 CFR 801.304 - Business hours.

    Science.gov (United States)

    2010-04-01

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

  4. Training Physicians to Provide High-Value, Cost-Conscious Care A Systematic Review

    NARCIS (Netherlands)

    Stammen, L.A.; Stalmeijer, R.E.; Paternotte, E.; Pool, A.O.; Driessen, E.W.; Scheele, F.; Stassen, L.P.S.

    2015-01-01

    Importance Increasing health care expenditures are taxing the sustainability of the health care system. Physicians should be prepared to deliver high-value, cost-conscious care. Objective To understand the circumstances in which the delivery of high-value, cost-conscious care is learned, with a goal

  5. Content changes of selected mineral nutrients in mare’s colostrums in the first 72 hours after foaling

    Directory of Open Access Journals (Sweden)

    Branislav Gálik

    2012-01-01

    Full Text Available The aim of this study was to monitor levels of minerals in mare’s colostrum in the first 3 days after foaling. Colostrum samples from four warm-blood mares (in three repetitions were analysed 2, 12, 24, 36, 48 and 72 hours postpartum. The samples were obtained by hand milking. Calcium (Ca, phosphorus (P, magnesium (Mg, sodium (Na, potassium (K, zinc (Zn, copper (Cu, iron (Fe and manganese (Mn contents were analysed in each sample. Non-significant decrease of postpartum Ca and Na contents was found in the analysed samples. Significant differences (P < 0.05 in P content were detected between 2 and 36 hours postpartum. Content of Mg showed statistically significant differences (P < 0.05 during the period after foaling (2, 24, 36, 48 and 72 hours post foaling. Mg concentration reached its maximum (21.8 g.kg−1 of dry matter 2 hours postpartum and it dropped to its lowest level (5.27 g.kg−1 of dry matter 48 hours after foaling. Similarly, the highest K content (significant in relation to values obtained 36, 48 and 72 hours postpartum was detected 2 hours after foaling while the lowest K level (37.96 g.kg−1 of dry matter was found 48 hours postpartum. As regards the microelements, Cu showed insignificant differences in its postpartum levels (P > 0.05. Besides growth of Fe levels, decrease of Zn and Mn (P > 0.05 was also observed.

  6. Impact of Working Hours on Work-Life Balance

    OpenAIRE

    Sarah Holly; Alwine Mohnen

    2012-01-01

    To examine the influence of working hours on employees' satisfaction, this article uses a large, representative set of panel data from German households (GSOEP). The results show that high working hours and overtime in general do not lead to decreased satisfaction. Rather, increasing working hours and overtime have positive effects on life and job satisfaction, whereas the desire to reduce working hours has a negative impact on satisfaction. In 2009, nearly 60% of employees wanted to reduce t...

  7. Production Facility Prototype Blower 1000 Hour Test Results II

    Energy Technology Data Exchange (ETDEWEB)

    Wass, Alexander Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Woloshun, Keith Albert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dale, Gregory E. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dalmas, Dale Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Romero, Frank Patrick [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2018-01-08

    Long duration tests of the Aerzen GM 12.4 roots style blower in a closed loop configuration provides valuable data and lessons learned for long-term operation at the Mo-99 production facility. The blower was operated in a closed loop configuration with the flow conditions anticipated in plant operation with a Mo-100 target inline. The additional thermal energy generated from beam heating of the Mo-100 disks were not included in these tests. Five 1000 hour tests have been completed since the first test was performed in January of 2016. All five 1000 hour tests have proven successful in exposing preventable issues related to oil and helium leaks. All blower tests to this date have resulted in stable blower performance and consistency. A summary of the results for each test, including a review of the first and second tests, are included in this report.

  8. The economic value of the climate regulation ecosystem service provided by the Amazon rainforest

    Science.gov (United States)

    Heil Costa, Marcos; Pires, Gabrielle; Fontes, Vitor; Brumatti, Livia

    2017-04-01

    The rainy Amazon climate allowed important activities to develop in the region as large rainfed agricultural lands and hydropower plants. The Amazon rainforest is an important source of moisture to the regional atmosphere and helps regulate the local climate. The replacement of forest by agricultural lands decreases the flux of water vapor into the atmosphere and changes the precipitation patterns, which may severely affect such economic activities. Assign an economic value to this ecosystem service may emphasize the significance to preserve the Amazon rainforest. In this work, we provide a first approximation of the quantification of the climate regulation ecosystem service provided by the Amazon rainforest using the marginal production method. We use climate scenarios derived from Amazon deforestation scenarios as input to crop and runoff models to assess how land use change would affect agriculture and hydropower generation. The effects of forest removal on soybean production and on cattle beef production can both be as high as US 16 per year per ha deforested, and the effects on hydropower generation can be as high as US 8 per year per ha deforested. We consider this as a conservative estimate of a permanent service provided by the rainforest. Policy makers and other Amazon agriculture and energy businesses must be aware of these numbers, and consider them while planning their activities.

  9. On the use of hourly pricing in techno-economic analyses for solar photovoltaic systems

    International Nuclear Information System (INIS)

    Sommerfeldt, Nelson; Madani, Hatef

    2015-01-01

    Highlights: • The typical price year (TPY) method is described. • The impact of pricing simplification models on revenues and NPV are tested. • The TPY is shown to be a good long-term price curve for techno-economic studies. • A static mean annual price can replace hourly in the Swedish market with minimal error. - Abstract: The use of hourly prices in distributed photovoltaic (PV) techno-economic analysis is rare, but may become necessary as time-of-day retail pricing becomes more common. A methodology is presented for selecting an hourly price curve suitable for long-term analysis, called the typical price year (TPY), which is based on the methodology for TMY weather data. Using a techno-economic analysis with annual revenues and net present value as indicators, a TPY curve for the Swedish market is validated and then compared to 18 price simplification methods to determine the error introduced by the use of non-hourly prices. Results show that the TPY method produces a curve which accurately represents long term pricing trends, but using a static annual mean introduces minor revenue errors of 1.3%. This suggests the TPY may not be necessary in the Swedish market, but further analysis of the method is suggested for other markets

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

    Science.gov (United States)

    2014-04-01

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

  11. A new approach for evaluating flexible working hours.

    Science.gov (United States)

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

    2004-01-01

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

  12. The early printed Books of Hours in the Grey Collection in Cape Town: evidence of an information revolution

    Directory of Open Access Journals (Sweden)

    F C Steyn

    2014-11-01

    Full Text Available Printed books of hours, the best-seller of the late medieval trade in books, provide evidence of an information revolution equal to that occasioned by the Internet today. The Grey Collection of the National Library in Cape Town possesses eight books of hours, printed between 1498 and 1530, and they are almost completely unknown. Yet these valuable incunabula, all of them printed on vellum with hand-painted initials, and some of them with hand-painted miniatures, are of importance to anybody interested in books, the history of the book, the dissemination of information, the art of the late 15th to the early 16th centuries and early printing. They are also religious books, and of value to people interested in that discipline. The books are therefore eminently suitable as subjects for transdisciplinary research through which the subjects of history, sociology, art and religion can be drawn together. Two of these books, printed by Thielman Kerver in Paris, are discussed in detail in this article. The books are especially remarkable for their many illustrations that include pictures around the borders of each page as well as full-page illustrations. The pictures are neither metal cuts nor woodcuts, as were usual in that period, but relief prints. The most important part of the texts is a sequence of prayers to the Virgin Mary. Soon after these books were printed , in 1571, Pope Pius V prohibited the use of all existing books of hours.

  13. Gender-specific dynamics in hours worked : Exploring the potential for increasing hours worked in an ageing society

    NARCIS (Netherlands)

    Noback, Inge; Broersma, Lourens; van Dijk, Jouke; Karlsson, Charlie; Andersson, Martin; Norman, Therese

    2015-01-01

    The Dutch labour market differs from that of other countries due to a unique combination of high employment rates and a low average number of hours worked. Dutch employment rates are among the highest in the world, at 77 per cent in 2011. At the same time, the average number of hours worked annually

  14. Interns shall not sleep: the duty hours boomerang

    Directory of Open Access Journals (Sweden)

    Quan SF

    2017-04-01

    Full Text Available No abstract available. Article truncated after 150 words. On March 10, 2017, the Accreditation Council for Graduate Medical Education (ACGME announced revisions to its common program requirements related to duty hours (1. Effective on July 1, 2017, the most important change will be an increase in the maximum consecutive hours that an intern may work. Interns will now be able to continuously perform patient care work up to a maximum of 24 hours with an additional 4 hours for managing care transitions. This reverses the controversial reduction to 16 hours that occurred in 2011 (2. The regulation of house staff duty hours formally began in the late 1980s. It was precipitated largely because of the publicity resulting from the 1984 death of Libby Zion in a New York teaching hospital that was attributed partly to poor decisions made by fatigued and overworked house staff (3. Consequently, the state of New York in 1989 passed laws restricting the …

  15. A Study of Postmodern Narrative in Michael Cunningham's The Hours

    Directory of Open Access Journals (Sweden)

    Hajar Abbasi Narinabad

    2012-09-01

    Full Text Available This project aims at providing a detailed analysis of the major features of the theory of postmodern narrative and at going through the novel The Hours by the American writer Michael Cunningham concentrating on some postmodern narrative techniques. To do so, the researcher goes through the theories set forth by some postmodern theoreticians like Roland Barthes, Jacque Derrida, Jean-François Lyotard and Julia Kristeva to investigate the postmodern narrative techniques and elements used in the novel. The researcher first examines the theories and then critically applies them on the novel. The article goes through the most eminent elements of postmodern narrative including intertextuality, stream of consciousness style, fragmentation and representation respectively which are delicately utilized in The Hours. The article concludes by recommending a few directions for the further research.

  16. Economic Analysis of Long Working Hours (Japanese)

    OpenAIRE

    OHTAKE Fumio; OKUDAIRA Hiroko

    2008-01-01

    In this paper we set out the economic grounds for restrictions on long working hours and conduct an empirical analysis using surveys from the perspective of behavioral economics. The results of the analysis indicate that, on a year-on-year basis, if state of health improves, the probability of working more than 60 hours per week increases significantly, but that even when state of health deteriorates there is no decrease in the probability of working long hours. Moreover, among male managemen...

  17. Use of non-linear mixed-effects modelling and regression analysis to predict the number of somatic coliphages by plaque enumeration after 3 hours of incubation.

    Science.gov (United States)

    Mendez, Javier; Monleon-Getino, Antonio; Jofre, Juan; Lucena, Francisco

    2017-10-01

    The present study aimed to establish the kinetics of the appearance of coliphage plaques using the double agar layer titration technique to evaluate the feasibility of using traditional coliphage plaque forming unit (PFU) enumeration as a rapid quantification method. Repeated measurements of the appearance of plaques of coliphages titrated according to ISO 10705-2 at different times were analysed using non-linear mixed-effects regression to determine the most suitable model of their appearance kinetics. Although this model is adequate, to simplify its applicability two linear models were developed to predict the numbers of coliphages reliably, using the PFU counts as determined by the ISO after only 3 hours of incubation. One linear model, when the number of plaques detected was between 4 and 26 PFU after 3 hours, had a linear fit of: (1.48 × Counts 3 h + 1.97); and the other, values >26 PFU, had a fit of (1.18 × Counts 3 h + 2.95). If the number of plaques detected was PFU after 3 hours, we recommend incubation for (18 ± 3) hours. The study indicates that the traditional coliphage plating technique has a reasonable potential to provide results in a single working day without the need to invest in additional laboratory equipment.

  18. Valuing the Resilience Provided by Solar and Battery Energy Storage Systems

    Energy Technology Data Exchange (ETDEWEB)

    McLaren, Joyce A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gagnon, Pieter J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mullendore, Seth [Clean Energy Group

    2018-02-05

    This paper explores the impact of valuing resilience on the economics of photovoltaics (PV) and storage systems for commercial buildings. The analysis presented here illustrates that accounting for the cost of grid power outages can change the breakeven point for PV and storage system investment, and increase the size of systems designed to deliver the greatest economic benefit over time. In other words, valuing resilience can make PV and storage systems economical in cases where they would not be otherwise. As storage costs decrease, and outages occur more frequently, PV and storage are likely to play a larger role in building design and management considerations.

  19. Economic model of a cloud provider operating in a federated cloud

    OpenAIRE

    Goiri Presa, Íñigo; Guitart Fernández, Jordi; Torres Viñals, Jordi

    2012-01-01

    Resource provisioning in Cloud providers is a challenge because of the high variability of load over time. On the one hand, the providers can serve most of the requests owning only a restricted amount of resources, but this forces to reject customers during peak hours. On the other hand, valley hours incur in under-utilization of the resources, which forces the providers to increase their prices to be profitable. Federation overcomes these limitations and allows pro...

  20. Changing commuters' behavior using rewards: a study of rush-hour avoidance

    NARCIS (Netherlands)

    Ben Elia, E.; Ettema, D.F.

    2011-01-01

    In a 13-week field study conducted in The Netherlands, participants were provided with daily rewards – monetary and in-kind, in order to encourage them to avoid driving during the morning rush-hour. Participants could earn a reward (money or credits to keep a Smartphone handset), by driving to work

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

    Science.gov (United States)

    Iwasaki, Kenji; Takahashi, Masaya; Nakata, Akinori

    2006-10-01

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

  2. Multiple-dose pharmacokinetic study of proguanil and cycloguanil following 12-hourly administration of 100 mg proguanil hydrochloride.

    Science.gov (United States)

    Jamaludin, A; Mohamad, M; Navaratnam, V; Yeoh, P Y; Wernsdorfer, W H

    1990-09-01

    A pharmacokinetic study with 12-hourly doses of 100 mg proguanil hydrochloride over 15 days has been conducted in six adult male Malaysian volunteers. Steady state for proguanil was established after the fourth dose on Day 2, for the active metabolite cycloguanil as from Day 3 inclusive. The steady state mean peak concentration of proguanil was 1201.6 +/- 132.4 nmol/l, the mean trough concentration 650.0 +/- 58.1 nmol/l. The corresponding values for cycloguanil were 317.0 +/- 44.4 nmol/l (mean peak) and 230.8 +/- 35.1 nmol/l (mean trough). The profiles and peak/trough ratios of proguanil and cycloguanil with 12-hourly dosing offer better prospects for protection against malaria than those obtained with 24-hourly doses of 200 mg proguanil hydrochloride, the current routine in malaria chemoprophylaxis.

  3. Demands, values, and burnout: relevance for physicians.

    Science.gov (United States)

    Leiter, Michael P; Frank, Erica; Matheson, Timothy J

    2009-12-01

    T o explore the interaction between workload and values congruence (personal values with health care system values) in the context of burnout and physician engagement and to explore the relative importance of these factors by sex, given the distinct work patterns of male and female physicians. National mailed survey. Canada. A random sample of 8100 Canadian physicians (response rate 40%, N = 3213); 2536 responses (from physicians working more than 35 hours per week) were analyzed. Levels of burnout, values congruence, and workload, by sex, measured by the Maslach Burnout Inventory-General Scale and the Areas of Worklife Scale. Results showed a moderate level of burnout among Canadian physicians, with relatively positive scores on exhaustion, average scores on cynicism, and mildly negative scores on professional efficacy. A series of multiple regression analyses confirmed parallel main effect contributions from manageable workload and values congruence. Both workload and values congruence predicted exhaustion and cynicism for men and women (P = .001). Only values congruence provided a significant prediction of professional efficacy for both men and women (P = .001) These predictors interacted for women on all 3 aspects of burnout (exhaustion, cynicism, and diminished efficacy). Howevever, overall levels of the burnout indicators departed only modestly from normative levels. W orkload and values congruence make distinct contributions to physician burnout. Work overload contributes to predicting exhaustion and cynicism; professional values crises contribute to predicting exhaustion, cynicism, and low professional efficacy. The interaction of values and workload for women in particular has implications for the distinct work-life patterns of male and female physicians. Specifically, the congruence of individual values with values inherent in the health care system appeared to be of greater consequence for women than for men.

  4. A feasible method to study the Danish out-of-hours primary care service

    DEFF Research Database (Denmark)

    Flarup, Lone; Moth, Grete; Christensen, Morten Bondo

    2014-01-01

    INTRODUCTION: The primary care out-of-hours (OOH) service is of considerable importance; it is the main provider of freely accessible medical advice outside daytime hours, and it covers 75% of the active time in the healthcare system. Although the OOH handles three million contacts annually, only...... little is known about the reasons for encounter, the performed clinical work and the patient perspectives. MATERIAL AND METHODS: During a one-year period (2010- 2011), data on patient contacts were collected using pop-up questionnaires integrated into the existing IT system. The questions explored...

  5. Long working hours and physical activity.

    Science.gov (United States)

    Angrave, David; Charlwood, Andy; Wooden, Mark

    2015-08-01

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

  6. 29 CFR 1904.40 - Providing records to government representatives.

    Science.gov (United States)

    2010-07-01

    ...) business hours of the request. If you maintain the records at a location in a different time zone, you may... under part 1904, you must provide copies of the records within four (4) business hours. (b... responsible for administering a State plan approved under section 18 of the Act. (2) Do I have to produce the...

  7. Flexible working hours and well-being in Finland.

    Science.gov (United States)

    Kandolin, I; Härmä, M; Toivanen, M

    2001-12-01

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

  8. A Century of Human Capital and Hours

    OpenAIRE

    Diego Restuccia; Guillaume Vandenbroucke

    2012-01-01

    An average person born in the United States in the second half of the nineteenth century completed 7 years of schooling and spent 58 hours a week working in the market. By contrast, an average person born at the end of the twentieth century completed 14 years of schooling and spent 40 hours a week working. In the span of 100 years, completed years of schooling doubled and working hours decreased by 30 percent. What explains these trends? We consider a model of human capital and labor supply t...

  9. Associations between hours worked, symptoms and health resource utilization among full-time male Japanese workers.

    Science.gov (United States)

    Sato, Keiko; Yamazaki, Shin; Hayashino, Yasuaki; Takegami, Misa; Tokuda, Yasuharu; Takahashi, Osamu; Shimbo, Takuro; Hinohara, Shigeaki; Fukui, Tsuguya; Fukuhara, Shunichi

    2011-01-01

    To investigate the association between hours worked, symptoms experienced, and health resource utilization. Data were collected from a nationally representative sample of households in Japan. We studied full-time male workers aged 18-65 yr who worked 100 h or more per month. First, we examined the association between hours worked and symptoms experienced. Second, we examined the association between hours worked and the type of health resource utilized, such as physician visits, over-the-counter (OTC) medication use, dietary supplement use, and complementary and alternative medicine (CAM) provider visits. We used a multivariable negative binominal model in each analysis. Of the 762 male workers, 598 reported experiencing symptoms at least once a month. We categorized participants based on the number of hours worked per month (h/mo): 100-200 h/mo, 201-250 h/mo, and over 250 h/mo. Compared with those working 201-250 h/mo, those working 100-200 h/mo had more frequent physician visits (rate ratio:1.67, 95% CI: 1.17 to 2.38) and those working over 250 h/mo had significantly lower rates of CAM provider visits and tended to use dietary supplements for symptoms. Participants who worked 201-250 h/mo used OTC medication most frequently. No significant association was observed between the number of hours worked and number of symptoms experienced. The more hours worked by full-time male workers, the more likely they were to use health resources that had a lower time requirement. Greater attention should be paid to patterns of health resource utilization among workers and their consequent influence on long-term health status.

  10. Regulating danger on the highways: hours of service regulations.

    Science.gov (United States)

    Mansfield, Daniel; Kryger, Meir

    2015-12-01

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

  11. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    .2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. CONCLUSIONS: Individuals whose working hours exceed standard......OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies......, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were...

  12. Time-varying value of electric energy efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Mims, Natalie A.; Eckman, Tom; Goldman, Charles

    2017-06-30

    Electric energy efficiency resources save energy and may reduce peak demand. Historically, quantification of energy efficiency benefits has largely focused on the economic value of energy savings during the first year and lifetime of the installed measures. Due in part to the lack of publicly available research on end-use load shapes (i.e., the hourly or seasonal timing of electricity savings) and energy savings shapes, consideration of the impact of energy efficiency on peak demand reduction (i.e., capacity savings) has been more limited. End-use load research and the hourly valuation of efficiency savings are used for a variety of electricity planning functions, including load forecasting, demand-side management and evaluation, capacity and demand response planning, long-term resource planning, renewable energy integration, assessing potential grid modernization investments, establishing rates and pricing, and customer service. This study reviews existing literature on the time-varying value of energy efficiency savings, provides examples in four geographically diverse locations of how consideration of the time-varying value of efficiency savings impacts the calculation of power system benefits, and identifies future research needs to enhance the consideration of the time-varying value of energy efficiency in cost-effectiveness screening analysis. Findings from this study include: -The time-varying value of individual energy efficiency measures varies across the locations studied because of the physical and operational characteristics of the individual utility system (e.g., summer or winter peaking, load factor, reserve margin) as well as the time periods during which savings from measures occur. -Across the four locations studied, some of the largest capacity benefits from energy efficiency are derived from the deferral of transmission and distribution system infrastructure upgrades. However, the deferred cost of such upgrades also exhibited the greatest range

  13. Value Co-creation in the Interface Between City Logistics Provider and In-store Processes

    DEFF Research Database (Denmark)

    Gammelgaard, Britta; Bech Godskesen Andersen, Christina; Aastrup, Jesper

    2016-01-01

    This paper develops a framework for understanding how city logistics service co-creates value with users. The users’ perspective in city logistics research is limited, and value added services are rarely emphasized. The framework developed is based on literature on value in business markets, and in......-store processes. Two case stores and their use of city logistics demonstrate how value is co-created when changes in delivery patterns and value added services affect especially the use of store employees. Further, we show that there is a barrier to the co-creation of value when services get close to core...

  14. Migration plans and hours of work in Malaysia.

    Science.gov (United States)

    Gillin, E D; Sumner, D A

    1985-01-01

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

  15. Time spent sitting during and outside working hours in bus drivers: A pilot study.

    Science.gov (United States)

    Varela-Mato, Veronica; Yates, Thomas; Stensel, David J; Biddle, Stuart J H; Clemes, Stacy A

    2016-06-01

    This cross-sectional pilot study objectively measured sedentary and non-sedentary time in a sample of bus drivers from the East Midlands, United Kingdom. Participants wore an activPAL3 inclinometer for 7 days and completed a daily diary. Driver's blood pressure, heart rate, waist circumference and body composition were measured objectively at the outset. The proportions of time spent sedentary and non-sedentary were calculated during waking hours on workdays and non-workdays and during working-hours and non-working-hours on workdays. 28 (85% of those enrolled into the study) provided valid objective monitoring data (89.3% male, [median ± IQR] age: 45.2 ± 12.8 years, BMI 28.1 ± 5.8 kg/m(2)). A greater proportion of time was spent sitting on workdays than non-workdays (75% [724 ± 112 min/day] vs. 62% [528 ± 151 min/day]; p working-hours than non-working-hours (83% [417 ± 88 min/day] vs. 68% [307 ± 64 min/day]; p less than 3% of their overall time stepping. Bus drivers accumulate high levels of sitting time during working-hours and outside working-hours. Interventions are urgently needed in this at-risk group, which should focus on reducing sitting and increasing movement during breaks and increasing physical activity during leisure time to improve cardiovascular health.

  16. Are long physician working hours harmful to patient safety?

    Science.gov (United States)

    Ehara, Akira

    2008-04-01

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

  17. Work-hour restrictions as an ethical dilemma for residents.

    Science.gov (United States)

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

    2006-04-01

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

  18. Mesoscale storm and dry period parameters from hourly precipitation data: program documentation

    Energy Technology Data Exchange (ETDEWEB)

    Thorp, J.M.

    1984-09-01

    Wet deposition of airborne chemical pollutants occurs primarily from precipitation. Precipitation rate, amount, duration, and location are important meteorological factors to be considered when attempting to understand the relationship of precipitation to pollutant deposition. The Pacific Northwest Laboratory (PNL) has conducted studies and experiments in numerous locations to collect data that can be incorporated into theories and models that attempt to describe the complex relationship between precipitation occurrence and chemical wet desposition. Model development often requires the use of average rather than random condition as input. To provide mean values of storm parameters, the task, Climatological Analysis of Mesoscale Storms, was created as a facet of the Environmental Protection Agency's related-service project, Precipitation Scavenging Module Development. Within this task computer programs have been developed at PNL which incorporate hourly precipitation data from National Weather Service stations to calculate mean values and frequency distributions of precipitation periods and of the interspersed dry periods. These programs have been written with a degree of flexibiity that will allow user modification for applications to different, but similar, analyses. This report describes in detail the rationale and operation of the two computer programs which produce the tables of average and frequency distributions of storm and dry period parameters from the precipitation data. A listing of the programs and examples of the generated output are included in the appendices. 3 references, 3 figures, 6 tables.

  19. Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care.

    Science.gov (United States)

    Pesut, Barbara; Bottorff, Joan L; Robinson, Carole A

    2011-09-28

    Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative

  20. Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-09-01

    Full Text Available Abstract Background Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of

  1. AIP1OGREN: Aerosol Observing Station Intensive Properties Value-Added Product

    Energy Technology Data Exchange (ETDEWEB)

    Koontz, Annette [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Flynn, Connor [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2017-09-15

    The aip1ogren value-added product (VAP) computes several aerosol intensive properties. It requires as input calibrated, corrected, aerosol extensive properties (scattering and absorption coefficients, primarily) from the Aerosol Observing Station (AOS). Aerosol extensive properties depend on both the nature of the aerosol and the amount of the aerosol. We compute several properties as relationships between the various extensive properties. These intensive properties are independent of aerosol amount and instead relate to intrinsic properties of the aerosol itself. Along with the original extensive properties we report aerosol single-scattering albedo, hemispheric backscatter fraction, asymmetry parameter, and Ångström exponent for scattering and absorption with one-minute averaging. An hourly averaged file is produced from the 1-minute files that includes all extensive and intensive properties as well as submicron scattering and submicron absorption fractions. Finally, in both the minutely and hourly files the aerosol radiative forcing efficiency is provided.

  2. Long working hours and alcohol use

    DEFF Research Database (Denmark)

    Virtanen, Marianna; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies......, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were...... countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1...

  3. Duty hour reform in a shifting medical landscape.

    Science.gov (United States)

    Jena, Anupam B; Prasad, Vinay

    2013-09-01

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

  4. Work hours and absenteeism among police officers.

    Science.gov (United States)

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

    2013-01-01

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

  5. Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics.

    Science.gov (United States)

    Kovacs, Mark D; Sheafor, Douglas H; Thacker, Paul G; Hardie, Andrew D; Costello, Philip

    2018-03-01

    In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets. Value-added work metrics selected for tracking included interdisciplinary conferences, hospital committee meetings, consulting on nonbilled outside studies, and practice-based quality improvement. Over a period of 4 months, value-added work data were collected for all clinical attending faculty members in a university-based radiology department (n = 39). Time required for data entry was analyzed for 2 faculty members over the same time period. Thirty-nine faculty members (equivalent to 36.4 full-time equivalents) reported a total of 1,223.5 hours of value-added work time (VAWT). A formula was used to calculate "value-added RVUs" (vRVUs) from VAWT. VAWT amounted to 5,793.6 vRVUs or 6.0% of total work performed (vRVUs plus work RVUs [wRVUs]). Were vRVUs considered equivalent to wRVUs for staffing purposes, this would require an additional 2.3 full-time equivalents, on the basis of average wRVU calculations. Mean data entry time was 56.1 seconds per day per faculty member. As health care reimbursement evolves with an emphasis on value-based medicine, it is imperative that radiologists demonstrate the value they add to patient care beyond wRVUs. This free and easy-to-use cloud-based system allows the efficient quantification of value-added work activities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Evaluation of a twelve-hour/day shift schedule

    International Nuclear Information System (INIS)

    Lewis, P.M.; Swaim, D.J.

    1986-01-01

    In April 1985, the operating crews at the Fast Flux Test Facility near Richland, Washington, changed their rotating shift schedule from an 8-hour to a 12-hour a day work schedule. The primary purpose of the change was to reduce the attrition of operators by increasing their job satisfaction. Eighty-four percent of the operators favored the change. A program was established to evaluate the effects on plant performance, operator alertness, attrition, sleep, health, job satisfaction, and off-the-job satisfaction. Preliminary results from that evaluation program indicate that the 12-hour shift schedule is a reasonable alternative to an 8-hour schedule at this facility

  7. Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference.

    Science.gov (United States)

    Rothstein, Brooke E; Gonzalez, Jessica; Cunningham, Kiera; Saraiya, Ami; Dornelles, Adriana C; Nguyen, Bichchau M

    2017-12-01

    The direct and indirect costs of dermatology clinic visits are infrequently quantified. Indirect costs, such as the time spent traveling to and from appointments and the value of lost earnings from time away from work, are substantial costs that often are not included in economic analyses but may pose barriers to receiving care. Due to the national shortage of dermatologists, patients may have to wait longer for appointments or travel further to see dermatologists outside of their local community, resulting in high time and travel costs for patients. Patients' lost time and earnings comprise the opportunity cost of obtaining care. A monetary value for this opportunity cost can be calculated by multiplying a patient's hourly wage by the number of hours that the patient dedicated to attending the dermatology appointment. Using a single institution survey, this study quantified the direct and indirect patient costs, including opportunity costs and time burden, associated with dermatology clinic visits to better appreciate the impact of these factors on health care access and dermatologic provider preference.

  8. Full-time Workers Want to Work Fewer Hours, Part-time Workers Want to Work Longer Hours

    OpenAIRE

    Holst, Elke

    2009-01-01

    Since the reunification of Germany, average working times for men and women have followed different trends. There are various reasons for the difference. More and more women are gainfully employed; they engage in part-time and marginal employment, both of which are on the rise. The importance of full-time employment has declined. This accounts for most of the reduction in their average workweek, which decreased by 2.3 hours to 31.9 hours between 1993 and 2007. The full-time employment of men ...

  9. Impairing DNA methylation obstructs memory enhancement for at least 24 hours in Lymnaea.

    Science.gov (United States)

    Rothwell, Cailin M; Lukowiak, Ken D

    2017-01-01

    Stressor-induced memory enhancement has previously been shown to involve DNA methylation in the mollusc Lymnaea stagnalis . Specifically, injection of the DNA methylation inhibitor 5-AZA one hour before exposure to a memory-enhancing stressor obstructs memory augmentation. However, the duration of the influence of 5-AZA on this memory enhancement has not yet been examined. In this study, 2 memory-enhancing stressors (a thermal stress and exposure to the scent of a predator) were used to examine whether injection of the DNA methylation inhibitor 5-AZA 24 hours before stress exposure would still impair memory enhancement. Indeed, it was observed that memory is still obstructed when 5-AZA is injected 24 hours before exposure to either of these stressors in Lymnaea . Understanding that 5-AZA still effectively impairs memory enhancement after a period of 24 hours is valuable because it indicates that experimental manipulations do not need to be made within one hour after the injection of this DNA methylation inhibitor and can instead be made within one day (i.e. 24 hours). These results will allow for a future examination of the possible involvement of DNA methylation in memory enhancement related to longer-term stressors or environmental changes. This study further elucidates the involvement of epigenetic changes in memory enhancement in Lymnaea , providing insight into the process of memory formation in this mollusc.

  10. Time-Varying Value of Energy Efficiency in Michigan

    Energy Technology Data Exchange (ETDEWEB)

    Mims, Natalie; Eckman, Tom; Schwartz, Lisa C.

    2018-04-02

    Quantifying the time-varying value of energy efficiency is necessary to properly account for all of its benefits and costs and to identify and implement efficiency resources that contribute to a low-cost, reliable electric system. Historically, most quantification of the benefits of efficiency has focused largely on the economic value of annual energy reduction. Due to the lack of statistically representative metered end-use load shape data in Michigan (i.e., the hourly or seasonal timing of electricity savings), the ability to confidently characterize the time-varying value of energy efficiency savings in the state, especially for weather-sensitive measures such as central air conditioning, is limited. Still, electric utilities in Michigan can take advantage of opportunities to incorporate the time-varying value of efficiency into their planning. For example, end-use load research and hourly valuation of efficiency savings can be used for a variety of electricity planning functions, including load forecasting, demand-side management and evaluation, capacity planning, long-term resource planning, renewable energy integration, assessing potential grid modernization investments, establishing rates and pricing, and customer service (KEMA 2012). In addition, accurately calculating the time-varying value of efficiency may help energy efficiency program administrators prioritize existing offerings, set incentive or rebate levels that reflect the full value of efficiency, and design new programs.

  11. Long work hours and obesity in Korean adult workers.

    Science.gov (United States)

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

    2014-01-01

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

  12. 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.

  13. 24-Hour Academic Libraries: Adjusting to Change

    Science.gov (United States)

    Bowman, Adam C.

    2013-01-01

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

  14. Typology of after-hours care instructions for patients

    Science.gov (United States)

    Bordman, Risa; Bovett, Monica; Drummond, Neil; Crighton, Eric J.; Wheler, David; Moineddin, Rahim; White, David

    2007-01-01

    OBJECTIVE To develop a typology of after-hours care (AHC) instructions and to examine physician and practice characteristics associated with each type of instruction. DESIGN Cross-sectional telephone survey. Physicians’ offices were called during evenings and weekends to listen to their messages regarding AHC. All messages were categorized. Thematic analysis of a subset of messages was conducted to develop a typology of AHC instructions. Logistic regression analysis was used to identify associations between physician and practice characteristics and the instructions left for patients. SETTING Family practices in the greater Toronto area. PARTICIPANTS Stratified random sample of family physicians providing office-based primary care. MAIN OUTCOME MEASURES Form of response (eg, answering machine), content of message, and physician and practice characteristics. RESULTS Of 514 after-hours messages from family physicians’ offices, 421 were obtained from answering machines, 58 were obtained from answering services, 23 had no answer, 2 gave pager numbers, and 10 had other responses. Message content ranged from no AHC instructions to detailed advice; 54% of messages provided a single instruction, and the rest provided a combination of instructions. Content analysis identified 815 discrete instructions or types of response that were classified into 7 categories: 302 instructed patients to go to an emergency department; 122 provided direct contact with a physician; 115 told patients to go to a clinic; 94 left no directions; 76 suggested calling a housecall service; 45 suggested calling Telehealth; and 61 suggested other things. About 22% of messages only advised attending an emergency department, and 18% gave no advice at all. Physicians who were female, had Canadian certification in family medicine, held hospital privileges, or had attended a Canadian medical school were more likely to be directly available to their patients. CONCLUSION Important issues identified

  15. Modeling temporal and spatial variability of traffic-related air pollution: Hourly land use regression models for black carbon

    Science.gov (United States)

    Dons, Evi; Van Poppel, Martine; Kochan, Bruno; Wets, Geert; Int Panis, Luc

    2013-08-01

    Land use regression (LUR) modeling is a statistical technique used to determine exposure to air pollutants in epidemiological studies. Time-activity diaries can be combined with LUR models, enabling detailed exposure estimation and limiting exposure misclassification, both in shorter and longer time lags. In this study, the traffic related air pollutant black carbon was measured with μ-aethalometers on a 5-min time base at 63 locations in Flanders, Belgium. The measurements show that hourly concentrations vary between different locations, but also over the day. Furthermore the diurnal pattern is different for street and background locations. This suggests that annual LUR models are not sufficient to capture all the variation. Hourly LUR models for black carbon are developed using different strategies: by means of dummy variables, with dynamic dependent variables and/or with dynamic and static independent variables. The LUR model with 48 dummies (weekday hours and weekend hours) performs not as good as the annual model (explained variance of 0.44 compared to 0.77 in the annual model). The dataset with hourly concentrations of black carbon can be used to recalibrate the annual model, resulting in many of the original explaining variables losing their statistical significance, and certain variables having the wrong direction of effect. Building new independent hourly models, with static or dynamic covariates, is proposed as the best solution to solve these issues. R2 values for hourly LUR models are mostly smaller than the R2 of the annual model, ranging from 0.07 to 0.8. Between 6 a.m. and 10 p.m. on weekdays the R2 approximates the annual model R2. Even though models of consecutive hours are developed independently, similar variables turn out to be significant. Using dynamic covariates instead of static covariates, i.e. hourly traffic intensities and hourly population densities, did not significantly improve the models' performance.

  16. Estimating Hourly Beam and Diffuse Solar Radiation in an Alpine Valley: A Critical Assessment of Decomposition Models

    Directory of Open Access Journals (Sweden)

    Lavinia Laiti

    2018-03-01

    Full Text Available Accurate solar radiation estimates in Alpine areas represent a challenging task, because of the strong variability arising from orographic effects and mountain weather phenomena. These factors, together with the scarcity of observations in elevated areas, often cause large modelling uncertainties. In the present paper, estimates of hourly mean diffuse fraction values from global radiation data, provided by a number (13 of decomposition models (chosen among the most widely tested in the literature, are evaluated and compared with observations collected near the city of Bolzano, in the Adige Valley (Italian Alps. In addition, the physical factors influencing diffuse fraction values in such a complex orographic context are explored. The average accuracy of the models were found to be around 27% and 14% for diffuse and beam radiation respectively, the largest errors being observed under clear sky and partly cloudy conditions, respectively. The best performances were provided by the more complex models, i.e., those including a predictor specifically explaining the radiation components’ variability associated with scattered clouds. Yet, these models return non-negligible biases. In contrast, the local calibration of a single-equation logistical model with five predictors allows perfectly unbiased estimates, as accurate as those of the best-performing models (20% and 12% for diffuse and beam radiation, respectively, but at much smaller computational costs.

  17. “Friday off”: Reducing Working Hours in Europe

    Directory of Open Access Journals (Sweden)

    Jack Rossiter

    2013-04-01

    Full Text Available This article explores the pros and cons for reducing working hours in Europe. To arrive to an informed judgment we review critically the theoretical and empirical literature, mostly from economics, concerning the relation between working hours on the one hand, and productivity, employment, quality of life, and the environment, on the other. We adopt a binary economics distinction between capital and labor productiveness, and are concerned with how working hours may be reduced without harming the earning capacity of workers. There are reasons to believe that reducing working hours may absorb some unemployment, especially in the short-run, even if less than what is advocated by proponents of the proposal. Further, there may well be strong benefits for the quality of peoples’ lives. Environmental benefits are likely but depend crucially on complementary policies or social conditions that will ensure that the time liberated will not be directed to resource-intensive or environmentally harmful consumption. It is questionable whether reduced working hours are sustainable in the long-term given resource limits and climate change. We conclude that while the results of reducing working hours are uncertain, this may be a risk worth taking, especially as an interim measure that may relieve unemployment while other necessary structural changes are instituted.

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-20

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

  20. “Friday off”: Reducing Working Hours in Europe

    OpenAIRE

    Kallis, Giorgos; Kalush, Michael; O.'Flynn, Hugh; Rossiter, Jack; Ashford, Nicholas A.

    2013-01-01

    This article explores the pros and cons for reducing working hours in Europe. To arrive to an informed judgment we review critically the theoretical and empirical literature, mostly from economics, concerning the relation between working hours on the one hand, and productivity, employment, quality of life, and the environment, on the other. We adopt a binary economics distinction between capital and labor productiveness, and are concerned with how working hours may be reduced without harming ...

  1. Nursing work hours: individual needs versus working conditions.

    Science.gov (United States)

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

    2011-12-01

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

  2. 39 CFR 959.3 - Office, business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office, business hours. 959.3 Section 959.3 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE PRIVATE EXPRESS STATUTES § 959.3 Office, business hours. The offices of the officials mentioned in these rules are...

  3. 39 CFR 952.4 - Office business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 952.4 Section 952.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO FALSE REPRESENTATION AND LOTTERY ORDERS § 952.4 Office business hours. The offices of the officials mentioned in these...

  4. 39 CFR 954.4 - Office business hours.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Office business hours. 954.4 Section 954.4 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.4 Office business hours. The offices of the...

  5. MODELS OF HOURLY DRY BULB TEMPERATURE AND ...

    African Journals Online (AJOL)

    Hourly meteorological data of both dry bulb temperature and relative humidity for 18 locations in Nigeria for the period 1995 to 2009 were analysed to obtain the mean monthly average and monthly hourly average of each of the two meteorological variables for each month for each location. The difference between the ...

  6. 17 CFR 12.3 - Business address; hours.

    Science.gov (United States)

    2010-04-01

    ... REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.3 Business address; hours. The... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Business address; hours. 12.3..., DC 20581. It is open each day, except Saturdays, Sundays, and legal public holidays, from 8:15 a.m...

  7. Effect of a 12-hour/day shift on performance

    International Nuclear Information System (INIS)

    Lewis, P.M.; Swaim, D.J.

    1988-06-01

    The operating crews at the Fast Flux Facility near Richland, Washington, changed their rotating shift schedule from an 8- to 12- hour/day work schedule. The primary reason for the change was to reduce the attrition of operators by increasing their job satisfaction. Eighty-four percent of the operators favored the change. Plant performance and safety were not adversely affected. A statistical analysis of 53 operator-related, off-normal events in 28 months concluded that there was no significant difference in either the number or the severity of off-normal events on the 12-hour shift. A statistical analysis of 200,000 log entries concluded that the error rate in completing logs actually declined by 25 percent on the 12-hour shift. Alertness, which was measured using computerized tests of mathematics and logical reasoning, reach a nadir on the first night shift for the 8- and 12-hour schedules alike, which indicates that the primary cause of fatigue was sleep disruption, not cumulative hours of work. All supervisors and 52 percent of the operators believe their crews work more effectively on the 12-hour shift; only 12 percent of the operators believe that their crews work less effectively. The evaluation indicated that the 12-hour shift scheduled is a reasonable alternative to an 8-hour schedule at this facility. 2 refs

  8. Perspectives on the working hours of Australian junior doctors.

    Science.gov (United States)

    Glasgow, Nicholas J; Bonning, Michael; Mitchell, Rob

    2014-01-01

    The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work-life balance. It is notable that reductions in junior doctors' working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.

  9. No Correlation Between Work-Hours and Operative Volumes

    DEFF Research Database (Denmark)

    Kjærgaard, Jane; Sillesen, Martin; Beier-Holgersen, Randi

    2016-01-01

    OBJECTIVE: Since 2003, United States residents have been limited to an 80-hour workweek. This has prompted concerns of reduced educational quality, especially inadequate operating exposure. In contrast, the Danish surgical specialty-training program mandates a cap on working hours of 37 per week....... We hypothesize that there is no direct correlation between work-hours and operative volume achieved during surgical residency. To test the hypothesis, we compare Danish and US operative volumes achieved during surgical residency training. DESIGN: Retrospective comparative study. PARTICIPANTS...... find no difference in overall surgical volumes between Danes and US residents during their surgical training. When time in training was accounted for, differences between weekly surgical volumes achieved were minor, indicating a lack of direct correlation between weekly work-hours and operative volumes...

  10. 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

  11. 29 CFR 778.318 - Productive and nonproductive hours of work.

    Science.gov (United States)

    2010-07-01

    ... Special Problems Effect of Failure to Count Or Pay for Certain Working Hours § 778.318 Productive and... Act; such nonproductive working hours must be counted and paid for. (b) Compensation payable for... which such nonproductive hours are properly counted as working time but no special hourly rate is...

  12. Health and psychosocial effects of flexible working hours.

    Science.gov (United States)

    Janssen, Daniela; Nachreiner, Friedhelm

    2004-12-01

    To examine whether any impairments in health and social lives can be found under different kinds of flexible working hours, and whether such effects are related to specific characteristics of these working hours. Two studies -- a company based survey (N=660) and an internet survey (N=528) -- have been conducted. The first one was a questionnaire study (paper and pencil) on employees working under some 'typical' kinds of different flexible working time arrangements in different companies and different occupational fields (health care, manufacturing, retail, administration, call centres). The second study was an internet-based survey, using an adaptation of the questionnaire from the first study. The results of both studies consistently show that high variability of working hours is associated with increased impairments in health and well-being and this is especially true if this variability is company controlled. These effects are less pronounced if variability is self-controlled; however, autonomy does not compensate the effects of variability. Recommendations for an appropriate design of flexible working hours should be developed in order to minimize any impairing effects on health and psychosocial well-being; these recommendations should include -- besides allowing for discretion in controlling one's (flexible) working hours -- that variability in flexible working hours should be kept low (or at least moderate), even if this variability is self-controlled.

  13. Impacts of extended working hours in logging

    Science.gov (United States)

    Dana Mitchell; Tom Gallagher

    2008-01-01

    Last year at the 2007 AIM in Minneapolis, MN, the authors presented the human factors impacts to consider when implementing extended working hours in the logging industry. In a continuation of this project, we have researched existing literature to identify possible actions that logging business owners can take to reduce the impact of extended working hours on their...

  14. GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Chi Xiaohua; Li Guiping; Liu Feng; Wang Bing; Du Li; Deng Zhifang; Li Wei

    2013-01-01

    Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R 2 =0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

  15. Partial differential equations & boundary value problems with Maple

    CERN Document Server

    Articolo, George A

    2009-01-01

    Partial Differential Equations and Boundary Value Problems with Maple presents all of the material normally covered in a standard course on partial differential equations, while focusing on the natural union between this material and the powerful computational software, Maple. The Maple commands are so intuitive and easy to learn, students can learn what they need to know about the software in a matter of hours- an investment that provides substantial returns. Maple''s animation capabilities allow students and practitioners to see real-time displays of the solutions of partial differential equations.  Maple files can be found on the books website. Ancillary list: Maple files- http://www.elsevierdirect.com/companion.jsp?ISBN=9780123747327  Provides a quick overview of the software w/simple commands needed to get startedIncludes review material on linear algebra and Ordinary Differential equations, and their contribution in solving partial differential equationsIncorporates an early introduction to Sturm-L...

  16. Forecasting Day-Ahead Electricity Prices: Utilizing Hourly Prices

    OpenAIRE

    Raviv, Eran; Bouwman, Kees E.; van Dijk, Dick

    2013-01-01

    This discussion paper led to a publication in 'Energy Economics' , 2015, 50, 227-239. The daily average price of electricity represents the price of electricity to be delivered over the full next day and serves as a key reference price in the electricity market. It is an aggregate that equals the average of hourly prices for delivery during each of the 24 individual hours. This paper demonstrates that the disaggregated hourly prices contain useful predictive information for the daily average ...

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

    Science.gov (United States)

    Yu, Jungok

    2017-03-01

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

  18. The effects of Smoke Free Work Hours in Danish municipalities

    OpenAIRE

    Tina Termansen; Simon Rask

    2017-01-01

    Since 2011, 15 Danish municipalities have implemented smoke free work hours, meaning that an employee working for the municipality may not smoke in his or her work time (about 7,5 hours a day). This is a much stricter prevention method, than former strategies preventing smoking mostly at locations and not during working hours. Research concerning the effects of smoke free work hours is non-existing. We therefore wish to look into the specific outcomes of smoke free work hours related to smoki...

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

    Science.gov (United States)

    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.

  20. The Associations Between Long Working Hours, Physical Inactivity, and Burnout.

    Science.gov (United States)

    Hu, Nien-Chih; Chen, Jong-Dar; Cheng, Tsun-Jen

    2016-05-01

    To examine the correlations between long working hours, physical activity, and burnout. A cross-sectional survey was administered to 1560 full-time employees, who underwent periodic health examinations in the year 2013. The subjects were divided into upper, middle, and lower tertiles according to the Copenhagen Burnout Inventory (CBI) score. The comparison of the high- and low-burnout groups revealed that long working hours were significantly correlated with burnout in a dose-dependent manner. Long working hours were more significantly associated with burnout among individuals younger than 50 years, females, and physically inactive employees. Long working hours are correlated with burnout when working over 40 hours per week and is even stronger when working over 60 hours per week. Limiting working hours to 40 weekly may be beneficial for the prevention of burnout. Physical activity helps reduce the risk of burnout.

  1. A direct sensitivity approach to predict hourly ozone resulting from compliance with the National Ambient Air Quality Standard.

    Science.gov (United States)

    Simon, Heather; Baker, Kirk R; Akhtar, Farhan; Napelenok, Sergey L; Possiel, Norm; Wells, Benjamin; Timin, Brian

    2013-03-05

    In setting primary ambient air quality standards, the EPA's responsibility under the law is to establish standards that protect public health. As part of the current review of the ozone National Ambient Air Quality Standard (NAAQS), the US EPA evaluated the health exposure and risks associated with ambient ozone pollution using a statistical approach to adjust recent air quality to simulate just meeting the current standard level, without specifying emission control strategies. One drawback of this purely statistical concentration rollback approach is that it does not take into account spatial and temporal heterogeneity of ozone response to emissions changes. The application of the higher-order decoupled direct method (HDDM) in the community multiscale air quality (CMAQ) model is discussed here to provide an example of a methodology that could incorporate this variability into the risk assessment analyses. Because this approach includes a full representation of the chemical production and physical transport of ozone in the atmosphere, it does not require assumed background concentrations, which have been applied to constrain estimates from past statistical techniques. The CMAQ-HDDM adjustment approach is extended to measured ozone concentrations by determining typical sensitivities at each monitor location and hour of the day based on a linear relationship between first-order sensitivities and hourly ozone values. This approach is demonstrated by modeling ozone responses for monitor locations in Detroit and Charlotte to domain-wide reductions in anthropogenic NOx and VOCs emissions. As seen in previous studies, ozone response calculated using HDDM compared well to brute-force emissions changes up to approximately a 50% reduction in emissions. A new stepwise approach is developed here to apply this method to emissions reductions beyond 50% allowing for the simulation of more stringent reductions in ozone concentrations. Compared to previous rollback methods, this

  2. Duty hours restriction for our surgical trainees: An ethical obligation or a bad idea?

    Science.gov (United States)

    Adin, Christopher A; Fogle, Callie A; Marks, Steven L

    2018-04-01

    To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors. Effects on resident training are program specific, with duty hours restrictions having the most deleterious effects on surgical disciplines. Because veterinary specialists assume a similar role in providing 24-hour patient care, interns and residents face work-related stress as a result of extended working hours, on-call duty, and an increasingly complex caseload. The North Carolina State Veterinary Hospital is staffed by approximately 100 house officers representing almost every veterinary specialty group. We surveyed departing house officers regarding their quality of life and training experience. Sixty-six percent of interns and residents reported that they do not have time to take care of personal needs, and 57%-62% felt neutral or dissatisfied with their mental and physical well-being. Most trainees believed that decreased duty hours would improve learning, but 42% believed that decreased caseload would be detrimental to training. Veterinary educators must consider post-DVM veterinary training guidelines that maintain patient care with a good learning environment for interns and residents. © 2018 The American College of Veterinary Surgeons.

  3. Improvement of Endovascular Stroke Treatment: A 24-Hour Neuroradiological On-Site Service Is Not Enough

    Directory of Open Access Journals (Sweden)

    Omid Nikoubashman

    2018-01-01

    Full Text Available Background and Purpose. With the advent of endovascular stroke treatment (EST with mechanical thrombectomy, stroke treatment has also become more challenging. Purpose of this study was to investigate whether a fulltime neuroradiological on-site service and workflow optimization with a structured documentation of the interdisciplinary stroke workflow resulted in improved procedural times. Material and Methods. Procedural times of 322 consecutive patients, who received EST (1 before (n=96 and (2 after (n=126 establishing a 24-hour neuroradiological on-site service as well as (3 after implementation of a structured interdisciplinary workflow documentation (“Stroke Check” (n=100, were analysed. Results. A fulltime neuroradiological on-site service resulted in a nonsignificant improvement of procedural times during out-of-hours admissions (p≥0.204. Working hours and out-of-hours procedural times improved significantly, if additional workflow optimization was realized (p≤0.026. Conclusions. A 24-hour interventional on-site service is a major prerequisite to adequately provide modern reperfusion therapies in patients with acute ischemic stroke. However, simple measures like standardized and focused documentation that affect the entire interdisciplinary pre- and intrahospital stroke rescue chain seem to be important.

  4. The 24- hour pattern of intraocular pressure in suspected glaucoma patients

    Directory of Open Access Journals (Sweden)

    Shan-Shan Li

    2018-05-01

    Full Text Available AIM: To analyze the value of 24-hour intraocular pressure(IOPmonitoring in suspected glaucoma patients.METHODS: Totally 48 suspected glaucoma(96 eyeswere selected for 24-hour IOP monitoring by using Accupen tonometer(24-3000and non-contact tonometer(NCT, CT-80Afrom 9:30 to 7:30 next day(once in 2h. During 07:30 to 21:30, patients were measured in sitting position, while during 23:30 to 05:30 in both sitting and supine position.RESULTS: A morning peak of IOP was shown at 7:30 in traditional position by using two measures with 22.05±3.608mmHg of NCT and 19.79±4.147mmHg of Accupen tonometer. The peak IOP in habitual position appeared in 5:30 with 21.64±4.814mmHg. The lowest IOP occurred in both position at 21:30 with 15.73±3.649mmHg. Both positions showed IOP trend of going up at night and then declining in the morning. CONCLUSION: The peak IOP in suspected glaucoma occurs mostly at early morning. Supine IOP of sleeping time is higher than that of sitting position.

  5. Invar hardening under keeping of low values of temperature coefficient of linear expansion

    International Nuclear Information System (INIS)

    Bashnin, Yu.A.; Shiryaeva, A.N.; Omel'chenko, A.V.

    1982-01-01

    Complex invar alloying with chromium, zirconium and nitrogen is conducted for increasing hardness and assuring low values of the temperature coefficient of linear expansion. It is shown that alloying with nitride-forming elements-chromium, zirconium and the following high-temperature saturation under high pressure with nitrogen provides the invar hardening at assuring a low temperature coefficient of linear expansion. Saturation with nitrogen under 100 MPa pressure at 1050 deg C during 3 hours permits to prepare an invar containing up to 0.2% N 2 uniformly distributed over the whole cross section of samples with 4 mm diameter. Nitrogen in invar alloys alloyed with chromium and zirconium affects the Curie point similarly to carbon and nickel shifting it towards higher temperatures, it slightly changes the value of the temperature coefficient of linear expansion and provides linear character of thermal expansion dependence on temperature in the +100 deg C - -180 deg C range

  6. Consumer fears and familiarity of processed food. The value of information provided by the FTNS.

    Science.gov (United States)

    Verneau, Fabio; Caracciolo, Francesco; Coppola, Adele; Lombardi, Pasquale

    2014-02-01

    Food choice and consumption behaviour are influenced by many interacting factors. In this paper we present an empirical effort to enhance understanding of the neophobia-neophilia forces affecting food choice. Starting from the analysis of consumer preferences for some of the most familiar highly processed foods, namely fat-reduced, functional (enriched drinks and yogurt) and ready-to-eat frozen food, our study investigates the role of traditional demographic variables vs attitudes to new food technologies in predicting the consumption behaviour of a sample of Italians buying such products. Consumer attitudes toward food technologies were collected by means of the Food Technology Neophobia Scale (FTNS). Moreover, this paper explicitly analyses the value of the information provided by the FTNS. Underlying the research is the hypothesis that the FTNS may contribute to provide a comprehensive picture of the driving forces behind consumers' behavioural responses towards processed foods which are the end-result of mature technologies. The four FTNS components, once measured and used independently, help clarify the influence on food choices of each neophobia-neophilia force (risk perception and novelty seeking, media influence, own health and environmental concerns) into a single, comprehensive framework. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Unsupervised/supervised learning concept for 24-hour load forecasting

    Energy Technology Data Exchange (ETDEWEB)

    Djukanovic, M [Electrical Engineering Inst. ' Nikola Tesla' , Belgrade (Yugoslavia); Babic, B [Electrical Power Industry of Serbia, Belgrade (Yugoslavia); Sobajic, D J; Pao, Y -H [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Electrical Engineering and Computer Science

    1993-07-01

    An application of artificial neural networks in short-term load forecasting is described. An algorithm using an unsupervised/supervised learning concept and historical relationship between the load and temperature for a given season, day type and hour of the day to forecast hourly electric load with a lead time of 24 hours is proposed. An additional approach using functional link net, temperature variables, average load and last one-hour load of previous day is introduced and compared with the ANN model with one hidden layer load forecast. In spite of limited available weather variables (maximum, minimum and average temperature for the day) quite acceptable results have been achieved. The 24-hour-ahead forecast errors (absolute average) ranged from 2.78% for Saturdays and 3.12% for working days to 3.54% for Sundays. (Author)

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

    Science.gov (United States)

    Borycka, K.; Kasprzyk, I.

    2018-06-01

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

  9. 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 ...

  10. The value of flexibility in power markets

    International Nuclear Information System (INIS)

    Goutte, Stephane; Vassilopoulos, Philippe

    2017-01-01

    In this paper we attempt to quantify the net revenues that can be captured by a flexible resource able to react to the short term price variations on the day-ahead and intra-day markets in Germany. We find that the difference between day-ahead and intra-day revenues for a flexible resource has been increasing (although the profitability has been decreasing on both markets). This difference is more pronounced once 15 mn price variations can be captured by a flexible resource. The net revenues from the local 15 mn auction (which is held 3 hours after the hourly 'coupled' day-ahead auction) are more than eight times higher than the day-ahead hourly auction but below the net revenues that can be captured with the high prices from the continuous market. The results of the backward-looking empirical estimations allow us to distinguish and quantify two components of flexibility: (1) the 'immediacy' value as we are approaching real-time and the urgency of the delivery increases (this value is revealed during the continuous intra-day process and is highly linked to the stochastic nature of power supply and demand (i.e. wind/solar forecasts, forced outages of thermal generation,...) forecast error risk), and (2) the 'flexibility' component as a resource can react to variations of shorter granularity (15 mn Vs 60 mn). We model and quantify the 'flexibility' component. (authors)

  11. Modeling Hourly Resident Productivity in the Emergency Department.

    Science.gov (United States)

    Joseph, Joshua W; Henning, Daniel J; Strouse, Connie S; Chiu, David T; Nathanson, Larry A; Sanchez, Leon D

    2017-08-01

    Resident productivity, defined as new patients per hour, carries important implications for emergency department operations. In high-volume academic centers, essential staffing decisions can be made on the assumption that residents see patients at a static rate. However, it is unclear whether this model mirrors reality; previous studies have not rigorously examined whether productivity changes over time. We examine residents' productivity across shifts to determine whether it remained consistent. This was a retrospective cohort study conducted in an urban academic hospital with a 3-year emergency medicine training program in which residents acquire patients ad libitum throughout their shift. Time stamps of all patient encounters were automatically logged. A linear mixed model was constructed to predict productivity per shift hour. A total of 14,364 8- and 9-hour shifts were worked by 75 residents between July 1, 2010, and June 20, 2015. This comprised 6,127 (42.7%) postgraduate year (PGY) 1 shifts, 7,236 (50.4%) PGY-2 shifts, and 998 (6.9%) PGY-3 nonsupervisory shifts (Table 1). Overall, residents treated a mean of 10.1 patients per shift (SD 3.2), with most patients at Emergency Severity Index level 3 or more acute (93.8%). In the initial hour, residents treated a mean of 2.14 patients (SD 1.2), and every subsequent hour was associated with a significant decrease, with the largest in the second, third, and final hours. Emergency medicine resident productivity during a single shift follows a reliable pattern that decreases significantly hourly, a pattern preserved across PGY years and types of shifts. This suggests that resident productivity is a dynamic process, which should be considered in staffing decisions and studied further. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  12. Funnel plot control limits to identify poorly performing healthcare providers when there is uncertainty in the value of the benchmark.

    Science.gov (United States)

    Manktelow, Bradley N; Seaton, Sarah E; Evans, T Alun

    2016-12-01

    There is an increasing use of statistical methods, such as funnel plots, to identify poorly performing healthcare providers. Funnel plots comprise the construction of control limits around a benchmark and providers with outcomes falling outside the limits are investigated as potential outliers. The benchmark is usually estimated from observed data but uncertainty in this estimate is usually ignored when constructing control limits. In this paper, the use of funnel plots in the presence of uncertainty in the value of the benchmark is reviewed for outcomes from a Binomial distribution. Two methods to derive the control limits are shown: (i) prediction intervals; (ii) tolerance intervals Tolerance intervals formally include the uncertainty in the value of the benchmark while prediction intervals do not. The probability properties of 95% control limits derived using each method were investigated through hypothesised scenarios. Neither prediction intervals nor tolerance intervals produce funnel plot control limits that satisfy the nominal probability characteristics when there is uncertainty in the value of the benchmark. This is not necessarily to say that funnel plots have no role to play in healthcare, but that without the development of intervals satisfying the nominal probability characteristics they must be interpreted with care. © The Author(s) 2014.

  13. The Investigation of Hourly,Daily and Seasonal Changes of Duzce Air Quality Monitoring Station 2014 Data

    Directory of Open Access Journals (Sweden)

    Filiz Bolu

    2015-10-01

    Full Text Available Aim: To evaluate data of air quality in the year 2004 in Duzce by days, hours and seasons. Method: In this study, sulfur dioxide, particulate matter levels, wind speed and wind direction values of Duzce city center obtained from the web page of Ministry of Envoriment and Planning between 1 January -31 December 2014 were studied. Data were examined by on the time of hours, days, days of the week, months and seasons. Results: Annual average PM10 was 106,42+/-102 and #956;g/m3 , SO2 concentration was 6,15+/-5,39 and #956;g/m3. Winter PM10 and SO2 measurements were significantly higher than summer season. Wind speed in the summer season had a higher average than the winter season. Highest average PM10 was at November 189,4 +/- 171,8 and #956;g/m3. The lowest PM10 was at June 58,0+/-24,5 and #956;g/m3. The highest average wind speed was at June, the lowest average wind speed is at December. PM10 and SO2 measurements were positively correlated with wind direction, shows a negative correlation with wind speed. The highest PM10 measurements in the summer season were on Thursdays, in the winter season on Wednesdays. The lowest PM10 measurements both in two seasons were on Sundays. Average PM10 was significantly higher on weekdays than weekends. The highest PM10 value of 146,6 +/- 131,3 and #956;g/m3 was measured at 23.00. The lowest PM10 value of 73,8+/-55,9 and #956;g/m3 was measured at 15.00. Conclusion: There is air pollution in Duzce both in the summer and winter. Continuous monitoring of the emissions of existing establishments in the industrial pollution control should be provided. The high PM10 measurements in the evening may be due to traffic during the day and fuel use for heating purposes. Widespread use of natural gas and creating socially conscious individual measures can be effective in reducing air pollution. [TAF Prev Med Bull 2015; 14(5.000: 387-393

  14. 29 CFR 778.114 - Fixed salary for fluctuating hours.

    Science.gov (United States)

    2010-07-01

    ..., whatever their number, rather than for working 40 hours or some other fixed weekly work period, such a... compensation to the employee at a rate not less than the applicable minimum wage rate for every hour worked in..., in addition to such salary, for all overtime hours worked at a rate not less than one-half his...

  15. Associations of Work Hours, Job Strain, and Occupation with Endothelial Function: The Multi-Ethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

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

    2014-01-01

    Objective To investigate associations of work hours, job control, job demands, job strain, and occupational category with brachial artery flow-mediated dilation (FMD) in 1,499 MESA participants. Methods FMD was obtained using high-resolution ultrasound. Mean values of FMD were examined across categories of occupation, work hours, and the other exposures using regression analyses. Results Occupational category was significantly associated with FMD overall, with blue-collar workers showing the lowest mean values: Management/professional=4.97±0.22%; sales/office=5.19±0.28%; services=4.73 ± 0.29%; and blue-collar workers=4.01±0.26% (adjusted P <0.001). There was evidence of effect modification by gender (interaction P=0.031): significant associations were observed among women (adjusted P =0.002) and nearly significant results among men (adjusted P=0.087). Other exposures were not significantly associated with FMD. Conclusions Differences in endothelial function may account for some of the variation in cardiovascular disease across occupational groups. PMID:25376409

  16. 12-hour shifts: an ethical dilemma for the nurse executive.

    Science.gov (United States)

    Lorenz, Susan G

    2008-06-01

    Flexible work hours, including 12-hour shifts, have become a common scheduling option for nurses. The author explores whether 12-hour shifts are an ethical scheduling option for nurses because recent research suggests that 12-hour shifts are a potential hazard to patients. A multistep model for ethical decision making, reflecting the concept of procedural justice, is used to examine this issue.

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

    OpenAIRE

    Jungok Yu, RN, PhD

    2017-01-01

    Purpose: This study investigated gender differences in the relationship between long working hours and metabolic syndrome. Methods: Data based on the Sixth National Health and Nutrition Examination Survey (2014) pertaining to a total of 1,145 paid workers were analyzed. Working hours were divided into three groups (40–51 hours/week, 52–59 hours/week, ≥ 60 hours/week). The relationship between working hours and metabolic syndrome was then analyzed after adjusting for general and occupationa...

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

    NARCIS (Netherlands)

    Ingre, M.; Äkerstedt, T.; Ekstedt, M.; Kecklund, L.G.

    2012-01-01

    Objectives The main objective of the present study was to investigate relative personal fit as the association between rated needs and preferences for work hours, on the one hand, and actual work hours, on the other hand, in three groups (hospital, call-center, and police) working with periodic

  19. CERN takes part in Earth Hour

    CERN Multimedia

    Anaïs Vernède

    2011-01-01

    From 8.30 to 9.30 p.m. on Saturday, 26 March 2011, the Globe of Science and Innovation will be plunged into darkness to mark CERN's participation in Earth Hour. A growing number of countries and cities across the planet are involved in this global initiative against climate change, which was launched by the WWF in 2007.   The lights on the Globe were switched off for the 2009 Earth Hour event. Along with individuals, companies and tourist attractions in thousands of towns and cities all over the world participating in the fourth annual Earth Hour event, CERN will turn off the lights of the Globe for 60 minutes at 8.30 p.m. on Saturday 26 March. CERN's participation in the initiative is one of several examples of its commitment to respect the environment and keep its ecological footprint to the minimum. A recent example under the green transport heading was the replacement of part of CERN's petrol vehicle fleet with cars running on natural gas with a view to reducing air pollution. Other examples...

  20. Ozone Nonattainment Areas - 1 Hour

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Ozone - 1hour (Legacy...

  1. Do economic stresses influence child work hours on family farms?

    Science.gov (United States)

    Gadomski, Anne; de Long, Rachel; Burdick, Patrick; Jenkins, Paul

    2005-01-01

    Economic stresses are a frequently cited reason for children doing farm work. To explore the relationship between economic indicators and child agricultural work hours between January 2001 and October 2003. This ecologic study design compares trends in aggregate child work hours with national and regional economic indicators. Child work hours were obtained from quarterly surveillance data from a randomized field trial of agricultural task guidelines for children. 2,360 children living or working on 845 farms in central New York participated in the original study. The relationship between child work hours and three economic indicators: national all farm index (AFI) ratio, national fuel index, and regional milk prices was analyzed using times series plots, correlation, and multiple linear regression. The AFI ratio was positively correlated with child work hours (r = 0.49, p = 0.008) but there was no significant correlation between child work hours and fuel or milk prices. Multiple linear regression demonstrated that the relationship between AFI and child work hours is independent of a seasonal effect. Increased child work hours may be associated with periods of higher farm sector productivity, rather than economic stress per se. Findings are limited by the ecologic study design, use of national economic indicators, and the limited number of cycles of child work hours available for time series analysis. Economic conditions may influence decisions about children's farm work.

  2. 29 CFR 785.21 - Less than 24-hour duty.

    Science.gov (United States)

    2010-07-01

    ... Sleeping Time and Certain Other Activities § 785.21 Less than 24-hour duty. An employee who is required to be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... 29 Labor 3 2010-07-01 2010-07-01 false Less than 24-hour duty. 785.21 Section 785.21 Labor...

  3. Work-Family Conflict, Children, and Hour Mismatches in Australia

    Science.gov (United States)

    Reynolds, Jeremy; Aletraris, Lydia

    2007-01-01

    This article helps integrate research on work hours and work-family issues by examining how work-family conflict is related to the desire for more and fewer hours of work. Using the first wave of the Household Income and Labor Dynamics in Australia survey, we find that work-to-family conflict is associated with a desire for fewer hours of work.…

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

    Science.gov (United States)

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

    2018-02-01

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

  5. Fasting for 24 hours heightens reward from food and food-related cues.

    Science.gov (United States)

    Cameron, Jameason D; Goldfield, Gary S; Finlayson, Graham; Blundell, John E; Doucet, Eric

    2014-01-01

    We examined the impact of a 24 hour complete fast (vs. fed state) on two measures of food reward: 1) 'wanting', as measured by response to food images and by the relative-reinforcing value of food (RRV), and 2) 'liking', as measured by response to food images and the hedonic evaluation of foods consumed. Utilizing a randomized crossover design, 15 subjects (9 male; 6 female) aged 28.6±4.5 yrs with body mass index 25.3±1.4 kg/m(2) were randomized and counterbalanced to normal feeding (FED) and 24-hour fast (FASTED) conditions. Trait characteristics were measured with the Three Factor Eating Questionnaire. Two computer tasks measured food reward: 1) RRV progressive ratio task, 2) explicit 'liking' and 'wanting' (Leeds Food Preference Questionnaire, LFPQ). Also measured were ad libitum energy intake (EI; buffet) and food 'liking' (visual analogue scale) of personalized stimuli. There were no significant anthropometric changes between conditions. Appetite scores, hedonic ratings of 'liking', and ad libitum EI all significantly increased under the FASTED condition (pFASTED condition there were significant increases in the RRV of snack foods; similarly, explicit 'wanting' and 'liking' significantly increased for all food categories. 'Liking' of sweet foods remained high across-meals under FASTED, but savory foods decreased in hedonic saliency. Relative to a fed state, we observed an increase in hedonic ratings of food, the rewarding value of food, and food intake after a 24 hr fast. Alliesthesia to food and food cues is suggested by heightened hedonic ratings under the FASTED condition relative to FED.

  6. Planning Annuaulised hours when spike in demand exists

    Directory of Open Access Journals (Sweden)

    MR Sureshkumar

    2012-04-01

    Full Text Available Manpower planning using annualised hours is an effective tool where seasonal demand for staff in industry exists. In annualised hours (AH workers are contracted to work for a certain number of hours per year. The workers are associated with relative efficiency for different types of tasks. This paper proposes a Mixed Integer linear Programming (MILP model to solve an annualised working hours planning problem when spike in demand exists. The holiday weeks for the workers are considered as partially individualised. If a worker has been assigned with more than one type of working week in a week, this will be compensated with one or more holiday week. The performance of the model is demonstrated with an example. It can be seen that this type of modelling helps to meet the spikes in demand with less capacity shortage compared with one working week in a week.

  7. U.S. Hourly Precipitation Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Hourly Precipitation Data (HPD) is digital data set DSI-3240, archived at the National Climatic Data Center (NCDC). The primary source of data for this file is...

  8. Provision of out-of-hours interventional radiology services in Scotland

    International Nuclear Information System (INIS)

    Zealley, I.A.; Gordon, T.J.; Robertson, I.; Moss, J.G.; Gillespie, I.N.

    2012-01-01

    Aim: To evaluate the availability of out-of-hours (OOH) interventional radiology (IR) services in Scotland and discuss implications for service redesign. Materials and methods: Data were gathered via a survey conducted by telephone/e-mail interview. The setting was hospitals in Scotland with acute medical and/or surgical beds. The interviewees were consultant interventional radiologists representing each of the 14 geographical Health Boards in Scotland. Results: Three of the 14 geographical Health Boards provided a formal, prospectively planned OOH IR service in at least one hospital. Fourteen of the 34 acute hospitals provided an in-hours IR service, which includes endovascular haemorrhage control. Eight of the 34 acute hospitals had formal, prospectively planned on-call IR arrangements, 12 had an ad-hoc service, and 20 transferred patients to other facilities. Thirty-eight of the 223 consultant radiologists in Scotland were able to perform endovascular haemorrhage control procedures: only 18 of these 38 (47%) were included in on-call rotas. A further 42 radiologists were able to perform nephrostomy and a further 61 were able to perform abscess drainage. Eighty-two radiologists did not perform any interventional procedures. Conclusions: The provision of OOH IR services in Scotland is limited and available resources, both skills and equipment, are being underutilized. These data will be used to inform a process of OOH IR service redesign in Scotland.

  9. A 1.5 hour procedure for identification of Enterococcus Species directly from blood cultures.

    Science.gov (United States)

    Morgan, Margie A; Marlowe, Elizabeth; Novak-Weekly, Susan; Miller, J M; Painter, T M; Salimnia, Hossein; Crystal, Benjamin

    2011-02-10

    Enterococci are a common cause of bacteremia with E. faecalis being the predominant species followed by E. faecium. Because resistance to ampicillin and vancomycin in E. faecalis is still uncommon compared to resistance in E. faecium, the development of rapid tests allowing differentiation between enterococcal species is important for appropriate therapy and resistance surveillance. The E. faecalis OE PNA FISH assay (AdvanDx, Woburn, MA) uses species-specific peptide nucleic acid (PNA) probes in a fluorescence in situ hybridization format and offers a time to results of 1.5 hours and the potential of providing important information for species-specific treatment. Multicenter studies were performed to assess the performance of the 1.5 hour E. faecalis/OE PNA FISH procedure compared to the original 2.5 hour assay procedure and to standard bacteriology methods for the identification of enterococci directly from a positive blood culture bottle.

  10. 1-Hour OGTT Plasma Glucose as a Marker of Progressive Deterioration of Insulin Secretion and Action in Pregnant Women

    Directory of Open Access Journals (Sweden)

    Alessandra Ghio

    2012-01-01

    Full Text Available Considering old GDM diagnostic criteria, alterations in insulin secretion and action are present in women with GDM as well as in women with one abnormal value (OAV during OGTT. Our aim is to assess if changes in insulin action and secretion during pregnancy are related to 1-hour plasma glucose concentration during OGTT. We evaluated 3 h/100 g OGTT in 4,053 pregnant women, dividing our population on the basis of 20 mg/dL increment of plasma glucose concentration at 1 h OGTT generating 5 groups (<120 mg/dL, =661; 120–139 mg/dL, =710; 140–159 mg/dL, =912; 160–179 mg/dL, =885; and ≥180 mg/dL, =996. We calculated incremental area under glucose (AUCgluc and insulin curves (AUCins, indexes of insulin secretion (HOMA-B, and insulin sensitivity (HOMA-R, AUCins/AUCgluc. AUCgluc and AUCins progressively increased according to 1-hour plasma glucose concentrations (both <0.0001 for trend. HOMA-B progressively declined (<0.001, and HOMA-R progressively increased across the five groups. AUCins/AUCgluc decreased in a linear manner across the 5 groups (<0.001. Analysing the groups with 1-hour value <180 mg/dL, defects in insulin secretion (HOMA-B: −29.7% and sensitivity (HOMA-R: +15% indexes were still apparent (all <0.001. Progressive increase in 1-hour OGTT is associated with deterioration of glucose tolerance and alterations in indexes of insulin action and secretion.

  11. The pH Value of Fungicide, Insecticide and Mineral Fertilizer Mixtures Depending on Water Quality

    Directory of Open Access Journals (Sweden)

    Dušanka Inđić

    2008-01-01

    Full Text Available The paper deals with the effect of water quality on the pH value of fungicides, insecticides, mineral fertilizers and their mixtures. The fungicides propineb (Antracol WP-70 and mancozeb (Dithane M-70, insecticides pirimiphos-methyl (Actellic-50 and imidacloprid(Confidor 200-SL, several fertilizers (Ferticare I, Ferticare II, Ferticare III and Wuxal Super and their mixtures were analyzed for pH value under laboratory conditions using a potentiometric pH meter. Measurements were made directly after preparation or mixing with tap and well water and 24 hours later. Tap water exhibited a neutral reaction. A slightly alkaline reaction of well water was mostlikely due to high ammonium content. The suspensions of Antracol WP-70 exhibited slightly alkaline reactions with both water types during 24 hours. The spray liquids of Dithane M-70 mixed with tap or well water had neutral reaction after preparation and slightly alkaline reaction after 24 hours. The emulsions of Actellic-50 showed neutral reaction with both water types, followed by a pH increase in tap water after 24 hours. The solutions of Confidor200-SL had a slightly alkaline reaction after mixing and the pH value increased with both water types after 24 hours. It is therefore recommended to apply these insecticides directly after preparation. Mineral fertilizers considerably reduced pH values of the fungicide and insecticide components in double and triple mixtures, especially Ferticare nutrients which had a moderately acid reaction. Wuxal Super had a neutral reaction with both water types.The mixtures with well water increased pH values, which indicates that water pH does affect the pH value of the mixture. Both individual fertilizers and all mixtures (double and triple with Ferticare had pH values between 2.4 and 6, which allows their active liquids to be stored for 12 to 24 hours. The suspensions (Antracol WP-70, double and triple mixtures, emulsions (Actellic-50 and Actellic-50+Wuxal Super

  12. Acute dimethyl sulfoxide therapy in brain edema. Part 3: effect of a 3-hour infusion.

    Science.gov (United States)

    Del Bigio, M; James, H E; Camp, P E; Werner, R; Marshall, L F; Tung, H

    1982-01-01

    Albino rabbits with experimental brain edema produced by a combined cryogenic left hemisphere lesion and metabolic 6-aminonicotinamide lesion were administered a 3-hour intravenous infusion of dimethyl sulfoxide (DMSO). Simultaneous recording of intracranial pressure (ICP), systolic arterial pressure (SAP), and central venous pressure (CVP) and electroencephalography were performed while the animals were being ventilated mechanically to produce a constant Pa CO2 value (38-42 torr). At the end of the infusion, the brain water and electrolyte contents were measured. There was a persistent and progressive reduction of ICP during the infusion, the nadir occurring at 3 hours (p less than 0.005 from zero time), with no change in SAP or CVP. There was a reduction of brain water in both hemispheres when compared to untreated controls, but this was significant for the right hemisphere only (p less than 0.005). There was a significant reduction of the brain sodium content for both hemispheres, but no significant change occurred in brain potassium content. The DMSO infusion was effective not only in reducing ICP, but also in sustaining this reduction for 3 hours.

  13. Customer Strategies for Responding to Day-Ahead Market HourlyElectricity Pricing

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, Chuck; Hopper, Nicole; Bharvirkar, Ranjit; Neenan,Bernie; Boisvert, Dick; Cappers, Peter; Pratt, Donna; Butkins, Kim

    2005-08-25

    Real-time pricing (RTP) has been advocated as an economically efficient means to send price signals to customers to promote demand response (DR) (Borenstein 2002, Borenstein 2005, Ruff 2002). However, limited information exists that can be used to judge how effectively RTP actually induces DR, particularly in the context of restructured electricity markets. This report describes the second phase of a study of how large, non-residential customers' adapted to default-service day-ahead hourly pricing. The customers are located in upstate New York and served under Niagara Mohawk, A National Grid Company (NMPC)'s SC-3A rate class. The SC-3A tariff is a type of RTP that provides firm, day-ahead notice of hourly varying prices indexed to New York Independent System Operator (NYISO) day-ahead market prices. The study was funded by the California Energy Commission (CEC)'s PIER program through the Demand Response Research Center (DRRC). NMPC's is the first and longest-running default-service RTP tariff implemented in the context of retail competition. The mix of NMPC's large customers exposed to day-ahead hourly prices is roughly 30% industrial, 25% commercial and 45% institutional. They have faced periods of high prices during the study period (2000-2004), thereby providing an opportunity to assess their response to volatile hourly prices. The nature of the SC-3A default service attracted competitive retailers offering a wide array of pricing and hedging options, and customers could also participate in demand response programs implemented by NYISO. The first phase of this study examined SC-3A customers' satisfaction, hedging choices and price response through in-depth customer market research and a Constant Elasticity of Substitution (CES) demand model (Goldman et al. 2004). This second phase was undertaken to answer questions that remained unresolved and to quantify price response to a higher level of granularity. We accomplished these

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

    Science.gov (United States)

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

    2014-07-23

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

  15. 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

    , discussion of the Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled “Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?” was held at Harvard Medical School on June 17–18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine’s recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. Resident physician workload and supervision By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians’ time is dominated by

  16. On a European collaboration to identify organizational models, potential shortcomings and improvement options in out-of-hours primary health care.

    Science.gov (United States)

    Leutgeb, Ruediger; Walker, Nicola; Remmen, Roy; Klemenc-Ketis, Zalika; Szecsenyi, Joachim; Laux, Gunter

    2014-09-01

    Abstract Background: Out-of-hours care (OOHC) provision is an increasingly challenging aspect in the delivery of primary health care services. Although many European countries have implemented organizational models for out-of-hours primary care, which has been traditionally delivered by general practitioners, health care providers throughout Europe are still looking to resolve current challenges in OOHC. It is within this context that the European Research Network for Out-of-Hours Primary Health Care (EurOOHnet) was established in 2010 to investigate the provision of out-of-hours care across European countries, which have diverse political and health care systems. In this paper, we report on the EurOOHnet work related to OOHC organizational models, potential shortcomings and improvement options in out-of-hours primary health care. Needs assessment: The EurOOHnet expert working party proposed that models for OOHC should be reviewed to evaluate the availability and accessibility of OOHC for patients while also seeking ways to make the delivery of care more satisfying for service providers. To move towards resolution of OOHC challenges in primary care, as the first stage, the EurOOHnet expert working party identified the following key needs: clear and uniform definitions of the different OOHC models between different countries; adequate-ideally transnational-definitions of urgency levels and corresponding data; and educational programmes for nurses and doctors (e.g. in the use of a standardized triage system for OOHC). Finally, the need for a modern system of data transfer between different health care providers in regular care and providers in OOHC to prevent information loss was identified.

  17. The relationship between long working hours and depression among first-year residents in Japan.

    Science.gov (United States)

    Ogawa, Ryoko; Seo, Emiko; Maeno, Takami; Ito, Makoto; Sanuki, Masaru; Maeno, Tetsuhiro

    2018-03-27

    In Japan, some residents develop mental health problems. In previous studies, it was reported that long working hours might be a cause of stress reaction such as depression. There were some reports that compared residents with 80 or more working hours with those with less than 80 working hours. However, many residents are practically detained for extra-long time, designated as 100 h or more per week, for medical practice, training, self-study, etc. There have been few reports on extra-long hours of work. This study evaluated the working environment and the amount of stress experienced by first-year residents, and examined the relationship between long working hours and depression, especially in the group of extra-long working hours. The study included 1241 first-year residents employed at 250 training hospitals in 2011. A self-report questionnaire was administered at the beginning of the residency and 3 months later to collect data on demographics, depressive symptoms, and training conditions (e.g., duration of work, sleep, disposable time, and night shift). Depressive symptoms were rated using the Center for Epidemiologic Studies Depression Scale. The mean duration of work per week was 79.4 h, with 97 residents (7.8%) working 100 h or more. At 3 months, clinically significant depressive symptoms were reported by 45.5% of residents working 100 or more h per week, which proportion was significantly greater than that for respondents working less than 60 h (P working week of 80 to 99.9 h was associated with a 2.83 fold higher risk and 100 h or more was associated with a 6.96-fold higher risk of developing depressive symptoms compared with a working week of less than 60 h. Working excessively long hours was significantly associated with development of depressive symptoms. Proper management of resident physicians' working hours is critical to maintaining their physical and mental health and to improve the quality of care they provide.

  18. The effects of Smoke Free Work Hours in Danish municipalities

    Directory of Open Access Journals (Sweden)

    Tina Termansen

    2017-05-01

    Full Text Available Since 2011, 15 Danish municipalities have implemented smoke free work hours, meaning that an employee working for the municipality may not smoke in his or her work time (about 7,5 hours a day. This is a much stricter prevention method, than former strategies preventing smoking mostly at locations and not during working hours. Research concerning the effects of smoke free work hours is non-existing. We therefore wish to look into the specific outcomes of smoke free work hours related to smoking prevalence, sickness leave and work place culture through a semi-experimental study. As the decision to implement smoke free work hours is administrative and/or political, we will not be able to randomize the intervention. Instead, we use one or more Danish municipality who are planning to implement smoke free work hours as an intervention-group and similar municipalities as control group. Data will be collected both through questionnaires about employees smoking prevalence, sickness leave and work place community, and through register data about the citizens employed in the municipalities in question. This will primarily be data on socio-economic status and health. In this way we can compare the municipalities implementing smoke free work hours with each other and find similar control municipalities. We hope, that this study can contribute to understanding the specific outcomes of implementing smoke free work hours, focusing both on health outcomes and work place culture.

  19. A model for calculating hourly global solar radiation from satellite data in the tropics

    International Nuclear Information System (INIS)

    Janjai, S.; Pankaew, P.; Laksanaboonsong, J.

    2009-01-01

    A model for calculating global solar radiation from geostationary satellite data is presented. The model is designed to calculate the monthly average hourly global radiation in the tropics with high aerosol load. This model represents a physical relation between the earth-atmospheric albedo derived from GMS5 satellite data and the absorption and scattering coefficients of various atmospheric constituents. The absorption of solar radiation by water vapour which is important for the tropics, was calculated from ambient temperature and relative humidity. The relationship between the visibility and solar radiation depletion due to aerosols was developed for a high aerosol load environment. This relationship was used to calculate solar radiation depletion by aerosols in the model. The total column ozone from TOMS/EP satellite was employed for the determination of solar radiation absorbed by ozone. Solar radiation from four pyranometer stations was used to formulate the relationship between the satellite band earth-atmospheric albedo and broadband earth-atmospheric albedo required by the model. To test its performance, the model was used to compute the monthly average hourly global radiation at 25 solar radiation monitoring stations in tropical areas in Thailand. It was found that the values of monthly average of hourly global radiations calculated from the model were in good agreement with those obtained from the measurements, with the root mean square difference of 10%. After the validation the model was employed to generate hourly solar radiation maps of Thailand. These maps reveal the diurnal and season variation of solar radiation over the country.

  20. A model for calculating hourly global solar radiation from satellite data in the tropics

    Energy Technology Data Exchange (ETDEWEB)

    Janjai, S.; Pankaew, P.; Laksanaboonsong, J. [Solar Energy Research Laboratory, Department of Physics, Faculty of Science, Silpakorn University, Nakhon Pathom 73000 (Thailand)

    2009-09-15

    A model for calculating global solar radiation from geostationary satellite data is presented. The model is designed to calculate the monthly average hourly global radiation in the tropics with high aerosol load. This model represents a physical relation between the earth-atmospheric albedo derived from GMS5 satellite data and the absorption and scattering coefficients of various atmospheric constituents. The absorption of solar radiation by water vapour which is important for the tropics, was calculated from ambient temperature and relative humidity. The relationship between the visibility and solar radiation depletion due to aerosols was developed for a high aerosol load environment. This relationship was used to calculate solar radiation depletion by aerosols in the model. The total column ozone from TOMS/EP satellite was employed for the determination of solar radiation absorbed by ozone. Solar radiation from four pyranometer stations was used to formulate the relationship between the satellite band earth-atmospheric albedo and broadband earth-atmospheric albedo required by the model. To test its performance, the model was used to compute the monthly average hourly global radiation at 25 solar radiation monitoring stations in tropical areas in Thailand. It was found that the values of monthly average of hourly global radiations calculated from the model were in good agreement with those obtained from the measurements, with the root mean square difference of 10%. After the validation the model was employed to generate hourly solar radiation maps of Thailand. These maps reveal the diurnal and season variation of solar radiation over the country. (author)

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

    Science.gov (United States)

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

    2013-12-05

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

  2. Stochastic generation of hourly wind speed time series

    International Nuclear Information System (INIS)

    Shamshad, A.; Wan Mohd Ali Wan Hussin; Bawadi, M.A.; Mohd Sanusi, S.A.

    2006-01-01

    In the present study hourly wind speed data of Kuala Terengganu in Peninsular Malaysia are simulated by using transition matrix approach of Markovian process. The wind speed time series is divided into various states based on certain criteria. The next wind speed states are selected based on the previous states. The cumulative probability transition matrix has been formed in which each row ends with 1. Using the uniform random numbers between 0 and 1, a series of future states is generated. These states have been converted to the corresponding wind speed values using another uniform random number generator. The accuracy of the model has been determined by comparing the statistical characteristics such as average, standard deviation, root mean square error, probability density function and autocorrelation function of the generated data to those of the original data. The generated wind speed time series data is capable to preserve the wind speed characteristics of the observed data

  3. [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.

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

    Science.gov (United States)

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

    2016-11-22

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

  5. Acute Toxicity (LC50 96 Hours of Organophosphate Pesticide With Poksim Active Compound And Haematology And Histopathology Review Goldfish (Cyprinus carpio L

    Directory of Open Access Journals (Sweden)

    Dewi Nur Setyorini

    2015-04-01

    Full Text Available This research has the objectives to determine LC50 96 hours value and observation toward hematology, gills and kidney histology of goldfish (Cyprinus carpio exposed to organophosphate pesticide with Poksim active compound (trade brand FOKKER 500 EC. Method used in this paper is experiment to determine LC50 96 hour value with probit analysis. Descriptive method was used for gills and kidney tissues microanatomy observation with hematoxilin eosin (HE coloring and hematology. Toxicity result of Fokker 500 EC pesticide toward goldfish obtained LC50 96 hours with 41,7 ppm. Histological result showed that increasing exposure doses in real test had caused increase gills and kidney tissues damage. Hematology observation result during research obtained that along with the increasing exposure doses of pesticide in the real test, acute toxicity test would caused reduction in total erythrocyte, leukocyte and hemoglobin of goldfish. Result also showed that Fokker pesticide usage was allowed until 1,8 ppm dose based on histology and hematology evaluation. Keywords: acute toxicity, goldfish, histology, hematology, pesticide

  6. Shift work and health--a critical review of the literature on working hours.

    Science.gov (United States)

    Harrington, J M

    1994-09-01

    Working outside normal hours either by extended days or shift work is a fact of industrial society. Its economic advantages must be weighed against detrimental effects on the individual worker in the form of circadian rhythm disturbance, poorer quality and quantity of sleep and increased fatigue. The link between shift work and increased cardiovascular morbidity and mortality has strengthened in recent years. The case for an association with gastrointestinal disease remains quite good. Evidence of poorer work performance and increased accidents, particularly on the night shift, is persuasive, although individual factors may be as important as workplace factors. Correct shift work scheduling is important and for rotating shifts, rapid forward rotation is the least disruptive option. The compressed working week of 10 to 12-hour shifts is gaining popularity but evidence is too scant at present to suggest there are many long-term health and safety risks provided the rest day block is preserved. Optimal hours for the working week cannot be formulated on present scientific evidence, though working more than 48-56 hours a week probably carries serious health and safety implications. The inherent conflict between the interest of the worker and the enterprise over unsocial hours can be mitigated by improvements in working conditions especially at night and by advice to the worker on coping strategies. Further research is needed on the effects of the compressed working week, as well as the influence of culture, task and gender on any health effects. Studies to define individual characteristics which may cause shift work intolerance would be of great practical use.

  7. Detection of vancomycin resistances in enterococci within 3 1/2 hours

    Science.gov (United States)

    Schröder, U. -Ch.; Beleites, C.; Assmann, C.; Glaser, U.; Hübner, U.; Pfister, W.; Fritzsche, W.; Popp, J.; Neugebauer, U.

    2015-02-01

    Vancomycin resistant enterococci (VRE) constitute a challenging problem in health care institutions worldwide. Novel methods to rapidly identify resistances are highly required to ensure an early start of tailored therapy and to prevent further spread of the bacteria. Here, a spectroscopy-based rapid test is presented that reveals resistances of enterococci towards vancomycin within 3.5 hours. Without any specific knowledge on the strain, VRE can be recognized with high accuracy in two different enterococci species. By means of dielectrophoresis, bacteria are directly captured from dilute suspensions, making sample preparation very easy. Raman spectroscopic analysis of the trapped bacteria over a time span of two hours in absence and presence of antibiotics reveals characteristic differences in the molecular response of sensitive as well as resistant Enterococcus faecalis and Enterococcus faecium. Furthermore, the spectroscopic fingerprints provide an indication on the mechanisms of induced resistance in VRE.

  8. Uncovering configurations of HRM service provider intellectual capital and worker human capital for creating high HRM service value using fsQCA

    NARCIS (Netherlands)

    Meijerink, Jeroen Gerard; Bondarouk, Tatiana

    Although traditionally applied independently, this study combines two theoretical perspectives – the intellectual capital theory and the consumer perspective – to uncover value-creating configurations of human resource management (HRM) service providers' and workers' knowledge resources. We examined

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

    Science.gov (United States)

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

    2010-11-01

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

  10. Emotional exhaustion may trigger cut in working hours

    NARCIS (Netherlands)

    Koppes, L.

    2012-01-01

    Researchers in the Netherlands have been examining to what extent workers are modifying their hours to cope with high levels of work-related emotional exhaustion. Findings reveal that most full-time employees would prefer a cut in their hours, with those reporting emotional exhaustion wanting a

  11. Tasimelteon (Hetlioz™): A New Melatonin Receptor Agonist for the Treatment of Non-24-Hour Sleep-Wake Disorder.

    Science.gov (United States)

    Bonacci, Janene M; Venci, Jineane V; Gandhi, Mona A

    2015-10-01

    In January 2014, the US Food and Drug Administration approved tasimelteon (Hetlioz™), a melatonin-receptor agonist for the treatment of non-24-hour sleep-wake disorder. This article provides an overview of the mechanism of action, pharmacokinetic properties, as well as the clinical efficacy, safety, and tolerability of tasimelteon. Relevant information was identified through a comprehensive literature search of several databases using the key words tasimelteon, Non-24-hour Sleep-Wake disorder, Non-24, and melatonin. Further information was obtained from the tasimelteon package insert, fda.gov, clinicaltrials.gov, briefing materials provided by Vanda Pharmaceuticals, and posters from scientific meetings. © The Author(s) 2014.

  12. Quality of after-hours primary care in the Netherlands: a narrative review.

    Science.gov (United States)

    Giesen, Paul; Smits, Marleen; Huibers, Linda; Grol, Richard; Wensing, Michel

    2011-07-19

    Many Western countries are seeking an organizational model for after-hours primary care that is safe, efficient, and satisfactory for patients and health care professionals. Around the year 2000, Dutch primary care physicians (PCPs) reorganized their after-hours primary care and shifted from small rotation groups to large-scale PCP cooperatives. This article provides a narrative review of studies on a range of issues about after-hours primary care in the Netherlands, including experiences of health care professionals and patients, patient-safety incidents, adherence to practice guidelines, waiting times, and quality of telephone triage. Physicians expressed high satisfaction with PCP cooperatives; their workload decreased, and job satisfaction increased compared with the situation before the reorganization. In general, patients were also satisfied, but areas for improvement included telephone consultations, patient education, and distance to a pharmacy. A study identified patient-safety incidents in 2.4% of all contacts, of which most did not result in harm to patients. The average adherence to clinical guidelines by physicians was 77%, with lowest adherence scores for prescribing antibiotics and treatment in emergency cases. The average waiting time for home visits was 30 minutes. Seventy percent of patients with life-threatening problems were visited within the time target of 15 minutes. Telephone triage by nurses had positive effects on care efficiency by increasing the proportion of telephone consultations and decreasing the proportion of clinic consultations and home visits. The after-hours primary care system in the Netherlands might set an example for other countries struggling to find a good solution for the problems they encounter with after-hours primary care. Future developments in the Netherlands include integration and extensive collaboration with the accident and emergency departments of hospitals, in which PCPs take care of self-referring patients.

  13. Comparison of 24-hour urinary protein and protein-to-creatinine ratio in the assessment of proteinuria

    International Nuclear Information System (INIS)

    Wahbeh, Ayman M; Ewais, Mohammad H; Elsharif, Mahamed E

    2009-01-01

    To determine the correlation between protein-to-creatinine ratio (PCR) and 24-hour urinary protein (UP), we measured proteinuria in 68 patients attending the nephrology clinic at Jordan University Hospital by 24-hour urine protein excretion and protein-to-creatinine ratio. The cutoff values for spot urine protein-to-creatinine ratio in predicting 24-hour protein 'threshold' excretion of 0.5, 1.0 and 3.5 g/day were determined using receiver operating characteristic curves. A very good correlation (r= 0.832, P< 0.0001) was found between spot urine protein-to-creatinine ratio and 24-hour urine protein excretion. Bland-Altman plot showed the two tests had reasonable limits of agreement at low level of protein excretion but the limits became wider as the protein excretion increased. For protein excretion < 2.0 g/day, the limits of agreement of spot urine (PCR) and (UP) were +1.48 and -1.2 g/day. The spot urine protein-to-creatinine ratios of 0.72 (sensitivity 0.97; specificity 1.0), 1.2 (0.97; 0.89) and 3.23 (1.0; 0.86) mg/mg reliably predicted 24-hour urine total protein equivalent 'thresholds' of 0.5, 1.0 and 3.5 g/day, respectively. We conclude that the protein-to-creatinine ratio in spot urine specimens is an accurate, convenient, and reliable method to estimate the protein excretion in urine. However, the protein-to-creatinine ratio will likely be within clinically acceptable limits only when proteinuria is at reasonably low levels. (author)

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

    Science.gov (United States)

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

    2018-01-01

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

  15. Role of Combined Post-Operative Venous Lactate and 48 Hours C-Reactive Protein Values on the Etiology and Predictive Capacity of Organ-Space Surgical Site Infection after Elective Colorectal Operation.

    Science.gov (United States)

    Juvany, Montserrat; Guirao, Xavier; Oliva, Joan Carles; Badía Pérez, Jose M

    2017-04-01

    C-reactive protein (CRP) has been assessed to detect organ-space surgical site infection (OSI). Nevertheless, data about peri-operative oxygen debt and surgical stress-elicited biologic markers to explain and allow for the early detection of OSI are lacking. We analyzed immediate post-operative venous lactate, early CRP levels, and intra-operative hemodynamic values on the capacity to predict OSI after elective colorectal operation. Patients undergoing an elective colorectal surgical procedure with anastomosis between March 2013 and August 2014 were included and assessed prospectively. Post-operative lactate values at L-0, L-6, and L-24 hours, CRP (basal and 48 h), and the percentage of operative time (POT) with systolic blood pressure below 100 mm Hg and heart rate above 90 beats per minute in patients with and without OSI were compared. Binary logistic regression was constructed for L-0 and CRP-48, and receiver-operating characteristic (ROC) was analyzed for sensitivity (S), specificity (Sp), positive (PPV) and negative (NPV) predictive values. Patients with OSI (11 of 100) showed higher L-0 and L-24 (3.2 ± 2.5 vs. 1.6 ± 0.8; p = 0.025 and 1.9 ± 1.2 vs. 1.2 ± 0.4 mmol/L; p = 0.025) and CRP-48 (188 ± 80 vs. 74 ± 52 mg/L; p = 0.001). The ROC from logistic regression showed area under the curve of 0.899 (95% confidence interval [CI] 0.805-0.992), S of 72% (95% CI 43.2%-90.5%), Sp of 95% (95% CI 88.6%-98.4%), PPV of 66% (95% CI 38.9%-86.4%) and NPV of 0.96 (95% CI 90%-99%). L-0 was higher in those patients with hypotension during more than 60% of the POT (2.4 ± 2.1 vs. 1.6 ± 0.8; p = 0.038). Patients with OSI had a higher POT with hypotension (50 ± 28% vs. 30 ± 28%; p = 0.032) and tachycardia (18 ± 27% vs. 5 ± 16%; p = 0,024). The combination of immediate post-operative lactate and CRP at 48 hours proved to be useful in predicting OSI after elective colorectal operation

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

    Science.gov (United States)

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

    2017-07-15

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

  17. Values and behaviour model

    International Nuclear Information System (INIS)

    Anon

    2011-01-01

    Occupational injuries, accidents, trips of equipment, emergencies, and idle times represent a loss from each megawatt hour which we could have supplied to the network, or other costs related to settlement or compensation for damages. All of it can be caused by short lack of attention while doing a routine job, ignoring safety indicators, and rules. Such behaviour would not be a characteristic of a professional. People working at the nuclear power plants are the first ones to learn about the Values and Behaviour Model. (author)

  18. Long working hours and cancer risk: a multi-cohort study

    NARCIS (Netherlands)

    Heikkila, K.; Nyberg, S.T.; Madsen, I.E.; Vroome, E. de; Alfredsson, L.; Bjorner, J.B.; Borritz, M.; Burr, H.; Erbel, R.; Ferrie, J.E.; Fransson, E.; Geuskens, G.A.; Hooftman, W.E.; Houtman, I.L.; Jöckel, K.H.; Knutsson, A.; Koskenvuo, M.; Lunau, T.; Nielsen, M.L.; Nordin, M.; Oksanen, T.; Pejtersen, J.H.; Pentti, J.; Shipley, M.J.; Steptoe, A.; Suominen, S.B.; Theorell, T.; Vahtera, J.; Westerholm, P.J.M.; Westerlund, H.; Dragano, N.; Rugulies, R.; Kawachi, I.; Batty, G.D.; Singh-Manoux, A.; Virtanen, M.; Kivimäki, M.

    2016-01-01

    Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk

  19. Characteristics and outcomes for women physicians who work reduced hours.

    Science.gov (United States)

    Carr, Phyllis L; Gareis, Karen C; Barnett, Rosalind C

    2003-05-01

    To understand the characteristics of women physicians who work reduced hours in dual-earner couples and how such work schedules affect the quality of the marital role, parental role, and job role, as well as indicators of psychological distress, burnout, career satisfaction, and life satisfaction. Survey of a random sample of female physicians between 25 and 50 years of age, working within 25 miles of Boston, whose names were obtained from the Registry of Board Certification in Medicine in Massachusetts. Interviewers conducted a 60-minute face-to-face close-ended interview after a 20-minute mailed questionnaire had been completed. Fifty-one full-time physicians and 47 reduced-hours physicians completed the study, for a completion rate of 49.5%. There was no difference in age, number of years as a physician, mean household income, number of children, or presence of an infant in the home between reduced-hours and full-time physicians. Reduced-hours physicians, however, were more likely to be in a generalist specialty (40% vs. 12%, p = 0.001) and to spend a greater portion of their time in patient care (64.5% vs. 50.1%, p = 0.003) and less time in research (4.9% vs. 18.0%, p = 0.002) than full-time physicians. In addition, there was no difference between the two groups in the perception of work interfering with family life (1.8 vs. 1.7, p = 0.17; scale 1-7 with 7 high) or family life interfering with work (1.4 vs. 1.5, p = 0.62). Physicians who worked their preferred number of hours (25% of full-time and 57% of reduced-hours physicians), regardless of full-time (self-reported hours 35-90 hours per week) or reduced-hours (20-60 hours per week) status, reported better job role quality (r = 0.35, p = 0.001), schedule fit (r = 0.41, p Women physicians who work their preferred number of hours achieve the best balance of work and family outcomes.

  20. 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.

  1. Disponibilidade de horas de frio na região central do Rio Grande do Sul: 2 - Distribuição geográfica Chilling hours in the central region of Rio Grande do Sul state: 2 - Geographic distribution

    Directory of Open Access Journals (Sweden)

    Galileo Adeli Buriol

    2000-10-01

    Full Text Available Foram traçadas as cartas da distribuição de disponibilidade de horas de frio na região Central do Rio Grande do Sul. Para tal, utilizaram-se os dados de disponibilidade de ocorrência do número médio acumulado de horas de frio Maps of chilling hours distribution in the central region of Rio Grande do Sul, Brazil, were drawn. Mean of chilling hours bellow 7°C (HF<7 and 13°C (HF<13 accumulating every 15 days up to certain date were used. Isolines of different intensities were drawn using average accumulated values of the number of chilling hours for the occurrence probability of 50%. Two distribution combinations were used to determine the occurrence probability of chilling hours. One was a discrete distribution to verify if there was chilling hours accumulated during the 15 day interval and the other one was a continuous distribution used to identify the accumulate chilling hours. Regression equations that adjusted chilling hours values as a function of the local latitude and altitude were used to simplify isolines drawing. Lower values of accumulate chilling hours below 7°C and below 13°C were observed in locals with low altitudes, such as Jacuí, Vacacaí and Ibicuí river valleys and main tributary streams. However, higher values were observed in high altitudes mainly in Serra do Sudeste and Planalto highland areas.

  2. The corporate governance contribution as a creation of value for commercial partnerships between service providers and logistic operators

    Directory of Open Access Journals (Sweden)

    Carlos Alberto da Rocha

    2018-03-01

    Full Text Available This theoretical research identified the possibility that Governance factors contribute as evidence of value in the relationships of commercial partnerships between Logistic Operators and service providers. The data analysis allowed to identify three possible levels of grouping due to the variables of facilitators of proximity of partnerships that showed that it is possible to have a relationship with transparence between the client company and its suppliers. Most of these groups of suppliers were characterized by the intention to share operating profits with the client company, with little tolerance to financial risks of joint investments and a tendency to sign future supply contracts. Transparency, ethics and corporate responsibility have contributed to the consolidation of these groupings of partnerships among companies, as well as creating a mutual and evolutionary process of full confidence in such a way that Corporate Governance becomes the main value factor for this relationship.

  3. THE IMPACT OF CONJUGATED LINOLEIC ACID ADDITION ON PH VALUE OF LONGISSIMUS DORSI MUSCLE

    Directory of Open Access Journals (Sweden)

    Przemysław WASILEWSKI

    2009-08-01

    Full Text Available The subject of research was 60 crossbred gilts, divided into 6 groups, fed the fodder with addition of conjugated linoleic acid (CLA or sunflower oil (SFO in amount: 0.5; 1.0; and 2.0 %, respectively. Animals were slaughtered with the body weight ca. 95 kg. The aim of research was to determine pH value of loin meat tissue (Longissimus dorsi of right half-carcass in 45 minutes, 2, 3, 4, 5, 6 hours and 24 hours after slaughter. Results were statistically elaborated using one-way variance analysis. Longissimus dorsi muscle pH values measured 45 minutes after slaughter in case of all groups of pigs were in range from 6.34 up to 6.47, what shows good meat quality. The lowest pH1 (measured 45 minutes after slaughter had meat of fatteners where addition of 2 % sunflower oil was given into fodder and the highest value of this trait was in group of individuals where also was given sunflower oil in 1 % amount. Statistical significant differences in pH value measured in different time after slaughter i.e. after 45 minutes, 2, 3, 4, 6 and 24 hours between tested groups of pigs were not stated. The exception is the result of pH measurement 5 hours after slaughter. Statistical significant differences were between group of pigs getting 0.5 % addition of conjugated linoleic acid characterized by the highest pH value of meat and group of animals fed the fodder with 1 % addition of conjugated linoleic acid (P≤0.01. On the basis of the results obtained in presented paper may be stated that feeding pigs with addition of conjugated linoleic acid in amounts 0.5; 1.0 and 2.0 % did not impact negatively on meat quality defined by pH value.

  4. 12-hour-shift plant schedule improves operator productivity

    International Nuclear Information System (INIS)

    Gould, S.

    1989-01-01

    Twelve-hour scheduling has been a mainstay of the petrochemical industry, is common in the papermill industry, and is relatively new to the nuclear utility industry. A review of industry experiences, research, and a federal Nuclear Regulatory Commission (NRC) study of the 12-hour shift (NUREG/CR-4248) demonstrate that the advantages outweigh the disadvantages. The primary advantages are greater job satisfaction, fewer errors, and the better communications inherent in two shift turnovers versus three. Several companies that implemented the 12-hour shift found an increase in employee morale, no adverse effect on worker health, and no decline in safety. They experienced greater productivity, fewer operator errors, and better communication

  5. 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

  6. Four hour creatinine clearance is better than plasma creatinine for monitoring renal function in critically ill patients

    OpenAIRE

    Pickering, John W; Frampton, Christopher M; Walker, Robert J; Shaw, Geoffrey M; Endre, Zolt?n H

    2012-01-01

    Introduction Acute kidney injury (AKI) diagnosis is based on an increase in plasma creatinine, which is a slowly changing surrogate of decreased glomerular filtration rate. We investigated whether serial creatinine clearance, a direct measure of the glomerular filtration rate, provided more timely and accurate information on renal function than serial plasma creatinine in critically ill patients. Methods Serial plasma creatinine and 4-hour creatinine clearance were measured 12-hourly for 24 h...

  7. Long Working Hours and Emotional Well-Being in Korean Manufacturing Industry Employees

    OpenAIRE

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

    2013-01-01

    Objectives Korea is well known for its long work hours amongst employees. Because workers of the manufacturing industry are constantly exposed to extended work hours, this study was based on how long work hours affect their emotional well-being. Methods The analysis was done using the secondary Korean Working Condition Survey (KWCS). Long work hours were defined to be more than 48 hours, and they were subcategorized into units of 52 hours and 60 hours. Based on the WHO (five) well-being index...

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

    Science.gov (United States)

    Hartwell, Jennifer K

    2010-01-01

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

  9. Long working hours may increase risk of coronary heart disease.

    Science.gov (United States)

    Kang, Mo-Yeol; Cho, Soo-Hun; Yoo, Min-Sang; Kim, Taeshik; Hong, Yun-Chul

    2014-11-01

    To evaluate the association between long working hours and risk of coronary heart disease (CHD) estimated by Framingham risk score (FRS) in Korean adults. This study evaluated adult participants in Korean National Health and Nutrition Examination Survey IV (2007-2009). After inclusion and exclusion criteria were applied, the final sample size for this study model was 8,350. Subjects were asked about working hours and health status. Participants also completed physical examinations and biochemical measurement necessary for estimation of FRS. Multiple logistic regression was conducted to investigate the association between working hours and 10-year risk for CHD estimated by FRS. Compared to those who work 31-40 hr, significantly higher 10-year risk was estimated among subjects working longer hours. As working hours increased, odds ratio (OR) for upper 10 percent of estimated 10-year risk for CHD was increased up to 1.94. Long working hours are significantly related to risk of coronary heart disease. © 2014 Wiley Periodicals, Inc.

  10. Estimator's electrical man-hour manual

    CERN Document Server

    Page, John S

    1999-01-01

    This manual's latest edition continues to be the best source available for making accurate, reliable man-hour estimates for electrical installation. This new edition is revised and expanded to include installation of electrical instrumentation, which is used in monitoring various process systems.

  11. Nurses' extended work hours: Patient, nurse and organizational outcomes.

    Science.gov (United States)

    Kunaviktikul, W; Wichaikhum, O; Nantsupawat, A; Nantsupawat, R; Chontawan, R; Klunklin, A; Roongruangsri, S; Nantachaipan, P; Supamanee, T; Chitpakdee, B; Akkadechanunt, T; Sirakamon, S

    2015-09-01

    Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems

  12. 12 CFR 905.3 - Location and business hours.

    Science.gov (United States)

    2010-01-01

    ... Location and business hours. (a) Location. All office units of the Finance Board are located at 1777 F... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Location and business hours. 905.3 Section 905.3 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOUSING FINANCE BOARD ORGANIZATION AND...

  13. A decision tree model to estimate the value of information provided by a groundwater quality monitoring network

    Science.gov (United States)

    Khader, A. I.; Rosenberg, D. E.; McKee, M.

    2013-05-01

    Groundwater contaminated with nitrate poses a serious health risk to infants when this contaminated water is used for culinary purposes. To avoid this health risk, people need to know whether their culinary water is contaminated or not. Therefore, there is a need to design an effective groundwater monitoring network, acquire information on groundwater conditions, and use acquired information to inform management options. These actions require time, money, and effort. This paper presents a method to estimate the value of information (VOI) provided by a groundwater quality monitoring network located in an aquifer whose water poses a spatially heterogeneous and uncertain health risk. A decision tree model describes the structure of the decision alternatives facing the decision-maker and the expected outcomes from these alternatives. The alternatives include (i) ignore the health risk of nitrate-contaminated water, (ii) switch to alternative water sources such as bottled water, or (iii) implement a previously designed groundwater quality monitoring network that takes into account uncertainties in aquifer properties, contaminant transport processes, and climate (Khader, 2012). The VOI is estimated as the difference between the expected costs of implementing the monitoring network and the lowest-cost uninformed alternative. We illustrate the method for the Eocene Aquifer, West Bank, Palestine, where methemoglobinemia (blue baby syndrome) is the main health problem associated with the principal contaminant nitrate. The expected cost of each alternative is estimated as the weighted sum of the costs and probabilities (likelihoods) associated with the uncertain outcomes resulting from the alternative. Uncertain outcomes include actual nitrate concentrations in the aquifer, concentrations reported by the monitoring system, whether people abide by manager recommendations to use/not use aquifer water, and whether people get sick from drinking contaminated water. Outcome costs

  14. Economic Value of Army Foreign Military Sales

    Science.gov (United States)

    2015-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT ECONOMIC VALUE OF ARMY FOREIGN MILITARY SALES ...this collection of information is estimated to average 1 hour per response, including the time for reviewing instruction, searching existing data...sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden

  15. Social Norms on Working Hours, Work-Life Balance, and Fertility Choice

    OpenAIRE

    大洞, 公平; 田畑, 顕

    2013-01-01

    This paper studies the role played by the social norms of working hours in a household labor- leisure and fertility decision model. We suppose that social norms enforce workers not to deviate from the ideal level of working hours, which depends on past and current observations of working hours in workplaces. We show that the social norms lead to multiple equilibria: one with long working hours and a low fertility rate and another with short working hours and a high fertility rate. Our results...

  16. Hourly test reference weather data in the changing climate of Finland for building energy simulations

    Directory of Open Access Journals (Sweden)

    Kirsti Jylhä

    2015-09-01

    Full Text Available Dynamic building energy simulations need hourly weather data as input. The same high temporal resolution is required for assessments of future heating and cooling energy demand. The data presented in this article concern current typical values and estimated future changes in outdoor air temperature, wind speed, relative humidity and global, diffuse and normal solar radiation components. Simulated annual and seasonal delivered energy consumptions for heating of spaces, heating of ventilation supply air and cooling of spaces in the current and future climatic conditions are also presented for an example house, with district heating and a mechanical space cooling system. We provide details on how the synthetic future weather files were created and utilised as input data for dynamic building energy simulations by the IDA Indoor Climate and Energy program and also for calculations of heating and cooling degree-day sums. The information supplied here is related to the research article titled “Energy demand for the heating and cooling of residential houses in Finland in a changing climate” [1].

  17. Review of 12-hour shifts at nuclear generating stations

    International Nuclear Information System (INIS)

    Smiley, A.; Moray, N.P.

    1989-04-01

    This project reviewed the practice of 12-hour shift work schedules at nuclear power plants, and its relationship to safety. The current literature was examined for information on accidents, fatigue and personal preferences. Interviews with operators and maintainers showed that these groups had attitude and preference differences related to both 12 hour shift schedules and overtime work opportunities. Several factors related to 12-hour schedules were identified which could affect safety, but which have not been adequately considered. (24 refs.)

  18. Long working hours and cancer risk: a multi-cohort study.

    Science.gov (United States)

    Heikkila, Katriina; Nyberg, Solja T; Madsen, Ida E H; de Vroome, Ernest; Alfredsson, Lars; Bjorner, Jacob J; Borritz, Marianne; Burr, Hermann; Erbel, Raimund; Ferrie, Jane E; Fransson, Eleonor I; Geuskens, Goedele A; Hooftman, Wendela E; Houtman, Irene L; Jöckel, Karl-Heinz; Knutsson, Anders; Koskenvuo, Markku; Lunau, Thorsten; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Shipley, Martin J; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Dragano, Nico; Rugulies, Reiner; Kawachi, Ichiro; Batty, G David; Singh-Manoux, Archana; Virtanen, Marianna; Kivimäki, Mika

    2016-03-29

    Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported. During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working ⩾55 h per week was associated with 1.60-fold (95% confidence interval 1.12-2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift- and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity. Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.

  19. 76 FR 5324 - Hours of Service of Drivers

    Science.gov (United States)

    2011-01-31

    ... and how frequently the 11th hour is used. It seeks data on how much of the 11th hour is used when a... soliciting information on patterns of work for night drivers: 2a. For drivers who always drive at night, what... Act restrictions which prohibit Agency officials from engaging in policy discussions about open...

  20. Work Hours of Immigrant Versus U.S.-Born Female Workers.

    Science.gov (United States)

    Bae, Sung-Heui

    2017-10-01

    This study was a secondary analysis of cross-sectional data extracted from the 2011-2012 California Health Interview Survey. Data from 8,931 full-time (i.e., 21 hours or more per week) women workers aged 18 to 85 years were analyzed to examine the nature and prevalence of immigrant female workers' work hours, overtime, and related factors in the United States compared to U.S.-born female workers. Results showed that foreign-born female workers did not work longer hours than U.S.-born female workers. Foreign-born female workers who reported poor health worked longer hours than did their U.S.-born counterparts. Foreign-born female workers who were self-employed or worked in family businesses tended to work longer hours than did those women who worked for private companies or nonprofit organizations.

  1. Determining optimal interconnection capacity on the basis of hourly demand and supply functions of electricity

    International Nuclear Information System (INIS)

    Keppler, Jan Horst; Meunier, William; Coquentin, Alexandre

    2017-01-01

    Interconnections for cross-border electricity flows are at the heart of the project to create a common European electricity market. At the time, increase in production from variable renewables clustered during a limited numbers of hours reduces the availability of existing transport infrastructures. This calls for higher levels of optimal interconnection capacity than in the past. In complement to existing scenario-building exercises such as the TYNDP that respond to the challenge of determining optimal levels of infrastructure provision, the present paper proposes a new empirically-based methodology to perform Cost-Benefit analysis for the determination of optimal interconnection capacity, using as an example the French-German cross-border trade. Using a very fine dataset of hourly supply and demand curves (aggregated auction curves) for the year 2014 from the EPEX Spot market, it constructs linearized net export (NEC) and net import demand curves (NIDC) for both countries. This allows assessing hour by hour the welfare impacts for incremental increases in interconnection capacity. Summing these welfare increases over the 8 760 hours of the year, this provides the annual total for each step increase of interconnection capacity. Confronting welfare benefits with the annual cost of augmenting interconnection capacity indicated the socially optimal increase in interconnection capacity between France and Germany on the basis of empirical market micro-data. (authors)

  2. "Hour of Code": Can It Change Students' Attitudes toward Programming?

    Science.gov (United States)

    Du, Jie; Wimmer, Hayden; Rada, Roy

    2016-01-01

    The Hour of Code is a one-hour introduction to computer science organized by Code.org, a non-profit dedicated to expanding participation in computer science. This study investigated the impact of the Hour of Code on students' attitudes towards computer programming and their knowledge of programming. A sample of undergraduate students from two…

  3. A comparison of job descriptions for nurse practitioners working in out-of-hours primary care services: implications for workforce planning, patients and nursing.

    Science.gov (United States)

    Teare, Jean; Horne, Maria; Clements, Gill; Mohammed, Mohammed A

    2017-03-01

    To compare and contrast job descriptions for nursing roles in out-of-hours services to obtain a general understanding of what is required for a nurse working in this job. Out-of-hours services provide nursing services to patients either through telephone or face-to-face contact in care centres. Many of these services are newly created giving job opportunities to nurses working in this area. It is vital that nurses know what their role entails but also that patients and other professionals know how out-of-hours nurses function in terms of competence and clinical role. Content analysis of out-of-hours job descriptions. Content analysis of a convenience sample of 16 job descriptions of out-of-hours nurses from five out-of-hours care providers across England was undertaken. The findings were narratively synthesised, supported by tabulation. Key role descriptors were examined in terms of job titles, managerial skills, clinical skills, professional qualifications and previous experience. Content analysis of each out-of-hours job description revealed a lack of consensus in clinical competence and skills required related to job title although there were many similarities in skills across all the roles. This study highlights key differences and some similarities between roles and job titles in out-of-hours nursing but requires a larger study to inform workforce planning. Out-of-hours nursing is a developing area of practice which requires clarity to ensure patient safety and quality care. © 2016 John Wiley & Sons Ltd.

  4. 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.

  5. Decision-relevant evaluation of climate models: A case study of chill hours in California

    Science.gov (United States)

    Jagannathan, K. A.; Jones, A. D.; Kerr, A. C.

    2017-12-01

    The past decade has seen a proliferation of different climate datasets with over 60 climate models currently in use. Comparative evaluation and validation of models can assist practitioners chose the most appropriate models for adaptation planning. However, such assessments are usually conducted for `climate metrics' such as seasonal temperature, while sectoral decisions are often based on `decision-relevant outcome metrics' such as growing degree days or chill hours. Since climate models predict different metrics with varying skill, the goal of this research is to conduct a bottom-up evaluation of model skill for `outcome-based' metrics. Using chill hours (number of hours in winter months where temperature is lesser than 45 deg F) in Fresno, CA as a case, we assess how well different GCMs predict the historical mean and slope of chill hours, and whether and to what extent projections differ based on model selection. We then compare our results with other climate-based evaluations of the region, to identify similarities and differences. For the model skill evaluation, historically observed chill hours were compared with simulations from 27 GCMs (and multiple ensembles). Model skill scores were generated based on a statistical hypothesis test of the comparative assessment. Future projections from RCP 8.5 runs were evaluated, and a simple bias correction was also conducted. Our analysis indicates that model skill in predicting chill hour slope is dependent on its skill in predicting mean chill hours, which results from the non-linear nature of the chill metric. However, there was no clear relationship between the models that performed well for the chill hour metric and those that performed well in other temperature-based evaluations (such winter minimum temperature or diurnal temperature range). Further, contrary to conclusions from other studies, we also found that the multi-model mean or large ensemble mean results may not always be most appropriate for this

  6. Macro economic profitability of hourly measurements and binary communications

    International Nuclear Information System (INIS)

    Andersen, Christian; Lund, Arne-Christian

    2005-11-01

    There are several actors that are subject to hourly measurements and dynamic pricing. The effects are registered in several analyses. A typical division would be effects connected to power producers, power deliverers, network companies and end users. In a macro economic analysis the goal would be to identify alterations in total benefits and costs. The transition from studying isolated effects for single actors to a macro economic perspective produces several principal problems. When the analysis is based on the effects for various actors it would be important to identify transitions between various actors that in itself does not contribute to alterations in the macro economic profit. At the same time it will be important that effects to be valued are evaluated in a consistent an consequential way. In this context it may be beneficial to use a model for the actors adaptation to the power market where various effects may be used. This working paper describes utility and cost elements that is a basis for Norwegian and foreign analysis of hourly measurements and dynamic prices. The survey shows that it is a large agreement between different investigations with respect to principle effects to be emphasized. There is however, variation with respect to what effects actually are in operation and quantified. There may also be large deviances in the valuation of various utility and cost components. Some single effects are studied closer. An effort is made to compare certain figures from the literature. However, this comparison has been difficult because it is not always clear what conditions have lead to the figures in use. There are large variations between the various analysis estimates. There may be several reasons. The technical products to be priced may vary. It is also evident that the costs for changing measuring equipment may be dependent of the management strategy. The paper refers to newer theoretical literature about the effects of hourly measurements and dynamic

  7. Valuing future citizens' values regarding risk

    International Nuclear Information System (INIS)

    Fleming, Patricia

    2006-01-01

    Valuing present citizen's values regarding the risks they face is an important aspect of risk assessment and risk acceptability. Conferences like VALDOR are held for this reason. Governments like Sweden have national referendums on various risk-prone enterprises. The results of these referendums can determine the future of these programs. In the United States, when guidelines are set for determining acceptable levels of risk, the relevant federal agencies are often required to provide a comment period regarding proposed guidelines in order to ascertain the judgments, including the weights place on certain values, of individual members of society as well as stakeholder groups. After the comment period ends, the agency decides on the acceptable level of risk, taking into account the comments from present citizens. Do we also have a duty to value the not-yet-existing values of future citizens, especially if the risks created by the activities of present citizens extend into the future to citizens not yet living? If so, are there any circumstances which entitle us to de-value those not-yet-existing values. In this paper, I ground my discussion of the question of valuing future citizens' values in one of the areas of focus of the VALDOR conference: nuclear waste management and specifically the question facing the United States' program regarding an acceptable dose standard associated with the release of radioactivity into the biosphere from an underground repository. The underlying conference theme to which this discussion may be attached is community environmental justice as it applies to future citizens. I focus on the role that uncertainty plays is providing justice between present and future citizens

  8. Valuing future citizens' values regarding risk

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, Patricia [Creighton Univ., Omaha (United States). College of Arts and Sciences/Philosophy

    2006-09-15

    Valuing present citizen's values regarding the risks they face is an important aspect of risk assessment and risk acceptability. Conferences like VALDOR are held for this reason. Governments like Sweden have national referendums on various risk-prone enterprises. The results of these referendums can determine the future of these programs. In the United States, when guidelines are set for determining acceptable levels of risk, the relevant federal agencies are often required to provide a comment period regarding proposed guidelines in order to ascertain the judgments, including the weights place on certain values, of individual members of society as well as stakeholder groups. After the comment period ends, the agency decides on the acceptable level of risk, taking into account the comments from present citizens. Do we also have a duty to value the not-yet-existing values of future citizens, especially if the risks created by the activities of present citizens extend into the future to citizens not yet living? If so, are there any circumstances which entitle us to de-value those not-yet-existing values. In this paper, I ground my discussion of the question of valuing future citizens' values in one of the areas of focus of the VALDOR conference: nuclear waste management and specifically the question facing the United States' program regarding an acceptable dose standard associated with the release of radioactivity into the biosphere from an underground repository. The underlying conference theme to which this discussion may be attached is community environmental justice as it applies to future citizens. I focus on the role that uncertainty plays is providing justice between present and future citizens.

  9. 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.

  10. Serious gaming: A tool to educate health care providers about domestic violence.

    Science.gov (United States)

    Mason, Robin; Turner, Linda

    2018-05-10

    Due to many adverse health effects, victims of domestic violence are frequently seen in the health care system. Yet, health care providers may lack the training to assist them. Online curricula can be an effective instructional tool. Our competency-based, serious video game, Responding to Domestic Violence in Clinical Settings, was designed to address health care providers' knowledge gaps through 17 modules, each a half hour in length. Nearly 9,000 participants completed at least one module; nursing students completed the most modules, approximately five hours of instruction. This serious video game-based curriculum is useful in helping health providers and students learn about Domestic Violence.

  11. A critical evalution of 24 hours whole-body (skeletal) retention of diphosphonate measurements

    International Nuclear Information System (INIS)

    Fogelman, I.; Bessent, R.G.; Scullion, J.E.; Cuthbert, G.F.

    1982-01-01

    In previous studies we have found that 24 hour whole-body retention (WBR) of diphosphonate is a valuable test for the assessment of skeletal metabolism. However, the reproducibility, accuracy and possible sources of error in WBR measurements have not previously been studied. In 21 paired studies the technique was found to be highly reproducible (r = 0.998, p < 0.0001). The coefficient of variation for whole-body counts on day 1 was 0.1% and on day 2, 1.1%. The net whole-body count of a phantom representing the 24 hour whole-body distribution of tracer was 98% of that of a uniform phantom. Ten subjects, counted twice within a few minutes to study the effect of repositioning showed a mean difference between counts of only 0.8%. For eleven subjects with traumatic fractures it was found that 9 had normal values for WBR, while 2 had minimally elevated results. For twenty patients with renal disease but no apparent skeletal disease a significant correlation between serum creatinine and WBR was found (r = 0.72, p<0.001). However WBR results were always normal when serum creatinine values were <130 μmol/l. It is suggested that WBR measurement is accurate and the technique is highly reproducible. The presence of a focal lesion is unlikely to affect a WBR result significantly and if serum creatinine is in the normal range then an elevated WBR result can be assumed to reflect increased skeletal metabolism without further concern as to renal function. (Author)

  12. A case study of cost-efficient staffing under annualized hours.

    Science.gov (United States)

    van der Veen, Egbert; Hans, Erwin W; Veltman, Bart; Berrevoets, Leo M; Berden, Hubert J J M

    2015-09-01

    We propose a mathematical programming formulation that incorporates annualized hours and shows to be very flexible with regard to modeling various contract types. The objective of our model is to minimize salary cost, thereby covering workforce demand, and using annualized hours. Our model is able to address various business questions regarding tactical workforce planning problems, e.g., with regard to annualized hours, subcontracting, and vacation planning. In a case study for a Dutch hospital two of these business questions are addressed, and we demonstrate that applying annualized hours potentially saves up to 5.2% in personnel wages annually.

  13. Will British weather provide reliable electricity?

    International Nuclear Information System (INIS)

    Oswald, James; Raine, Mike; Ashraf-Ball, Hezlin

    2008-01-01

    There has been much academic debate on the ability of wind to provide a reliable electricity supply. The model presented here calculates the hourly power delivery of 25 GW of wind turbines distributed across Britain's grid, and assesses power delivery volatility and the implications for individual generators on the system. Met Office hourly wind speed data are used to determine power output and are calibrated using Ofgem's published wind output records. There are two main results. First, the model suggests that power swings of 70% within 12 h are to be expected in winter, and will require individual generators to go on or off line frequently, thereby reducing the utilisation and reliability of large centralised plants. These reductions will lead to increases in the cost of electricity and reductions in potential carbon savings. Secondly, it is shown that electricity demand in Britain can reach its annual peak with a simultaneous demise of wind power in Britain and neighbouring countries to very low levels. This significantly undermines the case for connecting the UK transmission grid to neighbouring grids. Recommendations are made for improving 'cost of wind' calculations. The authors are grateful for the sponsorship provided by The Renewable Energy Foundation

  14. 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.

  15. U.S. Hourly Precipitation Data Publication

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This publication contains hourly precipitation amounts obtained from recording rain gages located at National Weather Service, Federal Aviation Administration, and...

  16. Estimating the value of life and injury for pedestrians using a stated preference framework.

    Science.gov (United States)

    Niroomand, Naghmeh; Jenkins, Glenn P

    2017-09-01

    The incidence of pedestrian death over the period 2010 to 2014 per 1000,000 in North Cyprus is about 2.5 times that of the EU, with 10.5 times more pedestrian road injuries than deaths. With the prospect of North Cyprus entering the EU, many investments need to be undertaken to improve road safety in order to reach EU benchmarks. We conducted a stated choice experiment to identify the preferences and tradeoffs of pedestrians in North Cyprus for improved walking times, pedestrian costs, and safety. The choice of route was examined using mixed logit models to obtain the marginal utilities associated with each attribute of the routes that consumers chose. These were used to estimate the individuals' willingness to pay (WTP) to save walking time and to avoid pedestrian fatalities and injuries. We then used the results to obtain community-wide estimates of the value of a statistical life (VSL) saved, the value of an injury (VI) prevented, and the value per hour of walking time saved. The estimate of the VSL was €699,434 and the estimate of VI was €20,077. These values are consistent, after adjusting for differences in incomes, with the median results of similar studies done for EU countries. The estimated value of time to pedestrians is €7.20 per person hour. The ratio of deaths to injuries is much higher for pedestrians than for road accidents, and this is completely consistent with the higher estimated WTP to avoid a pedestrian accident than to avoid a car accident. The value of time of €7.20 is quite high relative to the wages earned. Findings provide a set of information on the VRR for fatalities and injuries and the value of pedestrian time that is critical for conducing ex ante appraisals of investments to improve pedestrian safety. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

  17. Work hours and work-family conflict: the double-edged sword of involvement in work and family.

    Science.gov (United States)

    Matthews, Russell A; Swody, Cathleen A; Barnes-Farrell, Janet L

    2012-08-01

    In this study, we examine the role of work hours in a model that incorporates involvement in both work and family with experiences of work-family conflict and subjective well-being. Self-report data were collected from 383 full-time employees and analysed using structural equation modelling techniques. Results demonstrate that role salience was positively related to behavioural involvement with work and with family. In turn, behavioural family involvement was negatively related to work hours and family-to-work conflict, while behavioural work involvement was positively related to work hours. Behavioural family involvement was also positively related to life satisfaction. Finally, both family-to-work conflict and end-of-workday strain were negatively related to life satisfaction. Our results provide insight into unexpected problems that might arise when employees place overly high importance on work and work long hours. This study serves as a foundation for researchers to examine the interplay of time spent with work and family with other aspects of the work-family interface. Copyright © 2011 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Kelekar, Uma; Naavaal, Shillpa

    2018-01-11

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

  19. Compensating wage differentials and the impact of health insurance in the public sector on wages and hours.

    Science.gov (United States)

    Qin, Paige; Chernew, Michael

    2014-12-01

    This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Radon remediation of a two-storey UK dwelling by active sub-slab depressurization: observations on hourly Radon concentration variations

    International Nuclear Information System (INIS)

    Denman, A.R.

    2008-01-01

    Radon concentration levels in a two-storey detached single-family dwelling in Northamptonshire, UK, were monitored at hourly intervals throughout a 5-week period during which sub-slab depressurization remediation measures, including an active sump system, were installed. Remediation of the property was accomplished successfully, with the mean radon levels upstairs and downstairs greatly reduced and the prominent diurnal variability in radon levels present prior to remediation almost completely removed. Following remediation, upstairs and downstairs radon concentrations were 32% and 16% of their pre-remediation values respectively. The mean downstairs radon concentration was lower than that upstairs, with pre-and post-remediation values of the upstairs/downstairs concentration ratio, R U/D , of 0.93 and 1.76 respectively. Cross-correlation between upstairs and downstairs radon concentration time-series indicates a time-lag of the order of 1 hour or less, suggesting that diffusion of soil-derived radon from downstairs to upstairs either occurs within that time frame or forms a relatively insignificant contribution to the upstairs radon level. Cross-correlation between radon concentration time-series and the corresponding time-series for local atmospheric parameters demonstrated correlation between radon concentrations and internal/external pressure-difference prior to remediation. This correlation disappears following remediation, confirming the effectiveness of the remediation procedure in mitigating radon ingress from the ground via the stack-effect. Overall, these observations provide further evidence that radon emanation from building materials makes a not insignificant contribution to radon concentration levels within the building. Furthermore, since this component remains essentially unaffected by sub-slab depressurization, its proportional contribution to the total radon levels in the home increases following remediation, leading to the conclusion that where

  1. 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.

  2. Optimizing value utilizing Toyota Kata methodology in a multidisciplinary clinic.

    Science.gov (United States)

    Merguerian, Paul A; Grady, Richard; Waldhausen, John; Libby, Arlene; Murphy, Whitney; Melzer, Lilah; Avansino, Jeffrey

    2015-08-01

    Value in healthcare is measured in terms of patient outcomes achieved per dollar expended. Outcomes and cost must be measured at the patient level to optimize value. Multidisciplinary clinics have been shown to be effective in providing coordinated and comprehensive care with improved outcomes, yet tend to have higher cost than typical clinics. We sought to lower individual patient cost and optimize value in a pediatric multidisciplinary reconstructive pelvic medicine (RPM) clinic. The RPM clinic is a multidisciplinary clinic that takes care of patients with anomalies of the pelvic organs. The specialties involved include Urology, General Surgery, Gynecology, and Gastroenterology/Motility. From May 2012 to November 2014 we performed time-driven activity-based costing (TDABC) analysis by measuring provider time for each step in the patient flow. Using observed time and the estimated hourly cost of each of the providers we calculated the final cost at the individual patient level, targeting clinic preparation. We utilized Toyota Kata methodology to enhance operational efficiency in an effort to optimize value. Variables measured included cost, time to perform a task, number of patients seen in clinic, percent value-added time (VAT) to patients (face to face time) and family experience scores (FES). At the beginning of the study period, clinic costs were $619 per patient. We reduced conference time from 6 min/patient to 1 min per patient, physician preparation time from 8 min to 6 min and increased Medical Assistant (MA) preparation time from 9.5 min to 20 min, achieving a cost reduction of 41% to $366 per patient. Continued improvements further reduced the MA preparation time to 14 min and the MD preparation time to 5 min with a further cost reduction to $194 (69%) (Figure). During this study period, we increased the number of appointments per clinic. We demonstrated sustained improvement in FES with regards to the families overall experience with their providers

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

    Science.gov (United States)

    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.

  4. How many hours do you usually work? An analysis of the working hours questions in 26 large-scale surveys in six countries and the European Union

    OpenAIRE

    Tijdens, K.; Dragstra, A.

    2007-01-01

    This article reviews how working hours are asked for in 26 large-scale surveys in six countries plus the European Union. Four dimensions of working time were investigated, notably number of working hours, timing of work, predictability and control over hours, and commuting time. Although almost all questionnaires ask for hours worked, the terminology varies greatly. In only half of the cases a reference period is taken into account and in half the reasons for working more/less in the survey w...

  5. How many hours do you usually work? An analysis of the working hours questions in 26 large-scale surveys in 6 countries and the European Union.

    OpenAIRE

    Dragstra, A.; Tijdens, K.

    2004-01-01

    This paper reviews how working hours are asked in 26 large-scale surveys in 6 countries plus the European Union. Four dimensions of working time were investigated, notably number of working hours, timing of work, predictability and control over hours, and commuting time. Although almost all questionnaires ask for hours worked, the terminology varies largely. In only half of the cases a reference period is taken into account and in half the reasons for working more/less in the survey week than...

  6. Indigenous environmental values as human values

    Directory of Open Access Journals (Sweden)

    Monica Gratani

    2016-12-01

    Full Text Available The claim that in natural resource management (NRM a change from anthropocentric values and ethics to eco-centric ones is necessary to achieve sustainability leads to the search for eco-centric models of relationship with the environment. Indigenous cultures can provide such models; hence, there is the need for multicultural societies to further include their values in NRM. In this article, we investigate the environmental values placed on a freshwater environment of the Wet Tropics by a community of indigenous Australians. We discuss their environmental values as human values, and so as beliefs that guide communities’ understanding of how the natural world should be viewed and treated by humans. This perspective represents a step forward in our understanding of indigenous environmental values, and a way to overcome the paradigm of indigenous values as valued biophysical attributes of the environment or processes happening in landscapes. Our results show that the participant community holds biospheric values. Restoring these values in the NRM of the Wet Tropics could contribute to sustainability and environmental justice in the area.

  7. 76 FR 16199 - Hours of Service of Railroad Employees; Substantive Regulations for Train Employees Providing...

    Science.gov (United States)

    2011-03-22

    ... hostlers.'' Other employees, such as food service providers or sleeping car attendants, who may work on... day. Because of natural circadian rhythms and environmental and social factors, most people are able... Effectiveness (SAFTE) model and Fatigue Avoidance Scheduling Tool TM (FAST) that have been validated and...

  8. Implementation of an Education Value Unit (EVU System to Recognize Faculty Contributions

    Directory of Open Access Journals (Sweden)

    Joseph House

    2015-11-01

    Full Text Available Introduction: Faculty educational contributions are hard to quantify, but in an era of limited resources it is essential to link funding with effort. The purpose of this study was to determine the feasibility of an educational value unit (EVU system in an academic emergency department and to examine its effect on faculty behavior, particularly on conference attendance and completion of trainee evaluations. Methods: A taskforce representing education, research, and clinical missions was convened to develop a method of incentivizing productivity for an academic emergency medicine faculty. Domains of educational contributions were defined and assigned a value based on time expended. A 30-hour EVU threshold for achievement was aligned with departmental goals. Targets included educational presentations, completion of trainee evaluations and attendance at didactic conferences. We analyzed comparisons of performance during the year preceding and after implementation. Results: Faculty (N=50 attended significantly more didactic conferences (22.7 hours v. 34.5 hours, p<0.005 and completed more trainee evaluations (5.9 v. 8.8 months, p<0.005. During the pre-implementation year, 84% (42/50 met the 30-hour threshold with 94% (47/50 meeting post-implementation (p=0.11. Mean total EVUs increased significantly (94.4 hours v. 109.8 hours, p=0.04 resulting from increased conference attendance and evaluation completion without a change in other categories. Conclusion: In a busy academic department there are many work allocation pressures. An EVU system integrated with an incentive structure to recognize faculty contributions increases the importance of educational responsibilities. We propose an EVU model that could be implemented and adjusted for differing departmental priorities at other academic departments.

  9. How many hours do you usually work? An analysis of the working hours questions in 26 large-scale surveys in 6 countries and the European Union.

    NARCIS (Netherlands)

    Dragstra, A.; Tijdens, K.

    2004-01-01

    This paper reviews how working hours are asked in 26 large-scale surveys in 6 countries plus the European Union. Four dimensions of working time were investigated, notably number of working hours, timing of work, predictability and control over hours, and commuting time. Although almost all

  10. How many hours do you usually work? An analysis of the working hours questions in 26 large-scale surveys in six countries and the European Union

    NARCIS (Netherlands)

    Tijdens, K.; Dragstra, A.

    2007-01-01

    This article reviews how working hours are asked for in 26 large-scale surveys in six countries plus the European Union. Four dimensions of working time were investigated, notably number of working hours, timing of work, predictability and control over hours, and commuting time. Although almost all

  11. Long working hours as a risk factor for atrial fibrillation

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Nyberg, Solja T.; Batty, G. David

    2017-01-01

    long hours (≤55 per week) and those working standard 35-40 h/week. Methods and results In this prospective multi-cohort study from the Individual-Participant-Data Meta-Analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years...... of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI= 1.13-1.80, P= 0......Aims Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working...

  12. 24-hour evaluation of dental plaque bacteria and halitosis after consumption of a single placebo or dental treat by dogs.

    Science.gov (United States)

    Jeusette, Isabelle C; Román, Aurora Mateo; Torre, Celina; Crusafont, Josep; Sánchez, Nuria; Sánchez, Maria C; Pérez-Salcedo, Leire; Herrera, David

    2016-06-01

    OBJECTIVE To determine whether consumption of a single dental treat with specific mechanical properties and active ingredients would provide a 24-hour effect on dental plaque bacteria and halitosis in dogs. ANIMALS 10 dogs of various breeds from a privately owned colony that had received routine dental scaling and polishing 4 weeks before the study began. PROCEDURES Dogs were randomly assigned to receive 1 placebo or dental treat first. A 4-week washout period was provided, and then dogs received the opposite treatment. Oral plaque and breath samples were collected before and 0.5, 3, 12, and 24 hours after treat consumption. Volatile sulfur compounds (VSCs) concentration was measured in breath samples. Total aerobic, total anaerobic, Porphyromonas gulae, Prevotella intermedia-like, Tannerella forsythia, and Fusobacterium nucleatum bacterial counts (measured via bacterial culture) and total live bacterial counts, total live and dead bacterial counts, and bacterial vitality (measured via quantitative real-time PCR assay) were assessed in plaque samples. RESULTS Compared with placebo treat consumption, dental treat consumption resulted in a significant decrease in breath VSCs concentration and all plaque bacterial counts, without an effect on bacterial vitality. Effects of the dental treat versus the placebo treat persisted for 12 hours for several bacterial counts and for 24 hours for breath VSCs concentration. CONCLUSIONS AND CLINICAL RELEVANCE Although clinical benefits should be investigated in larger scale, longer-term studies, results of this study suggested that feeding the evaluated dental treat may help to decrease oral bacterial growth in dogs for 12 hours and oral malodor for 24 hours. A feeding interval of 12 hours is therefore recommended.

  13. 76 FR 50359 - Hours of Service of Railroad Employees; Substantive Regulations for Train Employees Providing...

    Science.gov (United States)

    2011-08-12

    ..., with FAST requiring an effectiveness score greater than or equal to its threshold, and FAID requiring a... section 3 [49 U.S.C. 21105]) and hostlers.'' Other employees, such as food service providers or sleeping... evening that may affect one's fatigue and alertness. Because of natural circadian rhythms and...

  14. Measuring excessive hours of work, low hourly pay, and informal employment through a labour force survey a pilot survey in the Philippines

    OpenAIRE

    Mehran, Farhad

    2005-01-01

    Using 2004 data of the Philippines' labour force survey, evaluates the hours of work at all jobs, hourly pay among time-rated wage and salary workers, informal employment etc., with the aim to quantify a decent-work situation (i.e. acceptable productive employment, social protection, social dialogue, and rights at work).

  15. Out of hours ophthalmic surgery: a UK national survey.

    Science.gov (United States)

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

    2013-03-01

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

  16. Work-hour restrictions and orthopaedic resident education: a systematic review.

    Science.gov (United States)

    Mauser, Nathan S; Michelson, James D; Gissel, Hannah; Henderson, Corey; Mauffrey, Cyril

    2016-05-01

    The ACGME (US) and The European Working Time Directive (UK) placed work-hour restrictions on medical trainees with the goal of improved patient safety. However, there has been concern over a potential decrease in medical education. Orthopaedic training is the focus of this study. We examined previously published subjective and objective data regarding education and work-hour restrictions and developed the questions: Do specific perceptions emerge within the subjective studies examined? Are there objective differences in educational measures before and after work-hour restrictions? Is there a difference between the subjective and objective data? A systematic review was conducted via MedLine, regarding orthopaedic studies in the USA and UK, with reference to work-hour restrictions and education. Subjective survey studies demonstrate that residents and attending physicians have a negative response to work-hour restrictions because of the perceived impact on their overall education and operating room experience. Conversely, limited objective studies demonstrated no change in operative volume before or after implementation of restrictions. This review highlights the need for more objective studies on the educational implications of work-hour restrictions. Studies to date have not demonstrated a measurable difference based on case logs or training scores. Opinion-based surveys demonstrate an overall negative perception by both residents and attending physicians, on the impact of work-hour restrictions on orthopaedic education. Current published data is limited and stronger evidence-based data are needed before definitive conclusions can be reached.

  17. Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls.

    Science.gov (United States)

    Chin, Vivian L; Cai, Ziyong; Lam, Leslie; Shah, Bina; Zhou, Ping

    2015-03-01

    Changes in pharmacological agents and advancements in laboratory assays have changed the gonadotropin-releasing hormone analog stimulation test. To determine the best predictive model for detecting puberty in girls. Thirty-five girls, aged 2 years 7 months to 9 years 3 months, with central precocious puberty (CPP) (n=20) or premature thelarche/premature adrenarche (n=15). Diagnoses were based on clinical information, baseline hormones, bone age, and pelvic sonogram. Gonadotropins and E2 were analyzed using immunochemiluminometric assay. Logistic regression for CPP was performed. The best predictor of CPP is the E2-change model based on 3- to 24-h values, providing 80% sensitivity and 87% specificity. Three-hour luteinizing hormone (LH) provided 75% sensitivity and 87% specificity. Basal LH lowered sensitivity to 65% and specificity to 53%. The E2-change model provided the best predictive power; however, 3-h LH was more practical and convenient when evaluating puberty in girls.

  18. Evaluation of the value of availability and dispatchability in IPP contracts

    International Nuclear Information System (INIS)

    Camporeale, R.J.

    1990-01-01

    Consolidated Edison's resource plan relies on power from Independent Power Producers (IPPs) for a portion of future generation requirements. The additional restriction of obtaining this capacity through a bidding process requires the utility to evaluate a large number of potential contracts with different combinations of price, availability, and dispatchability. This paper discusses the theoretical considerations and outlines the methodology adopted for Consolidated Edison's first request for proposal. The value of an IPP contract is a function of the variable energy cost compared to the system avoided costs. For example, there is a value for availability only in those hours when contract cost is below the avoided cost and there is a penalty for non-dispatchability only in those hours when the contract cost is higher than the avoided cost. The best method to determine the value of an IPP contract would be to simulate the operation of the system with and without the IPP purchase using a perfect production cost model. In reality no model is perfect and there are trade-offs because not all aspects of system operation are captured. Performing a detailed production cost simulation for every proposal would be burdensome. Therefore, it was decided that a simplified methodology was needed. An additional benefit of a simplified approach is that the IPPs could score their own proposals and use this value as input into their final pricing scheme. The method developed relies on detailed production cost simulations to generate hourly avoided costs. A comparison of these avoided costs to the IPP variable costs becomes the basis for the calculation of the value of availability or dispatchability. This methodology can be applied consistently to all supply side resources; baseload or peaking, gas, oil or coal fired. This allows for the evaluation of all bid proposals on an equal basis

  19. SO2 8 Hour Nonattainment Areas

    Data.gov (United States)

    U.S. Environmental Protection Agency — This data layer identifies areas in the U.S. where air pollution levels have not met the National Ambient Air Quality Standards (NAAQS) for Sulfur dioxide 8 hour...

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

    Science.gov (United States)

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

    2016-07-22

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

  1. Long working hours and psychological distress among school teachers in Japan.

    Science.gov (United States)

    Bannai, Akira; Ukawa, Shigekazu; Tamakoshi, Akiko

    2015-01-01

    Long working hours have the possibility to influence human health. In Japan, it is well known that teachers have long working hours, and the number of leaves of absence due to mental disorders among public school teachers increased from 2,687 in 2002 to 4,960 in 2012. The aim of this study was to investigate the association between long working hours and psychological distress among school teachers. This cross-sectional study was conducted from mid-July to September in 2013 in Hokkaido Prefecture, Japan. Questionnaires were distributed to 1,245 teachers in public junior high schools. Information about basic characteristics, including working hours, and responses to the General Health Questionnaire-28 were collected anonymously. Multiple logistic regression analysis was used to calculate odds ratios (ORs) for the association between long working hours and psychological distress by gender. Of the 1,245 teachers contacted, 558 (44.8%) responded. After excluding responses with missing data, the final sample included 522 teachers (337 males and 185 females). Psychological distress was identified in 47.8% of males and 57.8% of females. Our results showed a significantly increased risk only in males working >60 hours per week (adjusted OR=4.71 [95% CI 2.04-11.56]) compared with those working ≤40 hours per week. There were no significant associations between long working hours and psychological distress for females. There is a significant association between long working hours and psychological distress in male teachers. However, the causal relationship remains unclear. Further studies such as cohort studies with large sample sizes are needed.

  2. Ethical aspects of limiting residents' work hours.

    Science.gov (United States)

    Wiesing, Urban

    2007-09-01

    The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. ARGUMENTS AND CONCLUSION: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over-work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians.

  3. Results of the 1000 Hour Rotary Microfilter Endurance Test

    International Nuclear Information System (INIS)

    Herman, D.

    2010-01-01

    During operation, a primary concern is lifetime of the mechanical seal. Leakage from main shaft mechanical seal is expected to be first indication of wear on rotary filter but will not be the ultimate failure of the filter. Initial clearance inadequate to support thermal expansion resulted in initial scarring of journal. Tolerances adjusted and no journal issues were found during 1000 hour test. Disassembly and inspection of the rotary joint seals showed no unusual wear. No leakage observed during test. Total operation time over 1500 hours. Test summary successfully demonstrated: (1) Filtration of a 'challenging' SRS simulant up to 15 wt % insoluble solids in a 5.6 M salt simulant; (2) Sludge washing; (3) In-situ acid cleaning with dilute acid; (4) Over 1000 hours of operation on new journal material; and (5) Over 1500 hours of operation on all seals. The filter out lasted: 2 air compressors, 2 power outages (one planned), 2 chillers, 1 fire, 1 electrical breaker and 1 feed pump seal.

  4. Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH?

    Science.gov (United States)

    Abbott, Joel E; Miller, Daniel L; Shi, William; Wenzler, David; Elkhoury, Fuad F; Patel, Nishant D; Sur, Roger L

    2017-09-01

    Accurate measurement of pH is necessary to guide medical management of nephrolithiasis. Urinary dipsticks offer a convenient method to measure pH, but prior studies have only assessed the accuracy of a single, spot dipstick. Given the known diurnal variation in pH, a single dipstick pH is unlikely to reflect the average daily urinary pH. Our goal was to determine whether multiple dipstick pH readings would be reliably comparable to pH from a 24-hour urine analysis. Kidney stone patients undergoing a 24-hour urine collection were enrolled and took images of dipsticks from their first 3 voids concurrently with the 24-hour collection. Images were sent to and read by a study investigator. The individual and mean pH from the dipsticks were compared to the 24-hour urine pH and considered to be accurate if the dipstick readings were within 0.5 of the 24-hour urine pH. The Bland-Altman test of agreement was used to further compare dipstick pH relative to 24-hour urine pH. Fifty-nine percent of patients had mean urinary pH values within 0.5 pH units of their 24-hour urine pH. Bland-Altman analysis showed a mean difference between dipstick pH and 24-hour urine pH of -0.22, with an upper limit of agreement of 1.02 (95% confidence interval [CI], 0.45-1.59) and a lower limit of agreement of -1.47 (95% CI, -2.04 to -0.90). We concluded that urinary dipstick based pH measurement lacks the precision required to guide medical management of nephrolithiasis and physicians should use 24-hour urine analysis to base their metabolic therapy.

  5. 2011 Hours against hate

    OpenAIRE

    Cátedra Intercultural. UCO

    2011-01-01

    2011 Hours Against Hate is a campaign to stop bigotry and promote respect across lines of culture, religion, tradition, class, and gender. Launched by Special Representative to Muslim Communities Farah Pandith, and Special Envoy to Monitor and Combat Anti-Semitism Hannah Rosenthal, the State Department is asking young people around the world to pledge their time to stop hate—to do something for someone who doesn’t look like you, pray like you, or live like you. We are asking the next generati...

  6. 2004 list of MAK (maximum work place concentration) and BAT (biological workplace tolerance) values; MAK- und BAT-Werte-Liste 2004

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    The MAK value (maximum workplace concentration) is the highest permissible concentration of a working material occurring in the ambient air of the workplace as a gas or vapour or in suspended form which according to the present state of knowledge does not, in general, impair the health of or pose an unreasonable molestation (for example through repulsive odour) to employees even in the case of repeated, long-term exposure, that is as a rule 8 hours daily, assuming an average working week of no more than 40 hours. As a rule, MAK values are quoted as average values over a time period of up to one working day or shift. They are primarily defined in consideration of effect characteristics of the substances in question, but also - as far as possible - of the practical conditions attending the work processes or the exposure patterns which they entail. This is done on the basis of scientifically founded criteria of health protection, not on whether providing such protection is technically or economically feasible. In addition, substances are assessed in terms of carcinogenicity, sensitising effects, any contribution to systemic toxicity following cutaneous resorption, hazards for pregnancy and germ cell mutagenicity and are classified or marked accordingly. The Commission's procedures in assessing substances with respect to these criteria are described in corresponding sections of the MAK and BAT list of values, in the ''Toxicological and occupational medical explanations of MAK values'' and in scientific journals.

  7. COLOUR AND pH VALUE OF ISTRIAN SHEEP LAMBS MEAT

    Directory of Open Access Journals (Sweden)

    Valentino Držaić

    2016-06-01

    Full Text Available The aim of the present study was to evaluate the effect of sex and slaughter weight of Istrian sheep lambs on pH value and meat colour. The study included 118 lambs of both sexes (64 male and 54 female which were, prior slaughter, divided into two groups: light (17.76 kg; 28 male and 32 female and heavy (20.17 kg; 3 male and 22 female. Carcass weight was determined immediately after carcass processing and after 24 hours, while the pH value and meat colour were determined 45 minutes and 24 hours after slaughter. Average hot and cold carcass weights in light lambs were 9.76 and 9.47 kg, and in heavy lambs 11.80 and 11.49 kg, with chilling loss of 2.96 and 2.60% respectively. Istrian sheep lambs carcasses are quite uniform in relation to sex in terms of all the investigated traits, except value of L* and a* colour parameters. For the production of larger lamb meat quantities it might be recommended to increase lambs slaughter weight since the higher slaughter weight has the positive effect on carcass weight and chilling loss while retaining the desirable values of meat quality parameters.

  8. Both semiquantitative degree of rest Tl-201 uptake and reversibility at 24 hour-delay were needed to predict wall motion improvement after bypass surgery

    International Nuclear Information System (INIS)

    Lee, D. S.; Yoon, S. N.; Kim, K. B.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    Controversy still exists about how to use the uptake at rest and 24 hour delay in rest redistribution Tl-201 SPECT to predict improvement of wall motion abnormality after bypass surgery. To find the best way to combine diagnostic efficacy of Tl-201 SPECT to predict myocardial viability, we studied the predictive values (positive: PPV, negative: NPV) of rest and 24 hour-delay Tl-201 SPECT in 21 patients. Wall motion was assessed comparing preoperative post-stress gated Tc-99m-MIBI SPECT with that of 3 months after surgery. Four point scoring system was used for 17 myocardial segments to asses uptakes ( 0 to 3 for normal to defect) at rest and 24 hour-delay and wall motion ( 0 to 3 for normal to dyskinesia). Ejection fraction improved after surgery (5011% vs 4313%). Intra-observer and inter-observer reproducibility of EF was 7 and 9% respectively when we used 3D Perfusion-Motion Map. Sixty seven segments showed wall motion abnormality before surgery. Predictive values of rest Tl-201 uptake decrease were as follows: 0: 15/15(100%), 1: 30/34(88%), 2: 6/11 (55%), 3: 3/7(43%). So PPV of mild decrease was 88%, and NPV of severe decrease was 50%. Delayed reversibility was evaluated in 37 segments (15 patients). Twenty seven segment had persistence or aggravation, but the other 10 segments improved at 24 hour delay. PPV of reversible 10 segments was 80%, and NPV of reversibility was only 46%. PPV of combination of rest Tl-201 uptake of mild degree and 24 hour reversibility was 86% (38/44) and NPV of neither one was 88%. We concluded that both semi-quantitative degree of Tl-201 uptake at rest and reversibility at 24 hour delay was the best to warrant or abandon postoperative improvement of abnormal wall motion found at preoperative post-stress gated myocardial SPECT

  9. CDC Lab Values

    Centers for Disease Control (CDC) Podcasts

    More than fifteen hundred scientists fill the lab benches at CDC, logging more than four million hours each year. CDC’s laboratories play a critical role in the agency’s ability to find, stop, and prevent disease outbreaks. This podcast provides a brief overview of what goes on inside CDC’s labs, and why this work makes a difference in American’s health.

  10. Thallium reinjection after stress-redistribution imaging. Does 24-hour delayed imaging after reinjection enhance detection of viable myocardium

    International Nuclear Information System (INIS)

    Dilsizian, V.; Smeltzer, W.R.; Freedman, N.M.; Dextras, R.; Bonow, R.O.

    1991-01-01

    Thallium reinjection immediately after conventional stress-redistribution imaging improves the detection of viable myocardium, as many myocardial regions with apparently 'irreversible' thallium defects on standard 3-4-hour redistribution images manifest enhanced thallium uptake after reinjection. Because the 10-minute period between reinjection and imaging may be too short, the present study was designed to determine whether 24-hour imaging after thallium reinjection provides additional information regarding myocardial viability beyond that obtained by imaging shortly after reinjection. We studied 50 patients with chronic stable coronary artery disease undergoing exercise thallium tomography, radionuclide angiography, and coronary arteriography. Immediately after the 3-4-hour redistribution images were obtained, 1 mCi thallium was injected at rest, and images were reacquired at 10 minutes and 24 hours after reinjection. The stress, redistribution, reinjection, and 24-hour images were then analyzed qualitatively and quantitatively. Of the 127 abnormal myocardial regions on the stress images, 55 had persistent defects on redistribution images by qualitative analysis, of which 25 (45%) demonstrated improved thallium uptake after reinjection. At the 24-hour study, 23 of the 25 regions (92%) with previously improved thallium uptake by reinjection showed no further improvement. Similarly, of the 30 regions determined to have irreversible defects after reinjection, 29 (97%) remained irreversible on 24-hour images. These findings were confirmed by the quantitative analysis. The mean normalized thallium activity in regions with enhanced thallium activity after reinjection increased from 57 +/- 13% on redistribution studies to 70 +/- 14% after reinjection but did not change at 24 hours (71 +/- 14%)

  11. A Customer’s Possibilities to Increase the Performance of a Service Provider by Adding Value and Deepening the Partnership in Facility Management Service

    Directory of Open Access Journals (Sweden)

    Sillanpää Elina

    2016-06-01

    Full Text Available Reliable and good suppliers are an important competitive advantage for a customer and that is why the development of suppliers, improvement of performance and enhancement of customership are also in the interest of the customer. The purpose of this study is to clarify a customer’s possibilities to increase the performance of a service provider and to develop the service process in FM services and thus help to improve partnership development. This research is a qualitative research. The research complements the existing generic model of supplier development towards partnership development by customer and clarifies the special features that facility management services bring to this model. The data has been gathered from interviews of customers and service providers in the facility management service sector. The result is a model of customers’ possibilities to develop the performance of service providers from the viewpoint of value addition and relationship development and in that way ensure added value to the customer and the development of a long-term relationship. The results can be beneficial to customers when they develop the cooperation between the customer and the service provider toward being more strategic and more partnership focused.

  12. With long hours of work, might depression then lurk?

    DEFF Research Database (Denmark)

    Varma, Anshu; Marott, Jacob Louis; Stoltenberg, Christian Ditlev Gabriel

    2012-01-01

    The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship.......The aim of this study was to examine depression as a potential negative health effect of long work hours, anticipating an exposure-response relationship....

  13. Mortality Pattern within Twenty-Four Hours of Emergency Paediatric ...

    African Journals Online (AJOL)

    The highest mortality within the first 24 hours of admission was recorded among patients with malaria (89.0%) followed by protein energy malnutrition. CONCLUSION: Majority of deaths among emergency paediatric admission occur within the first 24 hours of admission and are associated with clinical conditions such as ...

  14. 78 FR 74222 - Hours of Service of Drivers: Oregon Trucking Associations; Application for Exemption

    Science.gov (United States)

    2013-12-10

    ... a limited exemption from the 30-minute rest-break requirement of the Agency's hours-of-service... including the specific section of this document to which each comment applies, and provide a reason for each... decision of the Agency must be published in the Federal Register (49 CFR 381.315(b)) with the reasons for...

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    The objective of this study was to evaluate the potential of predicting the pleural fluid output in patients after video-assisted thoracoscopic lobectomy of the lung. Detailed measurements of continuous fluid output were obtained prospectively using an electronic thoracic drainage device (Thopaz...... and 48 hours. Assessment of initial fluid production may predict high 24-hour fluid output (≥500 mL) but seems to lack clinical value in drain removal criteria....

  16. Hour of Code”: Can It Change Students’ Attitudes toward Programming?

    Directory of Open Access Journals (Sweden)

    Hayden Wimmer

    2016-03-01

    Full Text Available The Hour of Code is a one-hour introduction to computer science organized by Code.org, a non-profit dedicated to expanding participation in computer science. This study investigated the impact of the Hour of Code on students’ attitudes towards computer programming and their knowledge of programming. A sample of undergraduate students from two universities was selected to participate. Participants completed an Hour of Code tutorial as part of an undergraduate course. An electronic questionnaire was implemented in a pre-survey and post-survey format to gauge the change in student attitudes toward programming and their programming ability. The findings indicated the positive impact of the Hour of Code tutorial on students’ attitude toward programming. However, the students’ programming skills did not significantly change. The authors suggest that a deeper alignment of marketing, teaching, and content would help sustain the type of initiative exemplified by the Hour of Code.

  17. 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.

  18. Payroll data based description of working hours in the Danish regions

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Johnni; Kolstad, Henrik A.

    2018-01-01

    .0%); day/night (6.6%); evening/night (0.6%); and day/evening/night (10.2%). More men (9.1%) than women (5.9%) worked day/night, whereas more women (10.9%) than men (7.4%) worked day/evening/night. More young than older employees worked day/evening/night, and fewer worked permanent day or night. From 2008...... to 2015 we observed a trend towards more employees working permanent day and fewer employees working other schedules. Altogether DWHD provides a strong tool in research on working hours....

  19. Predictive Value of Glasgow Coma Score and Full Outline of Unresponsiveness Score on the Outcome of Multiple Trauma Patients.

    Science.gov (United States)

    Baratloo, Alireza; Shokravi, Masumeh; Safari, Saeed; Aziz, Awat Kamal

    2016-03-01

    The Full Outline of Unresponsiveness (FOUR) score was developed to compensate for the limitations of Glasgow coma score (GCS) in recent years. This study aimed to assess the predictive value of GCS and FOUR score on the outcome of multiple trauma patients admitted to the emergency department. The present prospective cross-sectional study was conducted on multiple trauma patients admitted to the emergency department. GCS and FOUR scores were evaluated at the time of admission and at the sixth and twelfth hours after admission. Then the receiver operating characteristic (ROC) curve, sensitivity, specificity, as well as positive and negative predictive value of GCS and FOUR score were evaluated to predict patients' outcome. Patients' outcome was divided into discharge with and without a medical injury (motor deficit, coma or death). Finally, 89 patients were studied. Sensitivity and specificity of GCS in predicting adverse outcome (motor deficit, coma or death) were 84.2% and 88.6% at the time of admission, 89.5% and 95.4% at the sixth hour and 89.5% and 91.5% at the twelfth hour, respectively. These values for the FOUR score were 86.9% and 88.4% at the time of admission, 89.5% and 100% at the sixth hour and 89.5% and 94.4% at the twelfth hour, respectively. Findings of this study indicate that the predictive value of FOUR score and GCS on the outcome of multiple trauma patients admitted to the emergency department is similar.

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

    Science.gov (United States)

    Johnson, Jeffrey V; Lipscomb, Jane

    2006-11-01

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

  1. 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.

  2. Valuing future citizens' values regarding risk

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, Patricia [Creighton Univ., Omaha (United States). College of Arts and Sciences/Philosophy

    2006-09-15

    Valuing present citizen's values regarding the risks they face is an important aspect of risk assessment and risk acceptability. Conferences like VALDOR are held for this reason. Governments like Sweden have national referendums on various risk-prone enterprises. The results of these referendums can determine the future of these programs. In the United States, when guidelines are set for determining acceptable levels of risk, the relevant federal agencies are often required to provide a comment period regarding proposed guidelines in order to ascertain the judgments, including the weights place on certain values, of individual members of society as well as stakeholder groups. After the comment period ends, the agency decides on the acceptable level of risk, taking into account the comments from present citizens. Do we also have a duty to value the not-yet-existing values of future citizens, especially if the risks created by the activities of present citizens extend into the future to citizens not yet living? If so, are there any circumstances which entitle us to de-value those not-yet-existing values. In this paper, I ground my discussion of the question of valuing future citizens' values in one of the areas of focus of the VALDOR conference: nuclear waste management and specifically the question facing the United States' program regarding an acceptable dose standard associated with the release of radioactivity into the biosphere from an underground repository. The underlying conference theme to which this discussion may be attached is community environmental justice as it applies to future citizens. I focus on the role that uncertainty plays is providing justice between present and future citizens.

  3. Working hours and common mental disorders in English police officers

    OpenAIRE

    Houdmont, Jonathan; Randall, Raymond

    2016-01-01

    Background: There is a paucity of evidence on working hours and their psychological correlates in police officers of the federated ranks in England.\\ud Aims: 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).\\ud Methods: Officers of the federated ranks (constable, sergeant, inspector) from two English county forces completed a questionnaire to report their ...

  4. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  5. Analysis of the distributions of hourly NO2 concentrations contributing to annual average NO2 concentrations across the European monitoring network between 2000 and 2014

    Directory of Open Access Journals (Sweden)

    C. S. Malley

    2018-03-01

    Full Text Available Exposure to nitrogen dioxide (NO2 is associated with negative human health effects, both for short-term peak concentrations and from long-term exposure to a wider range of NO2 concentrations. For the latter, the European Union has established an air quality limit value of 40 µg m−3 as an annual average. However, factors such as proximity and strength of local emissions, atmospheric chemistry, and meteorological conditions mean that there is substantial variation in the hourly NO2 concentrations contributing to an annual average concentration. The aim of this analysis was to quantify the nature of this variation at thousands of monitoring sites across Europe through the calculation of a standard set of chemical climatology statistics. Specifically, at each monitoring site that satisfied data capture criteria for inclusion in this analysis, annual NO2 concentrations, as well as the percentage contribution from each month, hour of the day, and hourly NO2 concentrations divided into 5 µg m−3 bins were calculated. Across Europe, 2010–2014 average annual NO2 concentrations (NO2AA exceeded the annual NO2 limit value at 8 % of > 2500 monitoring sites. The application of this chemical climatology approach showed that sites with distinct monthly, hour of day, and hourly NO2 concentration bin contributions to NO2AA were not grouped into specific regions of Europe, furthermore, within relatively small geographic regions there were sites with similar NO2AA, but with differences in these contributions. Specifically, at sites with highest NO2AA, there were generally similar contributions from across the year, but there were also differences in the contribution of peak vs. moderate hourly NO2 concentrations to NO2AA, and from different hours across the day. Trends between 2000 and 2014 for 259 sites indicate that, in general, the contribution to NO2AA from winter months has increased, as has the contribution from the rush-hour periods of

  6. Analysis of the distributions of hourly NO2 concentrations contributing to annual average NO2 concentrations across the European monitoring network between 2000 and 2014

    Science.gov (United States)

    Malley, Christopher S.; von Schneidemesser, Erika; Moller, Sarah; Braban, Christine F.; Hicks, W. Kevin; Heal, Mathew R.

    2018-03-01

    Exposure to nitrogen dioxide (NO2) is associated with negative human health effects, both for short-term peak concentrations and from long-term exposure to a wider range of NO2 concentrations. For the latter, the European Union has established an air quality limit value of 40 µg m-3 as an annual average. However, factors such as proximity and strength of local emissions, atmospheric chemistry, and meteorological conditions mean that there is substantial variation in the hourly NO2 concentrations contributing to an annual average concentration. The aim of this analysis was to quantify the nature of this variation at thousands of monitoring sites across Europe through the calculation of a standard set of chemical climatology statistics. Specifically, at each monitoring site that satisfied data capture criteria for inclusion in this analysis, annual NO2 concentrations, as well as the percentage contribution from each month, hour of the day, and hourly NO2 concentrations divided into 5 µg m-3 bins were calculated. Across Europe, 2010-2014 average annual NO2 concentrations (NO2AA) exceeded the annual NO2 limit value at 8 % of > 2500 monitoring sites. The application of this chemical climatology approach showed that sites with distinct monthly, hour of day, and hourly NO2 concentration bin contributions to NO2AA were not grouped into specific regions of Europe, furthermore, within relatively small geographic regions there were sites with similar NO2AA, but with differences in these contributions. Specifically, at sites with highest NO2AA, there were generally similar contributions from across the year, but there were also differences in the contribution of peak vs. moderate hourly NO2 concentrations to NO2AA, and from different hours across the day. Trends between 2000 and 2014 for 259 sites indicate that, in general, the contribution to NO2AA from winter months has increased, as has the contribution from the rush-hour periods of the day, while the contribution from

  7. Glycemic Index values of some Jaffna fruits

    Directory of Open Access Journals (Sweden)

    Selladurai Pirasath

    2012-02-01

    Full Text Available Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI values of fruits such as ‘Kathali’ (Yellow plantain, ‘Kappal’ (Golden plantain, and ‘Itharai’ (Green plantain varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public to decide the benefits ofthe consumption of fruits, particularly by diabetic and coronary heart disease patients.Methods: Healthy volunteers (20 Nos. of 21.05(±0.92 years, 53.90 (±9.36 kg body weights, 153.92 (±9.15 m heights, and 20.55 (±2.22 kgm-2body mass indexes were selected with their written consent. After overnight fasting, 75g glucose and each test fruit containing 75g digestible carbohydrate were administered at different instances and blood glucose levels were measured half hourly for two hours. The glycemic response and GI values were calculated and analyzed by Randomized Complete Block Design using SAS analytical package.Results: The mean GI values of the ‘Kathali’, ‘Kappal’, ‘Itharai’ varieties of plantains, jack fruit and papaya were 54.45 (±9.26, 50.43 (±5.79, 48.47 (±10.13, 65.36 (±8.00 and 34.80 (±12.78 % respectively. The GI value of papaya differed significantly (P<0.05 from other fruits. The GI value of ‘Itharai’ variety of plantain differed significantly (P<0.05 from other fruits except the ‘Kappal’ varietyof plantain.Conclusion: The three varieties of plantains and papaya were low GI fruits, and jack fruit was found to be an intermediate GI fruit. The presence of dietary fiber, esp. soluble fiber, reduces the glycemicresponse and glycemic index of foods.

  8. Duty hours and incidents in flight among commercial airline pilots.

    Science.gov (United States)

    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.

  9. An approach for generating synthetic fine temporal resolution solar radiation time series from hourly gridded datasets

    Directory of Open Access Journals (Sweden)

    Matthew Perry

    2017-06-01

    Full Text Available A tool has been developed to statistically increase the temporal resolution of solar irradiance time series. Fine temporal resolution time series are an important input into the planning process for solar power plants, and lead to increased understanding of the likely short-term variability of solar energy. The approach makes use of the spatial variability of hourly gridded datasets around a location of interest to make inferences about the temporal variability within the hour. The unique characteristics of solar irradiance data are modelled by classifying each hour into a typical weather situation. Low variability situations are modelled using an autoregressive process which is applied to ramps of clear-sky index. High variability situations are modelled as a transition between states of clear sky conditions and different levels of cloud opacity. The methods have been calibrated to Australian conditions using 1 min data from four ground stations for a 10 year period. These stations, together with an independent dataset, have also been used to verify the quality of the results using a number of relevant metrics. The results show that the method generates realistic fine resolution synthetic time series. The synthetic time series correlate well with observed data on monthly and annual timescales as they are constrained to the nearest grid-point value on each hour. The probability distributions of the synthetic and observed global irradiance data are similar, with Kolmogorov-Smirnov test statistic less than 0.04 at each station. The tool could be useful for the estimation of solar power output for integration studies.

  10. A COMPREHENSIVE STUDY OF HOURLY AND DAILY SEWAGE FLOW RATES IN FLORIDA PUBLIC SCHOOLS.

    Science.gov (United States)

    FOGARTY, WILLIAM J.; REEDER, MILTON E.

    A DETERMINATION OF THE HOURLY AND DAILY SEWAGE FLOW RATES IN FLORIDA PUBLIC SCHOOLS WAS MADE TO IDENTIFY THE FLOW CHARACTERISTICS AND TO PROVIDE A MORE PRECISE BASIS FOR THE ESTABLISHMENT OF DESIGN CRITERIA FOR SEWAGE DISPOSAL FACILITIES IN SCHOOLS. WATER FLOW DATA WAS COLLECTED FOR 158 SCHOOLS AND SEWAGE FLOW DATA FROM 42 SCHOOLS. THE FINDINGS…

  11. Working hours and economic performance : What are the lessons of the Coe-Rexecode report?

    OpenAIRE

    Heyer, Eric; Plane, Mathieu

    2012-01-01

    Do people work less in France than in the rest of Europe? Is France the only country to have reduced working time in the last decade? Is the 35-hour work week really dragging down the French economy? The report published on 11 January by the Coe-Rexecode Institute provides fresh material for answering these questions (...).

  12. Organizational interventions in response to duty hour reforms.

    Science.gov (United States)

    Law, Madelyn P; Orlando, Elaina; Baker, G Ross

    2014-01-01

    Changes in resident duty hours in Europe and North America have had a major impact on the internal organizational dynamics of health care organizations. This paper examines, and assesses the impact of, organizational interventions that were a direct response to these duty hour reforms. The academic literature was searched through the SCOPUS database using the search terms "resident duty hours" and "European Working Time Directive," together with terms related to organizational factors. The search was limited to English-language literature published between January 2003 and January 2012. Studies were included if they reported an organizational intervention and measured an organizational outcome. Twenty-five articles were included from the United States (n=18), the United Kingdom (n=5), Hong Kong (n=1), and Australia (n=1). They all described single-site projects; the majority used post-intervention surveys (n=15) and audit techniques (n=4). The studies assessed organizational measures, including relationships among staff, work satisfaction, continuity of care, workflow, compliance, workload, and cost. Interventions included using new technologies to improve handovers and communications, changing staff mixes, and introducing new shift structures, all of which had varying effects on the organizational measures listed previously. Little research has assessed the organizational impact of duty hour reforms; however, the literature reviewed demonstrates that many organizations are using new technologies, new personnel, and revised and innovative shift structures to compensate for reduced resident coverage and to decrease the risk of limited continuity of care. Future research in this area should focus on both micro (e.g., use of technology, shift changes, staff mix) and macro (e.g., culture, leadership support) organizational aspects to aid in our understanding of how best to respond to these duty hour reforms.

  13. Factors associated with variation in urgency of primary out-of-hours contacts in the Netherlands: a cross-sectional study.

    NARCIS (Netherlands)

    Zwaanswijk, M.; Nielen, M.M.J.; Hek, K.; Verheij, R.A.

    2015-01-01

    Objectives: Dutch primary out-of-hours care is provided by general practice cooperatives (GPCs). Although most GPCs use the same standardised triage system, differences between GPCs exist in the urgency assigned to patients’ health problems. This crosssectional study aims to provide insight into

  14. Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to the elderly.

    Science.gov (United States)

    Hollander, Marcus J; Liu, Guiping; Chappell, Neena L

    2009-01-01

    Canadians provide significant amounts of unpaid care to elderly family members and friends with long-term health problems. While some information is available on the nature of the tasks unpaid caregivers perform, and the amounts of time they spend on these tasks, the contribution of unpaid caregivers is often hidden. (It is recognized that some caregiving may be for short periods of time or may entail matters better described as "help" or "assistance," such as providing transportation. However, we use caregiving to cover the full range of unpaid care provided from some basic help to personal care.) Aggregate estimates of the market costs to replace the unpaid care provided are important to governments for policy development as they provide a means to situate the contributions of unpaid caregivers within Canada's healthcare system. The purpose of this study was to obtain an assessment of the imputed costs of replacing the unpaid care provided by Canadians to the elderly. (Imputed costs is used to refer to costs that would be incurred if the care provided by an unpaid caregiver was, instead, provided by a paid caregiver, on a direct hour-for-hour substitution basis.) The economic value of unpaid care as understood in this study is defined as the cost to replace the services provided by unpaid caregivers at rates for paid care providers.

  15. Exploring the value of peer feedback in online learning for the provider

    NARCIS (Netherlands)

    Marijke Kral; Gino Camp; Esther van Popta; Robert Jan Simons; Rob L. Martens

    2017-01-01

    This paper reviews studies of peer feedback from the novel perspective of the providers of that feedback. The possible learning benefits of providing peer feedback in online learning have not been extensively studied. The goal of this study was therefore to explore the process of providing online

  16. General practitioners' satisfaction with and attitudes to out-of-hours services

    Directory of Open Access Journals (Sweden)

    Wesseling Geertjan

    2005-03-01

    Full Text Available Abstract Background In recent years, Dutch general practitioner (GP out-of-hours service has been reorganised into large-scale GP cooperatives. Until now little is known about GPs' experiences with working at these cooperatives for out-of-hours care. The purpose of this study is to gain insight into GPs' satisfaction with working at GP cooperatives for out-of-hours care in separated and integrated cooperatives. Methods A GP cooperative separate from the hospital Accident and Emergency (A&E department, and a GP cooperative integrated within the A&E department of another hospital. Both cooperatives are situated in adjacent geographic regions in the South of the Netherlands. One hundred GPs were interviewed by telephone; fifty GPs working at the separated GP cooperative and fifty GPs from the integrated GP cooperative. Opinions on different aspects of GP cooperatives for out-of-hours care were measured, and regression analysis was performed to investigate if these could be related to GP satisfaction with out-of-hours care organisation. Results GPs from the separated model were more satisfied with the organisation of out-of-hours care than GPs from the integrated model (70 vs. 60 on a scale score from 0 to 100; P = 0.020. Satisfaction about out-of-hours care organisation was related to opinions on workload, guarantee of gatekeeper function, and attitude towards out-of-hours care as being an essential part of general practice. Cooperation with medical specialists was much more appreciated at the integrated model (77 vs. 48; P Conclusion GPs in this study appear to be generally satisfied with the organisation of GP cooperatives for out-of-hours care. Furthermore, GPs working at the separated cooperative seem to be more satisfied compared to GPs working at the integrated cooperative.

  17. Long-chain omega-3 from low-trophic-level fish provides value to farmed seafood.

    Science.gov (United States)

    Bibus, Douglas M

    2015-03-01

    Low-trophic-level fish are a crucial source of long-chain (LC) omega-3 fatty acids for farmed fish and humans. Many farm-raised fish species have a clear need for these nutrients. Farmed fish deposit the LC omega-3s in their flesh and transfer them up the food chain. However, the content of LC omega-3s in farm-raised seafood continues to decline, while the content of shorter-chain plant-sourced omega-3s, and pro-inflammtory omega-6s continue to increase. This reduces its nutritional worth. The value of low-trophic-level fish is often viewed merely as its price at the dock. Some reports and metrics steer public attention towards the mass balance between quantities of low-trophic-level fish and farmed seafood. However, the the nutritional value of seafood is more important than its mere quantities. The role of low-trophic-level fish in human nutrition, health, and wellbeing is a fundamental component of its economic value to society.

  18. Childhood fever: a qualitative study on parents' expectations and experiences during general practice out-of-hours care consultations.

    Science.gov (United States)

    de Bont, Eefje G P M; Loonen, Nicole; Hendrix, Dagmar A S; Lepot, Julie M M; Dinant, Geert-Jan; Cals, Jochen W L

    2015-10-07

    Fever in children is common and mostly caused by benign self-limiting infections. Yet consultation rates in primary care are high, especially during GP out-of-hours care. Therefore, we aimed to explore experiences of parents when having visited GP out-of-hours services with their febrile child. We performed a qualitative study using 20 semi-structured interviews among parents from different backgrounds presenting to GP out-of-hours care with a febrile child rationality and emotion, (3) expecting reassurance from a professional and (4) a need for consistent, reliable information. Not one symptom, but a combination of fever with other symptoms, made parents anxious and drove care seeking. Although parents carefully considered when to seek care, they experienced increased anxiety with increases in their child's temperature. Because parents work during the day and fever typically rises during the early evening, the decision to seek care was often made during out-of-hours care. When parents consulted a GP they did not have any set expectations other than seeking reassurance, however a proper physical examination diminished their anxiety. Parents did not demand antibiotics, but trusted on the expertise of the GP to assess necessity. Parents requested consistent, reliable information on fever and self-management strategies. Parents were inexperienced in self-management strategies and had a subsequent desire for reassurance; this played a pivotal role in out-of-hours help seeking for childhood fever. These factors provide clues to optimise information exchange between GPs and parents, by providing written, tailored, consistent information on self-management strategies for current and future fever episodes. GPs' had incorrect assumptions that parents expected antibiotic treatment.

  19. [Organization of socially acceptable working hours in nursing].

    Science.gov (United States)

    Büssing, A; Glaser, J

    1994-05-01

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

  20. Hourly metering for everybody. Benefits, regulations and economy; Timmaetning foer alla. Nytta, regelverk och ekonomi

    Energy Technology Data Exchange (ETDEWEB)

    Badano, Andrea; Fritz, Peter; Goeransson, Anders; Linden, Magnus

    2007-12-15

    Today extensive investments in new modern electricity meters (AMR systems) are taking place in Sweden. The main reason for these investments is the new requirements on monthly meter readings, but these systems can generally do a lot more. Other Market Design projects have identified the need for more demand response in the electricity market and the important role of hourly settlement instead of profiling. With present rules and regulation there is an obvious risk that the new AMR technology will not be used to its full socio-economical potential. A survey made in this study implies that 90 % of the meters in which grid companies are investing today, make it possible to both register and store hourly meter values. A considerably lower share of the new systems will fully meet the demands of hourly settlement. Hourly settlement is both individually and collectively an advantage for the customer. Better tariffs and means of control should lead to a more cost-effective power system and in the long term also give lower electricity prices and higher security of supply. Customers can be well paid when decreasing electricity consumption when electricity price is high. Better statistics and follow-up will also lead to lower electricity consumption. Consequently, customers can make great use of hourly meter readings and management at hour-based level. At the same time, care must be taken how these possibilities are presented for the customers. They must be given information which is brought into line with each costumer's individual needs as far as possible. For power suppliers, hourly settlement would mean possibilities to offer new attractive tariffs to customers. It would give customers opportunities to reduce their electricity consumption and at the same time reduce risk exposure for the power supplier. With the power supplier and the customer having this knowledge about his electricity consumption, the power supplier is able to develop new services such as helping