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Sample records for resident duty work-hours

  1. 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.

  2. Canadian Plastic Surgery Resident Work Hour Restrictions: Practices and Perceptions of Residents and Program Directors.

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    McInnes, Colin W; Vorstenbosch, Joshua; Chard, Ryan; Logsetty, Sarvesh; Buchel, Edward W; Islur, Avinash

    2018-02-01

    The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety. An anonymous online survey developed by the authors was sent to all Canadian plastic surgery residents and program directors. Basic summary statistics were calculated. Eighty (53%) residents and 10 (77%) program directors responded. Residents reported working an average of 73 hours in hospital per week with 8 call shifts per month and sleep 4.7 hours/night while on call. Most residents (88%) reported averaging 0 post-call days off per month and 61% will work post-call without any sleep. The majority want the option of working post-call (63%) and oppose an 80-hour weekly maximum (77%). Surgical and medical errors attributed to post-call fatigue were self-reported by 26% and 49% of residents, respectively. Residents and program directors expressed concern about the ability to master surgical skills without working post-call. The majority of respondents oppose duty hour restrictions. The reason is likely multifactorial, including the desire of residents to meet perceived expectations and to master their surgical skills while supervised. If duty hour restrictions are aggressively implemented, many respondents feel that an increased duration of training may be necessary.

  3. Surgical resident working hours in South Africa | Kong | South ...

    African Journals Online (AJOL)

    Background: Surgical training has undergone major changes worldwide, especially with regard to work hour regulations. Very little is known regarding the situation in South Africa, and how it compares with other countries. Method: We conducted a retrospective review of the hours worked by surgical residents in a major ...

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

    Science.gov (United States)

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

    2006-10-17

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

  5. 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.

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

    Romanchuk, Ken

    2004-05-01

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

  8. Surgical resident learning styles have changed with work hours.

    Science.gov (United States)

    Quillin, Ralph C; Cortez, Alexander R; Pritts, Timothy A; Hanseman, Dennis J; Edwards, Michael J; Davis, Bradley R

    2016-01-01

    The Accreditation Council for Graduate Medical Education instituted the 80-h workweek for residency programs in 2003. This presented a unique challenge for surgery residents who must acquire a medical and technical knowledge base during training. Therefore, learning should be delivered in an environment congruent with an individual's learning style. In this study, we evaluated the learning styles of general surgery residents to determine how learning styles changed after the implementation to the 80-h workweek. Kolb learning style inventory was taken by general surgery residents at the University of Cincinnati's Department of Surgery, and results from 1999-2012 were analyzed. Statistical analysis was performed using the chi-squared, logistic regression and Wilcoxon rank-sum test. Significance was defined as a P value of learning styles after the institution of the 80-h workweek to converging (43.9%) and accommodating (40.4%, P learning. This change paralleled the transition to a more team-based approach to patient care with the implementation of the 80-h workweek. These findings are important for surgical educators to consider in the development of surgical resident curriculum. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2015-05-01

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

  10. 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

    Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine’s report, entitled “Resident duty hours: Enhancing sleep, supervision and safety”, published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation’s teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release

  11. Business process improvement: an electronic system to monitor compliance with medical resident work hours.

    Science.gov (United States)

    Landesman, Linda Young; Markowitz, Forest; Conde, Nelson

    2010-01-01

    The limitation of medical intern and resident work hours, known as the Bell 405 regulations, was initiated in New York State in 1989 with a modification to the state hospital code. The Bell 405 regulations were strengthened in 2000, and facilities would now be fined for noncompliance. Monitoring systems in place at that time were insufficient to provide an adequate level of review for the New York City Health and Hospitals Corporation (HHC) with more than 7,000 medical residents whose training is based at or who rotate through these public hospitals. A "simple to use," yet comprehensive, method of monitoring compliance needed to be developed to ensure that residents and interns complied with laws regulating working hours. The subsequent development of national accreditation standards increased the stakes for reliable scrutiny. HHC developed and implemented a Web-based Structured Query Language (SQL) application that facilitated easy access to work hour surveys captured through electronic time sheets. The time sheet data automatically entered a database that provided instant analysis of conformance to state law. The development of an electronic on-line application accessible from anywhere allowed HHC to efficiently identify nonconformance and pinpoint corrective action. Since the inception of the application and its expansion allowing access through the intranet, 26,000 individual time sheets have been submitted for evaluation. With the national movement regulating work hours, other hospitals still at the pencil and manual computation stage would greatly benefit by developing a similar application.

  12. US public opinion regarding proposed limits on resident physician work hours.

    Science.gov (United States)

    Blum, Alexander B; Raiszadeh, Farbod; Shea, Sandra; Mermin, David; Lurie, Peter; Landrigan, Christopher P; Czeisler, Charles A

    2010-06-01

    In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue. We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations. Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with > or =5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor. The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.

  13. US public opinion regarding proposed limits on resident physician work hours

    Directory of Open Access Journals (Sweden)

    Lurie Peter

    2010-06-01

    Full Text Available Abstract Background In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue. Methods We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations. Results Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h and 58.3-h work weeks (95% CI 57.3 to 59.3 h. They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h, with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%. A total of 81% (95% CI 79% to 84% believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71% favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with ≥5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83% would then want a different doctor. Conclusions The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.

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

    Directory of Open Access Journals (Sweden)

    Blum AB

    2011-06-01

    Full Text Available Alexander B Blum1, Sandra Shea2, Charles A Czeisler3,4, Christopher P Landrigan3-5, Lucian Leape61Department of Health and Evidence Policy, Mount Sinai School of Medicine, New York, NY, USA; 2Committee of Interns and Residents, SEIU Healthcare Division, Service Employees International Union, New York, NY, USA; 3Harvard Work Hours, Health and Safety Group, Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; 4Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; 5Division of General Pediatrics, Department of Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA; 6Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USAAbstract: Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine.

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

    Science.gov (United States)

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

    2012-07-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  17. Improving education under work-hour restrictions: comparing learning and teaching preferences of faculty, residents, and students.

    Science.gov (United States)

    Jack, Megan C; Kenkare, Sonya B; Saville, Benjamin R; Beidler, Stephanie K; Saba, Sam C; West, Alisha N; Hanemann, Michael S; van Aalst, John A

    2010-01-01

    Faced with work-hour restrictions, educators are mandated to improve the efficiency of resident and medical student education. Few studies have assessed learning styles in medicine; none have compared teaching and learning preferences. Validated tools exist to study these deficiencies. Kolb describes 4 learning styles: converging (practical), diverging (imaginative), assimilating (inductive), and accommodating (active). Grasha Teaching Styles are categorized into "clusters": 1 (teacher-centered, knowledge acquisition), 2 (teacher-centered, role modeling), 3 (student-centered, problem-solving), and 4 (student-centered, facilitative). Kolb's Learning Style Inventory (HayGroup, Philadelphia, Pennsylvania) and Grasha-Riechmann's TSS were administered to surgical faculty (n = 61), residents (n = 96), and medical students (n = 183) at a tertiary academic medical center, after informed consent was obtained (IRB # 06-0612). Statistical analysis was performed using χ(2) and Fisher exact tests. Surgical residents preferred active learning (p = 0.053), whereas faculty preferred reflective learning (p teaching preferences, although both groups preferred student-centered, facilitative teaching, faculty preferred teacher-centered, role-modeling instruction (p = 0.02) more often. Residents had no dominant teaching style more often than surgical faculty (p = 0.01). Medical students preferred converging learning (42%) and cluster 4 teaching (35%). Statistical significance was unchanged when corrected for gender, resident training level, and subspecialization. Significant differences exist between faculty and residents in both learning and teaching preferences; this finding suggests inefficiency in resident education, as previous research suggests that learning styles parallel teaching styles. Absence of a predominant teaching style in residents suggests these individuals are learning to be teachers. The adaptation of faculty teaching methods to account for variations in resident

  18. Resident work hour restrictions do not improve patient safety in surgery: a critical appraisal based on 7 years of experience in Switzerland

    OpenAIRE

    Businger, Adrian P; Laffer, Urban; Kaderli, Reto

    2012-01-01

    Abstract In 2005 the Swiss government implemented new work-hour limitations for all residency programs in Switzerland, including a 50-hour weekly limit. The reduction in the working hours of doctors in training implicate an increase in their rest time and suggest an amelioration of doctors' clinical performance and consequently in patients' outcomes and safety - which was not detectable in a preliminary study at a large referral center in Switzerland. It remains elusive why work-hour restrict...

  19. Resident work hour restrictions do not improve patient safety in surgery: a critical appraisal based on 7 years of experience in Switzerland

    Directory of Open Access Journals (Sweden)

    Businger Adrian P

    2012-07-01

    Full Text Available Abstract In 2005 the Swiss government implemented new work-hour limitations for all residency programs in Switzerland, including a 50-hour weekly limit. The reduction in the working hours of doctors in training implicate an increase in their rest time and suggest an amelioration of doctors' clinical performance and consequently in patients' outcomes and safety - which was not detectable in a preliminary study at a large referral center in Switzerland. It remains elusive why work-hour restrictions did not improve patient safety. We are well advised to thoroughly examine and eliminate the known adverse effects of reduced work-hours to improve our patients' safety.

  20. Improvement of resident perceptions of nurse practitioners after the introduction of a collaborative care model: a benefit of work hour reform?

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    Bellini, Lisa M; Shea, Judy A

    2006-01-01

    Nurse practitioners (NPs) are assuming larger roles in many residency programs as a result of work hour reform, which is creating the potential for collaboration with interns and residents. To assess housestaff perceptions of NPs. We used a 17-item survey before and after the implementation of a collaborative care model in a university-based medicine residency. The majority of residents held favorable attitudes about NPs before the introduction of the collaborative care model. After 1 year, more interns and residents appreciated NPs' clinical judgment (effect size [ES] = .26, p =.02), thought they should be able to order laboratory tests (ES = .23, p = .05) and perform basic procedures (ES = .67, p collaborative care can be an unintended consequence of work hour reform. Educators are encouraged to think about how changes in the curriculum structure can provide opportunities for positive collaborative care experiences.

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

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

    2016-09-01

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

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

    Science.gov (United States)

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

    2015-03-25

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

  3. 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....

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

    Science.gov (United States)

    Brooks, Joanna Veazey; Bosk, Charles L.

    2012-01-01

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

  5. Long Working Hours and Cognitive Function

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

    2009-01-01

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

  6. Long working hours and cancer risk

    DEFF Research Database (Denmark)

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

    2016-01-01

    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......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...... 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...

  7. 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...

  8. 10 CFR 26.205 - Work hours.

    Science.gov (United States)

    2010-01-01

    ..., training, or pre-shift briefings for special evolutions; and holdovers for interviews needed for event... of this subpart, a break is defined as an interval of time that falls between successive work periods... shall— (1) Review the actual work hours and performance of individuals who are subject to this section...

  9. 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...... obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. RESULTS: Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine...

  10. 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...... obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. RESULTS: Cross sectional analysis was based on 61 studies representing 333,693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100,602 participants from nine...

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

    Science.gov (United States)

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

    2014-12-10

    In 2011, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hour requirements beyond those established in 2003, leading to concerns about the effects on patient care and resident training. To determine if the 2011 ACGME duty hour reform was associated with a change in general surgery patient outcomes or in resident examination performance. Quasi-experimental study of general surgery patient outcomes 2 years before (academic years 2009-2010) and after (academic years 2012-2013) the 2011 duty hour reform. Teaching and nonteaching hospitals were compared using a difference-in-differences approach adjusted for procedural mix, patient comorbidities, and time trends. Teaching hospitals were defined based on the proportion of cases at which residents were present intraoperatively. Patients were those undergoing surgery at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). General surgery resident performance on the annual in-training, written board, and oral board examinations was assessed for this same period. National implementation of revised resident duty hour requirements on July 1, 2011, in all ACGME accredited residency programs. Primary outcome was a composite of death or serious morbidity; secondary outcomes were other postoperative complications and resident examination performance. In the main analysis, 204,641 patients were identified from 23 teaching (n = 102,525) and 31 nonteaching (n = 102,116) hospitals. The unadjusted rate of death or serious morbidity improved during the study period in both teaching (11.6% [95% CI, 11.3%-12.0%] to 9.4% [95% CI, 9.1%-9.8%], P general surgery patient outcomes or differences in resident examination performance. The implications of these findings should be considered when evaluating the merit of the 2011 ACGME duty hour reform and revising related policies in the future.

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

    Science.gov (United States)

    Smith, Aaron; Braden, Lauren; Wan, Jim; Sebelik, Merry

    2017-06-01

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

  13. Decreased Parasympathetic Activity of Heart Rate Variability During Anticipation of Night Duty in Anesthesiology Residents.

    Science.gov (United States)

    Wang, Man-Ling; Lin, Pei-Lin; Huang, Chi-Hsiang; Huang, Hui-Hsun

    2018-03-01

    In residency programs, it is well known that autonomic regulation is influenced by night duty due to workload stress and sleep deprivation. A less investigated question is the impact on the autonomic nervous system of residents before or when anticipating a night duty shift. In this study, heart rate variability (HRV) was evaluated as a measure of autonomic nervous system regulation. Eight residents in the Department of Anesthesiology were recruited, and 5 minutes of electrocardiography were recorded under 3 different conditions: (1) the morning of a regular work day (baseline); (2) the morning before a night duty shift (anticipating the night duty); and (3) the morning after a night duty shift. HRV parameters in the time and frequency domains were calculated. Repeated measures analysis of variance was performed to compare the HRV parameters among the 3 conditions. There was a significant decrease of parasympathetic-related HRV measurements (high-frequency power and root mean square of the standard deviation of R-R intervals) in the morning before night duty compared with the regular work day. The mean difference of high-frequency power between the 2 groups was 80.2 ms (95% confidence interval, 14.5-146) and that of root mean square of the standard deviation of R-R intervals was 26 milliseconds (95% confidence interval, 7.2-44.8), with P = .016 and .007, respectively. These results suggest that the decrease of parasympathetic activity is associated with stress related to the condition of anticipating the night duty work. On the other hand, the HRV parameters in the morning after duty were not different from the regular workday. The stress of anticipating the night duty work may affect regulation of the autonomic nervous system, mainly manifested as a decrease in parasympathetic activity. The effect of this change on the health of medical personnel deserves our concern.

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

    Science.gov (United States)

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

    2018-03-01

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

  15. A Systematic Review of the Effects of Resident Duty Hour Restrictions in Surgery

    Science.gov (United States)

    Devitt, Katharine S.; Keshet, Itay; Spicer, Jonathan; Imrie, Kevin; Feldman, Liane; Cools-Lartigue, Jonathan; Kayssi, Ahmed; Lipsman, Nir; Elmi, Maryam; Kulkarni, Abhaya V.; Parshuram, Chris; Mainprize, Todd; Warren, Richard J.; Fata, Paola; Gorman, M. Sean; Feinberg, Stan; Rutka, James

    2014-01-01

    Background: In 2003, the Accreditation Council for Graduate Medical Education (ACGME) mandated 80-hour resident duty limits. In 2011 the ACGME mandated 16-hour duty maximums for PGY1 (post graduate year) residents. The stated goals were to improve patient safety, resident well-being, and education. A systematic review and meta-analysis were performed to evaluate the impact of resident duty hours (RDH) on clinical and educational outcomes in surgery. Methods: A systematic review (1980–2013) was executed on CINAHL, Cochrane Database, Embase, Medline, and Scopus. Quality of articles was assessed using the GRADE guidelines. Sixteen-hour shifts and night float systems were analyzed separately. Articles that examined mortality data were combined in a random-effects meta-analysis to evaluate the impact of RDH on patient mortality. Results: A total of 135 articles met the inclusion criteria. Among these, 42% (N = 57) were considered moderate-high quality. There was no overall improvement in patient outcomes as a result of RDH; however, some studies suggest increased complication rates in high-acuity patients. There was no improvement in education related to RDH restrictions, and performance on certification examinations has declined in some specialties. Survey studies revealed a perception of worsened education and patient safety. There were improvements in resident wellness after the 80-hour workweek, but there was little improvement or negative effects on wellness after 16-hour duty maximums were implemented. Conclusions: Recent RDH changes are not consistently associated with improvements in resident well-being, and have negative impacts on patient outcomes and performance on certification examinations. Greater flexibility to accommodate resident training needs is required. Further erosion of training time should be considered with great caution. PMID:24662409

  16. Duty hours, quality of care, and patient safety: general surgery resident perceptions.

    Science.gov (United States)

    Borman, Karen R; Jones, Andrew T; Shea, Judy A

    2012-07-01

    The balance between patient treatment risks and training residents to proficiency is confounded by duty-hour limits. Stricter limits have been recommended to enhance quality and safety, although supporting data are scarce. A previously piloted survey was delivered with the 2010 American Board of Surgery In-Training Examination (ABSITE). First postgraduate year (PGY1) and PGY2 trainees took the Junior examination (IJE); PGY3 and above took the Senior examination (ISE). Residency type, size, and location were linked to examinees using program codes. Five survey items queried all residents about the impact of further hour limits on care quality; online test residents answered 7 more items probing medical error sources. Data were analyzed using factorial ANOVA for association with sex, PGY level, and program demographics. There were 6,161 categorical surgery residents who took the ABSITE: 60% men, 60% ISE, and two-thirds in university programs. Paper (n = 5,079) and online (n = 1,082) examinees were similar. Item response rates ranged from 91% to 98%. Few (surgery residents do not perceive that reduced duty hours will noticeably improve quality of care. Resident perceptions of causes of medical errors suggest that system changes are more likely to enhance patient safety than further hour limits. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  17. 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.

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

    Science.gov (United States)

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

    2014-10-01

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

  19. 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.

  20. Association Between Flexible Duty Hour Policies and General Surgery Resident Examination Performance: A Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial Analysis.

    Science.gov (United States)

    Blay, Eddie; Hewitt, D Brock; Chung, Jeanette W; Biester, Thomas; Fiore, James F; Dahlke, Allison R; Quinn, Christopher M; Lewis, Frank R; Bilimoria, Karl Y

    2017-02-01

    Concerns persist about the effect of current duty hour reforms on resident educational outcomes. We investigated whether a flexible, less-restrictive duty hour policy (Flexible Policy) was associated with differential general surgery examination performance compared with current ACGME duty hour policy (Standard Policy). We obtained examination scores on the American Board of Surgery In-Training Examination, Qualifying Examination (written boards), and Certifying Examination (oral boards) for residents in 117 general surgery residency programs that participated in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial. Using bivariate analyses and regression models, we compared resident examination performance across study arms (Flexible Policy vs Standard Policy) for 2015 and 2016, and 1 year of the Qualifying Examination and Certifying Examination. Adjusted analyses accounted for program-level factors, including the stratification variable for randomization. In 2016, FIRST trial participants were 4,363 general surgery residents. Mean American Board of Surgery In-Training Examination scores for residents were not significantly different between study groups (Flexible Policy vs Standard Policy) overall (Flexible Policy: mean [SD] 502.6 [100.9] vs Standard Policy: 502.7 [98.6]; p = 0.98) or for any individual postgraduate year level. There was no difference in pass rates between study arms for either the Qualifying Examination (Flexible Policy: 90.4% vs Standard Policy: 90.5%; p = 0.99) or Certifying Examination (Flexible Policy: 86.3% vs Standard Policy: 88.6%; p = 0.24). Results from adjusted analyses were consistent with these findings. Flexible, less-restrictive duty hour policies were not associated with differences in general surgery resident performance on examinations during the FIRST Trial. However, more years under flexible duty hour policies might be needed to observe an effect. Copyright © 2016 American College of Surgeons

  1. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home.

    Science.gov (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith

    2012-02-01

    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pfeifer Roman

    2009-02-01

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

  4. [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

  5. Perceptions of the 2011 ACGME duty hour requirements among residents in all core programs at a large academic medical center.

    Science.gov (United States)

    Sandefur, Benjamin J; Shewmaker, Diana M; Lohse, Christine M; Rose, Steven H; Colletti, James E

    2017-11-10

    The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution. Residents were categorized as medical and pediatric, surgery, or other. In total, 736 residents representing 24 core specialty residency programs were surveyed. The authors received responses from 495 residents (67%). A majority reported satisfaction (78%) with DHRs and believed DHRs positively affect their training (73%). Residents in surgical specialties and in advanced stages of training were significantly less likely to view DHRs favorably. Most respondents believed fatigue contributes to errors (89%) and DHRs reduce both fatigue (80%) and performance of clinical duties while fatigued (74%). A minority of respondents (37%) believed that DHRs decrease medical errors. This finding may reflect beliefs that handovers contribute more to errors than fatigue (41%). Negative perceived effects included diminished patient familiarity and continuity of care (62%) and diminished clinical educational experiences for residents (41%). A majority of residents reported satisfaction with the 2011 DHRs, although satisfaction was significantly less among residents in surgical specialties and those in advanced stages of training.

  6. “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.

  7. 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.

  8. 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.

  9. Studying the association between postgraduate trainees' work hours, stress and the use of maladaptive coping strategies.

    Science.gov (United States)

    Kasi, Pashtoon Murtaza; Khawar, Talha; Khan, Farooq Hasan; Kiani, Jawad Ghazanfar; Khan, Umber Zaheer; Khan, Hadi Mohammad; Khuwaja, Urooj Bakht; Rahim, Musa

    2007-01-01

    The growing debate regarding long working hours of postgraduate trainees has been receiving considerable attention recently. This greater workload contributes to increasing stress. Our objective was to specifically study the association between long working hours, stress and the greater use of 'maladaptive' coping strategies. A cross-sectional descriptive study was carried out on all interns and residents at the Aga Khan University Hospital during February to May, 2005. Level of stress was measured by use of General Health Questionnaire (GHQ-12) and the use of maladaptive coping mechanisms through Brief Cope-28. 55.1% scored over the threshold for mild stress i.e. GHQ > 3, while more than 46% of the trainees scored over the threshold of more than 4 for morbid stress. Trainees under stress reported more working hours on average as compared to those not under stress, 83.8 and 74.7 hours respectively. At the same time, those working for longer hours were more likely to have used these negative coping mechanisms, which would further contribute to more stress rather than relieving it. Significant levels of stress have been identified. Along with this, those working for longer hours were more likely to have used these negative coping mechanisms. Reduction of working hours is important. Simultaneously, interventions need to be planned at imparting knowledge, awareness and skills to cope with various kinds of stressors encountered by a trainee during his/her training. Additionally, limits need to be devised for the working hours of the trainees.

  10. Administrative Circular No. 23 (Rev. 4) - Special working hours

    CERN Multimedia

    Department Head Office - HR Department

    2016-01-01

    Administrative Circular No. 23 (Rev. 4) entitled "Special working hours", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 22 March 2016, will be available on 1st September 2016 via the following link: https://cds.cern.ch/record/2208539.   This revised circular cancels and replaces Administrative Circular No. 23 (Rev. 3) also entitled "Special working hours" of January 2013. This document contains modifications to reflect the new career structure and ensuring the provision consistent with practice that compensation or remuneration of special working hours performed remotely is possible only in case of emergency.   This circular will enter into force on 1st September 2016.

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

    Science.gov (United States)

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

    2010-08-01

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

  12. Paediatric cardiology fellowship training: effect of work-hour regulations on scholarly activity.

    Science.gov (United States)

    Ronai, Christina; Lang, Peter

    2017-01-01

    In 2003, work-hour regulations were implemented by the Accreditation Council for Graduate Medical Education. Much has been published regarding resident rest and quality of life as well as patient safety. There has been no examination on the effect of work-hour restrictions on academic productivity of fellows in training. Paediatric subspecialty fellows have a scholarly requirement mandated by the American Board of Pediatrics. We have examined the impact of work-hour restrictions on the scholarly productivity of paediatric cardiology fellows during their fellowship. We conducted a literature search for all paediatric cardiology fellows between 1998 and 2007 at a single academic institution as first or senior authors on papers published during their 3-year fellowship and 3 years after completion of their categorical fellowship (n=63, 30 fellows before 2003 and 33 fellows after 2003). The numbers of first- or senior-author fellow publications before and after 2003 were compared. We also collected data on final paediatric cardiology subspecialty career choice. There was no difference in the number of fellow first-author publications before and after 2003. Before work-hour restrictions, the mean number of publications per fellow was 2.1 (±2.2), and after work-hour restrictions it was 2.0 (±1.8), (p=0.89). By subspecialty career choice, fellows who select electrophysiology, preventative cardiology, and heart failure always published within the 6-year time period. Since the implementation of work-hour regulations, total number of fellow first-authored publications has not changed. The role of subspecialty choice may play a role in academic productivity of fellows in training.

  13. Working Hour and its Impact on Backache from Gender Perspective

    Directory of Open Access Journals (Sweden)

    Amita Pradhan

    2011-04-01

    Full Text Available This paper aims to analyze the association between work burden and backache among women and men. The study design is descriptive cross sectional. Thirty two households are selected. From each of the households sample size of 64 in terms of a pair of either married couple or the unmarried sister and brother are selected. Respondent's age is between 15 to 49 years. Semi structured questionnaire is used to collect data. This study shows significant differences in working hour between male and female. The working hour is significantly higher among the persons with backache. Gender inequality is a stark reality. The gender division of labour may add more work to women resulting into longer working hour for women. This may reflect in some health hazards among women. Hence, more focused attention is needed to understand the non reproductive health problems of women. Keywords: working hour; backache; women empowerment; health problem; health seeking behaviour DOI: 10.3126/dsaj.v4i0.4523 Dhaulagiri Journal of Sociology and Anthropology Vol.4 2010 pp.235-246

  14. 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 Section 536.570-5 Federal Acquisition Regulations System GENERAL SERVICES ADMINISTRATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Contract Clauses 536.570-5 Working...

  15. 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 t...

  16. Work hours, social value of leisure and globalisation

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...

  17. Work Hours, Social Value of Leisure and Globalisation

    DEFF Research Database (Denmark)

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

    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...

  18. Time-motion studies of internal medicine residents' duty hours: a systematic review and meta-analysis.

    Science.gov (United States)

    Leafloor, Cameron W; Lochnan, Heather A; Code, Catherine; Keely, Erin J; Rothwell, Deanna M; Forster, Alan J; Huang, Allen R

    2015-01-01

    Since the mid-1980s, medical residents' long duty hours have been under scrutiny as a factor affecting patient safety and the work environment for the residents. After several mandated changes in duty hours, it is important to understand how residents spend their time before proposing and implementing future changes. Time-motion methodology may provide reliable information on what residents do while on duty. The purpose of this study is to review all available literature pertaining to time-motion studies of internal medicine residents while on a medicine service and to understand how much of their time is apportioned to various categories of tasks, and also to determine the effects of the Accreditation Council for Graduate Medical Education (ACGME)-mandated duty hour changes on resident workflow in North America. Electronic bibliographic databases were searched for articles in English between 1941 and April 2013 reporting time-motion studies of internal medicine residents rotating through a general medicine service. Eight articles were included. Residents spent 41.8% of time in patient care activities, 18.1% communicating, 13.8% in educational activities, 19.7% in personal/other, and 6.6% in transit. North American data showed the following changes after the implementation of the ACGME 2003 duty hours standard: patient care activities from 41.8% to 40.8%, communication activities from 19.0% to 22.3%, educational activities from 17.7% to 11.6%, and personal/other activities from 21.5% to 17.1%. There was a paucity of time-motion data. There was great variability in the operational definitions of task categories reported in the studies. Implementation of the ACGME duty hour standards did not have a significant effect on the percentage of time spent in particular tasks. There are conflicting reports on how duty hour changes have affected patient safety. A low proportion of time spent in educational activities deserves further study and may point to a review of the

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

    DEFF Research Database (Denmark)

    Kato, Takao; Owan, Hideo; Ogawa, Hiromasa

    hours: and (ii) the worker's OJT ability (the worker's ability to accumulate valuable human capital on the job through learning by doing). The worker's cost of working long hours is known only to the worker, while the worker's OJT ability is accurately assessed only by the firm observing him......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...

  20. Sunlight Exposure, Work Hours, Caffeine Consumption, and Sleep Duration in the Naval Environment.

    Science.gov (United States)

    Shattuck, Nita L; Matsangas, Panagiotis

    2017-06-01

    Sailors in the U.S. Navy are habitual shiftworkers, often experiencing circadian misalignment due to their irregular work/rest schedules. This study assessed the effect of sunlight exposure, work hours, and caffeinated beverage consumption on the daily sleep duration of crewmembers of a U.S. Navy ship during a 2-wk underway period. Working in an artificially lit area with no access to sunlight during work hours, U.S. Navy crew members (N = 91) used daily logs to report their daily activity, caffeinated beverage consumption, and exposure to sunlight while off-duty; sleep was assessed by wrist-worn actigraphy. Hours of sunlight exposure, work duration, and the amount of coffee/tea/soft drinks were statistically significant predictors of sleep duration. On average, crewmembers who reported more than one half-hour of sunlight each day slept on average ∼40 min (10%) less than their peers working the same shifts who received less than one half-hour of sunlight (on average 6.05 ± 0.90 h vs. 6.71 ± 0.91 h, respectively). Exposure to sunlight, work hours, and consumption of caffeinated beverages are important factors when planning watchstanding schedules at sea. Even though further research is needed, our results suggest that even brief exposure to sunlight may contribute to circadian misalignment that negatively affects sleep in the operational environment. Educating crewmembers about sleep hygiene, especially the important roles played by sunlight and caffeine, could potentially improve the sleep and fatigue levels of this population of maritime shiftworkers.Shattuck NL, Matsangas P. Sunlight exposure, work hours, caffeine consumption, and sleep duration in the naval environment. Aerosp Med Hum Perform. 2017; 88(6):579-585.

  1. Health and psychosocial effects of flexible working hours

    Directory of Open Access Journals (Sweden)

    Daniela Janssen

    2004-12-01

    Full Text Available OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.OBJETIVO: Investigar se ocorre prejuízo à saúde e à vida social com diferentes tipos de horas de trabalho flexíveis e se há relação entre estes efeitos e características específicas das horas de trabalho. MÉTODOS: Foram realizados dois estudos, uma pesquisa em uma empresa (N=660 e outra pela Internet (N=528. O primeiro estudo consistiu de um questionário (papel e lápis aplicado a funcionários sujeitos a diferentes ajustes "típicos" de horas de

  2. 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

    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...... confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours....

  3. Residents’ perception of duty hour limits through teaching hospital accreditation status—experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Tsung-Hsi Wang

    2017-05-01

    Full Text Available Residents’ work overload is a rising issue in Taiwan. Duty hours of the residents in the United States have been limited by the Accreditation Council for Graduate Medical Education Common Program Requirements since 2003; similar standards were not implemented in Taiwan until 2013. Taiwanese duty hour standards are the work hour limits adopted as part of the required teaching hospital accreditation status. In January 2015, the Ministry of Health and Welfare conducted a national survey for all house officers in Taiwan. We collected data including those on demographics and perceptions of residents regarding duty hour limits. Most respondents reported positive perceptions of the duty hour standards. They felt that these limits will improve resident education, quality of life, and patient safety. The strong incentive to follow the regulations (through teaching hospital accreditation could help protect residents (and patients from unsafe working conditions. However, further studies on the influence of shortened duty hour on professional development are necessary for future improvement.

  4. Time-motion studies of internal medicine residents' duty hours: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Leafloor CW

    2015-11-01

    Full Text Available Cameron W Leafloor,1 Heather A Lochnan,2,3,6 Catherine Code,2,4 Erin J Keely,2,3,6 Deanna M Rothwell,5,6 Alan J Forster,2,4–6 Allen R Huang2,6,7 1Faculty of Medicine, 2Department of Medicine, 3Division of Endocrinology and Metabolism, 4Division of General Internal Medicine, 5Performance Measurement and Innovation, 6Ottawa Hospital Research Institute, 7Division of Geriatric Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada Background: Since the mid-1980s, medical residents' long duty hours have been under scrutiny as a factor affecting patient safety and the work environment for the residents. After several mandated changes in duty hours, it is important to understand how residents spend their time before proposing and implementing future changes. Time-motion methodology may provide reliable information on what residents do while on duty.Purpose: The purpose of this study is to review all available literature pertaining to time-motion studies of internal medicine residents while on a medicine service and to understand how much of their time is apportioned to various categories of tasks, and also to determine the effects of the Accreditation Council for Graduate Medical Education (ACGME-mandated duty hour changes on resident workflow in North America.Methods: Electronic bibliographic databases were searched for articles in English between 1941 and April 2013 reporting time-motion studies of internal medicine residents rotating through a general medicine service.Results: Eight articles were included. Residents spent 41.8% of time in patient care activities, 18.1% communicating, 13.8% in educational activities, 19.7% in personal/other, and 6.6% in transit. North American data showed the following changes after the implementation of the ACGME 2003 duty hours standard: patient care activities from 41.8% to 40.8%, communication activities from 19.0% to 22.3%, educational activities from 17.7% to 11.6%, and personal

  5. Changes in outcomes for internal medicine inpatients after work-hour regulations.

    Science.gov (United States)

    Horwitz, Leora I; Kosiborod, Mikhail; Lin, Zhenqiu; Krumholz, Harlan M

    2007-07-17

    Limits on resident work hours are intended to reduce fatigue-related errors, but may raise risk by increasing transfers of responsibility for patients. To examine changes in outcomes for internal medicine patients after the implementation of work-hour regulations. Retrospective cohort study. Urban, academic medical center. 14,260 consecutive patients discharged from the teaching (housestaff) service and 6664 consecutive patients discharged from the nonteaching (hospitalist) service between 1 July 2002 and 30 June 2004. Outcomes included intensive care unit utilization, length of stay, discharge disposition, 30-day readmission rate to the study institution, pharmacist interventions to prevent error, drug-drug interactions and in-hospital death. The teaching service had net improvements in 3 outcomes. Relative to changes experienced by the nonteaching service, the rate of intensive care unit utilization decreased by 2.1% (95% CI, -3.3% to -0.7%; P = 0.002), the rate of discharge to home or rehabilitation facility versus elsewhere improved by 5.3% (CI, 2.6% to 7.6%; P error were reduced by 1.92 interventions per 100 patient-days (CI, -2.74 to -1.03 interventions per 100 patient-days; P < 0.001). Teaching and nonteaching services had similar changes over time in length of stay, 30-day readmission rate, and adverse drug-drug interactions. In-hospital death was uncommon in both groups, and change over time was similar in the 2 groups. The study was a retrospective, nonrandomized design that assessed a limited number of outcomes. Teaching and nonteaching cohorts may not have been affected similarly by secular trends in patient care. After the implementation of work-hour regulations, 3 of 7 outcomes improved for patients in the teaching service relative to those in the nonteaching service. The authors found no evidence of adverse unintended consequences after the institution of work-hour regulations.

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

    Science.gov (United States)

    Kanbayashi, Toshiyuki

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-11-01

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

  8. Gender-Based Differences in Surgical Residents' Perceptions of Patient Safety, Continuity of Care, and Well-Being: An Analysis from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial.

    Science.gov (United States)

    Ban, Kristen A; Chung, Jeanette W; Matulewicz, Richard S; Kelz, Rachel R; Shea, Judy A; Dahlke, Allison R; Quinn, Christopher M; Yang, Anthony D; Bilimoria, Karl Y

    2017-02-01

    Little is known about gender differences in residency training experiences and whether duty hour policies affect these differences. Using data from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial, we examined gender differences in surgical resident perceptions of patient safety, education, health and well-being, and job satisfaction, and assessed whether duty hour policies affected gender differences. We compared proportions of male and female residents expressing dissatisfaction or perceiving a negative effect of duty hours on aspects of residency training (ie patient safety, resident education, well-being, job satisfaction) overall and by PGY. Logistic regression models with robust clustered SEs were used to test for significant gender differences and interaction effects of duty hour policies on gender differences. Female PGY2 to 3 residents were more likely than males to be dissatisfied with patient safety (odds ratio [OR] = 2.50; 95% CI, 1.29-4.84) and to perceive a negative effect of duty hours on most health and well-being outcomes (OR = 1.51-2.10; all p gender differences in career dissatisfaction among interns (p = 0.028), but widened gender differences in negative perceptions of duty hours on patient safety (p job satisfaction (p Gender differences exist in perceptions of surgical residency. These differences vary across cohorts and can be influenced by duty hour policies. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Bullying Behavior, Parents' Work Hours and Early Adolescents' Perceptions of Time Spent with Parents

    Science.gov (United States)

    Christie-Mizell, C. Andre; Keil, Jacqueline M.; Laske, Mary Therese; Stewart, Jennifer

    2011-01-01

    This research investigates the relationships among bullying behavior, mother's and father's work hours, and early adolescents' perceptions of whether they spend sufficient time with their parents. In cross-sectional models, we find maternal work hours are modestly associated with increases in bullying behavior. However, in more rigorous change…

  10. Physiological and psychological impacts of extended work hours in logging operations

    Science.gov (United States)

    Dana Mitchell; Tom Gallagher

    2007-01-01

    A study was initiated in 2006 to develop an understanding of the considerations of using extended work hours in the logging industry in the southeastern United States. Through semistructured interviews, it was obvious that loggers were individually creating ways of successfully implementing extended working hours without understanding the impacts that extended working...

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

    Science.gov (United States)

    Baxter, Jennifer

    2011-01-01

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

  12. 45 CFR 2543.84 - Contract Work Hours and Safety Standards Act.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Contract Work Hours and Safety Standards Act. 2543... OTHER NON-PROFIT ORGANIZATIONS Statutory Compliance § 2543.84 Contract Work Hours and Safety Standards Act. Where applicable, all contracts awarded by recipients in excess of $2000 for construction...

  13. Influence on working hours among shift workers and effects on sleep quality - An intervention study

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Nabe-Nielsen, Kirsten; Aust, Birgit

    2011-01-01

    The aim of the present intervention study was to examine if increased influence on working hours among shift workers led to better sleep quality. 391 employees were categorized into groups based on the performed activities: High (self-rostering), moderate (education and/or policy for working hours......), and low intensity intervention (meetings and discussions) and reference. Sleep quality was assessed by Karolinska Sleep Questionnaire (KSQ) at baseline and follow-up (12 months). To elucidate the process of the intervention interviews were conducted. Influence on one's own working hours increased only...

  14. Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

    Science.gov (United States)

    Swanberg, Jennifer; Clouser, Jessica Miller; Gan, Wenqi; Flunker, John C; Westneat, Susan; Browning, Steven R

    2017-09-03

    This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD. MSD was divided into tertiles; the upper tertile was defined as elevated. Multivariable Poisson regression revealed associations between any elevated MSD and longer tenure on horse farms, longer work hours, and poor safety climate. Elevated neck/back MSD was associated with longer tenure, longer work hours, and poor safety climate. Elevated upper extremity MSD was associated with age and poor safety climate. Elevated lower extremity MSD was associated with longer tenure, longer work hours, and being female. Musculoskeletal discomfort is common among these workers. Improving safety climate and minimizing long work hours is recommended.

  15. The Gender-Specific Effect of Working Hours on Family Happiness in South Korea

    OpenAIRE

    Robert Rudolf; Seo-Young Cho

    2011-01-01

    This paper uses detailed longitudinal data from the Korean Labor and Income Panel Study (KLIPS) stretching from 1998 to 2008 to analyze the relationship between working hours and family happiness in Korea. The Korean labor market is characterized by high levels of gender inequality which is partly due to long working hours, a significant gender gap in earnings, yet also to traditional gender roles maintained until today. Therefore, post-marriage labor force participation rates for men are sti...

  16. Precarious employment, working hours, work-life conflict and health in hotel work.

    Science.gov (United States)

    McNamara, Maria; Bohle, Philip; Quinlan, Michael

    2011-01-01

    Precarious or temporary work is associated with adverse outcomes including low control over working hours, work-life conflict and stress. The rise in precarious employment is most marked in the service sector but little research has been done on its health effects in this sector. This study compares permanent and temporary workers in the hotel industry, where working hours are highly variable. Survey data from 150 workers from eight 3-Star hotels in urban and regional areas around Sydney were analyzed. Forty-five per cent were male and 52 per cent were female. Fifty four per cent were permanent full-time and 46 per cent were temporary workers. The effects of employment status on perceived job security, control over working hours, and work-life conflict are investigated using PLS-Graph 3.0. The effects of control over working hours, on work-life conflict and subsequent health outcomes are also explored. Temporary workers perceived themselves as less in control of their working hours, than permanent workers (β = .27). However, they also reported lower levels of work intensity (β = .25) and working hours (β = .38). The effects of low hours control (β = .20), work intensity (β = .29), and excessive hours (β = .39) on work-life conflict (r² = .50), and subsequent health effects (r² = .30), are illustrated in the final structural equation model. Copyright © 2010 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  17. Long working hours and risk of coronary heart disease and stroke

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Jokela, Markus; Nyberg, Solja T

    2015-01-01

    -response association for stroke, with RR estimates of 1·10 (95% CI 0·94-1·28; p=0·24) for 41-48 working hours, 1·27 (1·03-1·56; p=0·03) for 49-54 working hours, and 1·33 (1·11-1·61; p=0·002) for 55 working hours or more per week compared with standard working hours (ptrendEmployees who work......, Economic and Social Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working......BACKGROUND: Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. METHODS: We...

  18. 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

  19. Work hours and turnover intention among hospital physicians in Taiwan: does income matter?

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Tsai

    2016-11-01

    Full Text Available Abstract Background Physician shortage has become an urgent and critical challenge to many countries. According to the workforce dynamic model, long work hours may be one major pressure point to the attrition of physicians. Financial incentive is a common tool to human power retention. Therefore, this large-scale physician study investigated how pay satisfaction may influence the relationship between work hours and hospital physician’s turnover intention. Methods Data were obtained from a nationwide survey of full-time hospital staff members working at 100 hospitals in Taiwan. The analysis sample comprised 2423 full-time physicians. Dependent variable was degree of the physicians’ turnover intention to leave the current hospital. The pay satisfaction was assessed by physicians themselves. We employed ordinal logistic regression models to analyze the association between the number of work hours and turnover intention. To consider the cluster effect of hospitals, we used the “gllamm” command in the statistical software package Stata Version 12.1. Results The results show that 351 (14.5% of surveyed physicians reported strong intention to leave current hospital. The average work hours per week among hospital physicians was 59.8 h. As expected, work hours exhibited an independent relationship with turnover intention. More importantly, pay satisfaction could not effectively moderate the positive relationship between work hours and intentions to leave current hospital. Conclusions The findings show that overtime work is prevalent among hospital physicians in Taiwan. Both the Taiwanese government and hospitals must take action to address the emerging problem of physician high turnover rate. Furthermore, hospitals should not consider relying solely on financial incentives to solve the problem. This study encouraged tackling work hour problem, which would lead to the possibility of solving high turnover intention among hospital physicians in

  20. Use of a Night Float System to Comply With Resident Duty Hours Restrictions: Perceptions of Workplace Changes and Their Effects on Professionalism.

    Science.gov (United States)

    Sun, Ning-Zi; Gan, Runye; Snell, Linda; Dolmans, Diana

    2016-03-01

    Although some evidence suggests that resident duty hours reforms can lead to shift-worker mentality and loss of patient ownership, other evidence links long hours and fatigue to poor work performance and loss of empathy, suggesting the restrictions could positively affect professionalism. The authors explored perceived impacts of a 16-hour duty restriction, achieved using a night float (NF) system, on the workplace and professionalism. In 2013, the authors conducted semistructured interviews with 18 residents, 9 staff physicians, and 3 residency program directors in the McGill University core internal medicine residency program regarding their perceptions of the program's 12-hour shift-based NF system. Interviews were transcribed and coded for common themes. The authors used a descriptive qualitative methodology. Participants viewed implementation of the NF system as leading to decreased physical and mental exhaustion, more consistent interaction with patients, and more stable team structure within shifts compared with the previous 24-hour call system. These workplace changes were felt to improve teamwork and patient ownership within shifts, quality of work performed, and empathy. Across shifts, however, more frequent sign-overs, stricter application of shift time boundaries, and loose integration between daytime and NF teams were perceived as leading to emergence of shift-worker mentality around sign-over. Perceptions of optimal patient ownership changed from the traditional single-physician-24/7 model to team-based shared ownership. Duty hours restrictions, as exemplified by an NF system, have both positive and negative impacts on professionalism. Interventions and training toward effective team-based care are needed to curb emergence of shift-worker mentality.

  1. Long and atypical working hours and the impact on intimate family life social activities

    DEFF Research Database (Denmark)

    Andersen, Hans H. K.

    marriages or in general the intimate social activities of families. That is, some research point to the fact that having atypical working hours in families might have positive influence on family social activities, like supporting possibilities for the number of activities in which mothers and/or fathers......An increasing number of families has to meet the challenges of working in a 24-7 society and at the same time striving to take part in everyday family life. Research is not conclusive with respect to what degree atypical working hours has an impact on, for example, work-family balance, instable...... participate in together with their children (e.g. enjoying breakfasts together). On the other hand other research shows that factors like both parents having atypical working hours and small children in the home suggests a negative impact on family life. In addition, not much research has scrutinized...

  2. Office workers' objectively measured sedentary behavior and physical activity during and outside working hours.

    Science.gov (United States)

    Clemes, Stacy A; O'Connell, Sophie E; Edwardson, Charlotte L

    2014-03-01

    To examine objectively determined sedentary behavior and physical activity (PA) during and outside working hours in full-time office workers. A total of 170 participants wore an ActiGraph GT1M accelerometer for 7 days. Time spent sedentary (working hours and nonworking hours) and nonworkdays. Participants accumulated significantly higher levels of sedentary behavior (68% vs 60%) and lower levels of light-intensity activity (28% vs 36%) on workdays in comparison with nonworkdays. Up to 71% of working hours were spent sedentary. Individuals who were most sedentary at work were also more sedentary outside work. Those who are most sedentary at work do not compensate by increasing their PA or reducing their sedentary time outside work. Occupational interventions should address workplace and leisure-time sedentary behavior.

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

    Directory of Open Access Journals (Sweden)

    Hannan Peter J

    2010-12-01

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

  4. Nurse practitioners' work hours and overtime: How much, and under what working conditions?

    Science.gov (United States)

    Bae, Sung-Heui; Champion, Jane Dimmitt

    2016-03-01

    To explore the nature and prevalence of nurse practitioner (NP) overtime, work hours, and their relationship to practice within NP work conditions. A secondary analysis of data extracted from the 2012 National Sample Survey of Nurse Practitioners. The focus in this study was on data from NPs in active practice in clinical settings. The final analytic sample consisted of 9010 NPs. NPs working in hospitals and long-term care settings tended to work more than 40 h/week (p health records (p health records (p = .002), NPs were found to work more hours per week than those who did not. Regarding the type of relationships with physicians, NPs who worked more than 40 h/week either had hierarchical relationships with them (p work hours/overtime and work conditions related to longer work hours. Further study is indicated to assess the potential impact of work hours/overtime on NP roles and patient outcomes. ©2015 American Association of Nurse Practitioners.

  5. The relation between maternal work hours and cognitive outcomes of young school-aged children

    NARCIS (Netherlands)

    Künn-Nelen, A.C.; de Grip, A.; Fouarge, D.

    2013-01-01

    This paper is the first that analyzes the relation between maternal work hours and the cognitive outcomes of young school-going children. When children attend school, the potential time working mothers miss out with their children, is smaller than when children do not yet attend school. At the same

  6. Gender and the effect of working hours on firm-sponsored training

    NARCIS (Netherlands)

    Picchio, Matteo; van Ours, Jan

    Using employees’ longitudinal data, we study the effect of working hours on the propensity of firms to sponsor training of their employees. We show that, whereas male part-time workers are less likely to receive training than male full-timers, part-time working women are as likely to receive

  7. Gender and the Effect of Working Hours on Firm-Sponsored Training

    NARCIS (Netherlands)

    Picchio, Matteo; van Ours, Jan

    2015-01-01

    Using employees’ longitudinal data, we study the effect of working hours on the propensity of firms to sponsor training of their employees. We show that, whereas male part-time workers are less likely to receive training than male full-timers, parttime working women are as likely to receive training

  8. Flexible working hours, health, and well-being in Europe: some considerations from a SALTSA project

    NARCIS (Netherlands)

    Costa, Giovanni; Akerstedt, Torbjorn; Nachreiner, Friedhelm; Baltieri, Federica; Carvalhais, José; Folkard, Simon; Frings-Dresen, Monique; Gadbois, Charles; Gartner, Johannes; Sukalo, Hiltraud Grzech; Härmä, Mikko; Kandolin, Irja; Sartori, Samantha; Silvério, Jorge

    2004-01-01

    The project brought together researchers from 9 EU-Countries and resulted in a number of actions, in particular the following: (a) There is an urgent need of defining the concept of flexible working hours, since it has been used in many different and even counterintuitive ways; the most obvious

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Mothers' and Fathers' Work Hours, Child Gender, and Behavior in Middle Childhood

    Science.gov (United States)

    Johnson, Sarah; Li, Jianghong; Kendall, Garth; Strazdins, Lyndall; Jacoby, Peter

    2013-01-01

    This study examined the association between typical parental work hours (including nonemployed parents) and children's behavior in two-parent heterosexual families. Child behavior was measured by the Child Behavior Checklist (CBCL) at ages 5, 8, and 10 in the Western Australian Pregnancy Cohort (Raine) Study ("N" = 4,201 child-year…

  11. Chicago Mothers on Finding and Using Child Care during Nonstandard Work Hours

    Science.gov (United States)

    Stoll, Marcia; Alexander, David; Nicpon, Christine

    2015-01-01

    Few issues confound child care policy more than the fact that very large numbers of mothers work evenings, overnight, or weekend hours when fewer child care programs operate. The authors interviewed 50 single Chicago mothers with nontraditional work hours about their experiences finding and using child care. Participants' responses addressed…

  12. 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.

  13. The Risk of Developing Diabetes in Association With Long Working Hours Differs by Shift Work Schedules.

    Science.gov (United States)

    Bannai, Akira; Yoshioka, Eiji; Saijo, Yasuaki; Sasaki, Sachiko; Kishi, Reiko; Tamakoshi, Akiko

    2016-09-05

    The impact of long working hours on diabetes is controversial; however, shift work is known to increase the risk of diabetes. This study aimed to investigate the association between long working hours and diabetes among civil servants in Japan separately by shift work schedules. A prospective cohort study was conducted from April 2003 to March 2009. A total of 3195 men aged ≥35 years who underwent an annual health checkup at baseline were analyzed by shift work schedules (2371 non-shift workers and 824 shift workers). Self-reported working hours were categorized as 35-44 and ≥45 hours per week. The incidence of diabetes was confirmed by fasting plasma glucose concentration ≥126 mg/dL and/or self-reported medical diagnosis of diabetes at the annual checkup. A Cox proportional model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing diabetes associated with long working hours. The median follow-up period of non-shift and shift workers was 5.0 and 4.9 years, respectively. During this period, 138 non-shift workers and 46 shift workers developed diabetes. A decreased HR was found among non-shift workers working ≥45 hours per week (HR 0.84; 95% CI, 0.57-1.24); however, shift workers working ≥45 hours per week had a significantly increased risk of diabetes (HR 2.43; 95% CI, 1.21-5.10) compared with those working 35-44 hours per week. An analysis restricted to non-clerical workers also showed similar results. The risk of diabetes associated with long working hours differed by shift work schedules.

  14. Working hours, work-life conflict and health in precarious and "permanent" employment.

    Science.gov (United States)

    Bohle, Philip; Quinlan, Michael; Kennedy, David; Williamson, Ann

    2004-12-01

    The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.

  15. 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.

  16. Bottleneck congestion and distribution of work start times: The economics of staggered work hours revisited

    OpenAIRE

    Takayama, Yuki

    2014-01-01

    Since the seminal work of Henderson (1981), a number of studies examined the effect of staggered work hours by analyzing models of work start time choice that consider the trade-off between negative congestion externalities and positive production externalities. However, these studies described traffic congestion using flow congestion models. This study develops a model of work start time choice with bottleneck congestion and discloses the intrinsic properties of the model. To this end, this ...

  17. Maternal working hours and early childhood overweight in Japan: a population-based study.

    Science.gov (United States)

    Mitsuhashi, Toshiharu; Suzuki, Etsuji; Takao, Soshi; Doi, Hiroyuki

    2012-01-01

    There has been a growing concern that maternal employment could have adverse or beneficial effects on children's health. Although recent studies demonstrated that maternal employment was associated with a higher risk of childhood overweight, the evidence remains sparse in Asian countries. We sought to examine the relationship between maternal working hours and early childhood overweight in a rural town in Okayama Prefecture. In February 2008, questionnaires were sent to parents of all preschool children aged ≥3 yr in the town to assess maternal working status (working hours and form of employment), children's body mass index, and potential confounders. Childhood overweight was defined following the age and sex-specific criteria of the International Obesity Task Force. Odds ratios (ORs) and 95% confidence intervals (CIs) for childhood overweight were estimated in a logistic regression. We used generalized estimating equations with an exchangeable correlation matrix, considering the correlation between siblings. We analyzed 364 preschool children. Adjusting for each child's characteristics (age, sex), mother's characteristics (age, obesity, educational attainment, smoking status, and social participation), and family's characteristics (number of siblings), children whose mothers work children of non-working mothers, whereas the relationship was less pronounced among children whose mothers work ≥8 h/day (OR: 0.71, 95% CI: 0.19, 2.68). We observed similar patterns in a stratified analysis by the form of maternal employment. Short maternal working hours are associated with a lower odds of early childhood overweight.

  18. Long working hours and metabolic syndrome among Japanese men: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Kobayashi Tomoko

    2012-05-01

    Full Text Available Abstract Background The link between long working hours and health has been extensively studied for decades. Despite global concern regarding metabolic syndrome, however, no studies to date have solely evaluated the relationship between long working hours and that syndrome. We therefore examined the association between long working hours and metabolic syndrome in a cross-sectional study. Methods Between May and October 2009, we collected data from annual health checkups and questionnaires from employees at a manufacturing company in Shizuoka, Japan. Questionnaires were returned by 1,601 workers (response rate: 96.2%; 1,314 men, 287 women. After exclusions, including women because of a lack of overtime work, the analysis was performed for 933 men. We calculated odds ratios (ORs and 95% confidence intervals (CIs for metabolic syndrome. Further, we conducted a stratified analysis by age-group ( Results Metabolic syndrome was identified in 110 workers (11.8%. We observed a positive association between working hours and metabolic syndrome after adjusting for age, occupation, shift work, smoking status, frequency of alcohol consumption, and cohabiting status. Compared with subjects who worked 7–8 h/day, multivariate ORs for metabolic syndrome were 1.66 (95% CI, 0.91–3.01, 1.48 (95% CI, 0.75–2.90, and 2.32 (95% CI, 1.04–5.16 for those working 8–9 h/day, 9–10 h/day, and >10 h/day, respectively. Similar patterns were obtained when we excluded shift workers from the analysis. In age-stratified analysis, the corresponding ORs among workers aged ≥40 years were 2.02 (95% CI, 1.04–3.90, 1.21 (95% CI, 0.53–2.77, and 3.14 (95% CI, 1.24–7.95. In contrast, no clear association was found among workers aged Conclusions The present study suggests that 10 h/day may be a trigger level of working hours for increased risk of metabolic syndrome among Japanese male workers.

  19. Effect of sleep deprivation after a night shift duty on simulated crisis management by residents in anaesthesia. A randomised crossover study.

    Science.gov (United States)

    Arzalier-Daret, Ségolène; Buléon, Clément; Bocca, Marie-Laure; Denise, Pierre; Gérard, Jean-Louis; Hanouz, Jean-Luc

    2018-04-01

    Sleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology. A randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep-deprived state (deprived group, after a night shift duty) and control state (control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario. Resident's crisis management performance is associated with sleep deprivation (scenario 1: control=39 [33-42] points vs. deprived=26 [19-40] points, P=0.02; scenario 2: control=21 [17-24] vs. deprived=14 [12-19], P=0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation. The present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia. Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  20. 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 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.

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

    Science.gov (United States)

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

    2011-01-01

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

  2. A physically active occupation does not result in compensatory inactivity during out-of-work hours.

    Science.gov (United States)

    Tigbe, William W; Lean, Michael E J; Granat, Malcolm H

    2011-01-01

    To examine differences in non-occupational physical activity behaviour in workers who engage in high and low occupational physical activity. Cross-sectional survey of 112 otherwise comparable volunteers in active (56 walking postal delivery workers) or inactive (56 administrative postal workers) occupations in Glasgow (Scotland) in 2007. Twenty four-hour physical activity (steps and time standing, walking and sedentary) patterns were measured using activPAL™ for seven days. Comparisons were made during 8-hour work-shifts, during non-work hours on work-days and during the 2 non-work days. Age and body mass index of delivery and office staff, respectively, were (means (SD)) 38 (9) years versus 40 (7) years and 26.3 (3) kg m(-2) versus 27.4 (4) kg m(-2). Delivery staff spent substantially longer time than office staff upright (6.0 (1.1) h versus 3.9 (1.5) h) and walking (3.1 (0.7) h versus 1.6 (0.7) h) and amassed more steps (16,035 (4264) versus 6709 (2808)) during 8-hour work-shifts and over 24h on work days. During non-work hours of work-days and during non-work days, there were no significant differences in physical activity between the groups. The results were unchanged when the 15 women were excluded. Having a more active occupation is not associated with more inactivity during non-work hours. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Wessel Kristen

    2006-07-01

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

  4. The organization of working hours of selected employee categories in Czech businesses

    Directory of Open Access Journals (Sweden)

    Urbancová Hana

    2016-01-01

    Full Text Available In the current dynamic working environment, the adaptation of working hours is an important instrument for supporting the work and performance of all groups of employees. It also serves as an instrument that encourages their identification with the company. The aim of this article is to identify and evaluate the utilization of individual methods of work organization among selected groups of employees in Czech companies across the gamut of the business sector. The analysed data comes from a quantitative questionnairebased survey (n=315. The results show that in the Czech companies, flexitime is most frequent among regular employees (51.7% and graduates up to 30 years old (24.1%. A reduced work schedule is most frequently used by mothers with children and senior citizens (41.3%, 27% and as part-time work among students (41%. The use of flexible working hours is an instrument of diversity management and builds the company brand through enlisting the cooperation of different groups of employees.

  5. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes

    DEFF Research Database (Denmark)

    Kivimäki, Mika; Virtanen, Marianna; Kawachi, Ichiro

    2015-01-01

    BACKGROUND: Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. METHODS: We......·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06-1·57, difference in incidence 13 per 10 000 person-years, I2=0%, p=0·4662), but was null in the high socioeconomic status...... group (1·00, 95% CI 0·80-1·25, incidence difference zero per 10 000 person-years, I(2)=15%, p=0·2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers. INTERPRETATION: In this meta...

  6. Identifying Factors Reinforcing Robotization: Interactive Forces of Employment, Working Hour and Wage

    Directory of Open Access Journals (Sweden)

    Joonmo Cho

    2018-02-01

    Full Text Available Unlike previous studies on robotization approaching the future based on the cutting-edge technologies and adopting a framework where robotization is considered as an exogenous variable, this study considers that robotization occurs endogenously and uses it as a dependent variable for an objective examination of the effect of robotization on the labor market. To this end, a robotization indicator is created based on the actual number of industrial robots currently deployed in workplaces, and a multiple regression analysis is performed using the robotization indicator and labor variables such as employment, working hours, and wage. The results using the multiple regression considering the triangular relationship of employment–working-hours–wages show that job destruction due to robotization is not too remarkable yet that use. Our results show the complementary relation between employment and robotization, but the substituting relation between working hour and robotization. The results also demonstrate the effects of union, the size of the company and the proportion of production workers and simple labor workers etc. These findings indicate that the degree of robotization may vary with many factors of the labor market. Limitations of this study and implications for future research are also discussed.

  7. Falls From Agricultural Machinery: Risk Factors Related to Work Experience, Worked Hours, and Operators' Behavior.

    Science.gov (United States)

    Caffaro, Federica; Roccato, Michele; Micheletti Cremasco, Margherita; Cavallo, Eugenio

    2018-02-01

    Objective We investigated the risk factors for falls when egressing from agricultural tractors, analyzing the role played by worked hours, work experience, operators' behavior, and near misses. Background Many accidents occur within the agricultural sector each year. Among them, falls while dismounting the tractor represent a major source of injuries. Previous studies pointed out frequent hazardous movements and incorrect behaviors adopted by operators to exit the tractor cab. However, less is known about the determinants of such behaviors. In addition, near misses are known to be important predictors of accidents, but they have been under-investigated in the agricultural sector in general and as concerns falls in particular. Method A questionnaire assessing dismounting behaviors, previous accidents and near misses, and participants' relation with work was administered to a sample of Italian tractor operators ( n = 286). Results A mediated model showed that worked hours increase unsafe behaviors, whereas work experience decreases them. Unsafe behaviors in turn show a positive association with accidents, via the mediation of near misses. Conclusions We gave a novel contribution to the knowledge of the chain of events leading to fall accidents in the agricultural sector, which is one of the most hazardous industries. Applications Besides tractor design improvements, preventive training interventions may focus on the redesign of the actual working strategies and the adoption of engaging training methods in the use of machinery to optimize the learning of safety practices and safe behaviors.

  8. Work Hours Offer in Colombia: an Approach to its Determinants, 2012

    Directory of Open Access Journals (Sweden)

    Andrés Eduardo Rangel Jiménez

    2016-02-01

    Full Text Available When participating in the job market, an individual must determine the amount of work hours to offer, a situation illustrated by economic theory through the income and substitution effects. This paper reports the results of the econometric estimation of a three-stage model of the hours of individual work for Colombia, based on the 2012 Quality of Life Survey. In the first stage, a model of the probability of being employed is made; then, a Mincer Equation corrected by selection bias is estimated and, finally, an equation of work hours is estimated using the Tobit model, in terms of wages predicted to correct endogeneity. Results show that the substitution effect takes precedence over the income effect; that age (up to a threshold, being head of household, having children under five years of age, being married or living in a common-law marriage and, finally, having a written employment contract, have a positive effect on the number of hours offered; on the other hand, unearned income has a negative effect on the number of hours offered.

  9. Impact of Age and Hearing Impairment on Work Performance during Long Working Hours

    Directory of Open Access Journals (Sweden)

    Verena Wagner-Hartl

    2018-01-01

    Full Text Available Based on demographic prognoses, it must be assumed that a greater number of older workers will be found in the future labor market. How to deal with their possible age-related impairments of sensory functions, like hearing impairment and work performance during extended working time, has not been addressed explicitly until now. The study addresses this interplay. The study was performed on two consecutive days after normal working hours. The 55 participants had to “work” in the study at least three additional hours to simulate a situation of long working hours. The tested measures for (job performance were: general attention, long-term selective attention, concentration, and reaction time. All of the investigated variables were taken at both days of the study (2 × 2 × 2 repeated measurement design. The results show effects for age, the interaction of hearing impairment and time of measurement, and effects of the measurement time. Older participants reacted slower than younger participants did. Furthermore, younger participants reacted more frequently in a correct way. Hearing impairment seems to have a negative impact especially on measures of false reactions, and therefore especially on measurement time 1. The results can be interpreted in a way that hearing-impaired participants are able to compensate their deficits over time.

  10. The importance of individual preferences when evaluating the associations between working hours and indicators of health and well-being

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Kecklund, Göran; Ingre, Michael

    2010-01-01

    Previous studies indicate that the effect of a given shift schedule may depend on individual factors. The aim of the present study was to investigate whether a misfit between individual preferences and actual working hours affected the association between working hours and self-reported indicator...

  11. Influence of flexibility and variability of working hours on health and well-being.

    Science.gov (United States)

    Costa, Giovanni; Sartori, Samantha; Akerstedt, Torbjorn

    2006-01-01

    Flexible working hours can have several meanings and can be arranged in a number of ways to suit the worker and/or employer. Two aspects of "flexible" arrangement of working hours were considered: one more subjected to company control and decision (variability) and one more connected to individual discretion and autonomy (flexibility). The aim of the study was to analyze these two dimensions in relation to health and well-being, taking into consideration the interaction with some relevant background variables related to demographics plus working and social conditions. The dataset of the Third European Survey on working conditions, conducted in 2000 and involving 21,505 workers, was used. Nineteen health disorders and four psycho-social conditions were tested by means of multiple logistic regression analysis, in which mutually adjusted odds ratios were calculated for age, gender, marital status, number of children, occupation, mode of employment, shift work, night work, time pressure, mental and physical workload, job satisfaction, and participation in work organization. The flexibility and variability of working hours appeared inversely related to health and psycho-social well-being: the most favorable effects were associated with higher flexibility and lower variability. The analysis of the interactions with the twelve intervening variables showed that physical work, age, and flexibility are the three most important factors affecting health and well-being. Flexibility resulted as the most important factor to influence work satisfaction; the second to affect family and social commitment and the ability to do the same job when 60 years old, as well as trauma, overall fatigue, irritability, and headache; and the third to influence heart disease, stomachache, anxiety, injury, and the feeling that health being at risk because of work. Variability was the third most important factor influencing family and social commitments. Moreover, shift and night work confirmed to

  12. New Results on the Effect of Mothers’ Working Hours on Children’s Overweight Status

    DEFF Research Database (Denmark)

    Greve, Jane

    During the last 30 years almost all developed countries have experienced an increase in the number of overweight children. Existing empirical research derives mainly from the U.S., Canada, Australia and the UK, and points at maternal employment as an explanation for the increasing trend in child...... weight. This paper uses the Danish Longitudinal Survey of Children (DALSC) merged with Danish register data from 1995 to 2002 to explore whether a causal relationship exists between maternal working hours and Danish children’s overweight status at age 7½. The instrumental variables technique is used......, as results show that maternal employment has a reducing effect on children’s overweight status in formal daycare (kindergarten). For children in informal daycare (family daycare), maternal employment has no significant effect....

  13. Work status, work hours and health in women with and without children.

    Science.gov (United States)

    Floderus, B; Hagman, M; Aronsson, G; Marklund, S; Wikman, A

    2009-10-01

    The authors studied self-reported health in women with and without children in relation to their work status (employed, student, job seeker or homemaker), work hours and having an employed partner. The study group comprised of 6515 women born in 1960-1979 who were interviewed in one of the Swedish Surveys of Living Conditions in 1994-2003. Self-rated health, fatigue and symptoms of anxiety were analysed. Having children increased the odds of poor self-rated health and fatigue in employed women, female students and job seekers. The presence of a working partner marginally buffered the effects. In dual-earner couples, mothers reported anxiety symptoms less often than women without children. Few women were homemakers (5.8%). The odds of poor self-rated health and fatigue increased with increasing number of children in employed women, and in women working 40 h or more. Poor self-rated health was also associated with the number of children in students. Many mothers wished to reduce their working hours, suggesting time stress was a factor in their impaired health. The associations between having children and health symptoms were not exclusively attributed to having young children. Having children may contribute to fatigue and poor self-rated health particularly in women working 40 h or more per week. Student mothers and job seeking mothers were also at increased risk of poor self-rated health. The results should be noted by Swedish policy-makers. Also countries aiming for economic and gender equality should consider factors that may facilitate successful merging of work and family life.

  14. Working hours, work-life conflict and health in precarious and "permanent" employment

    Directory of Open Access Journals (Sweden)

    Philip Bohle

    2004-12-01

    Full Text Available OBJECTIVE: The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. METHODS: Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. RESULTS: Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. CONCLUSIONS:This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.OBJETIVOS: O crescimento do número de empregos precários em países da OECD está largamente associado a efeitos negativos à saúde e segurança. Embora muitos

  15. Is suicidal ideation linked to working hours and shift work in Korea?

    Science.gov (United States)

    Yoon, Chang-Gyo; Bae, Kyu-Jung; Kang, Mo-Yeol; Yoon, Jin-Ha

    2015-01-01

    This study attempted to use the community health survey (CHS) to identify the effect of long working hours (long WHs) and night/shift work on suicidal ideation among the employed population of Korea. This study used data from 67,471 subjects who were administered the 2008 CHS which obtained information regarding sociodemographic characteristics, health behaviors and working environment, using structured questionnaires and personal interviews. We adopted multiple logistic regression models for gender and employment stratification. Among male employees, suicidal ideation was significantly associated with only moderately long WHs (51-60 hours), after controlling covariates (adjusted odds ratio [aOR], 1.30; 95% confidence interval [95%CI], 1.07 to 1.57). Self-employed/male employer populations had higher suicidal ideation when they had moderately long WHs (aOR, 1.23; 95%CI, 1.01 to 1.50) and very long WHs (over 60 hours) (aOR, 1.31; 95%CI, 1.08 to 1.59). Among the female population, suicidal ideation was significantly association with moderately long WHs in the employee group (aOR, 1.31; 95%CI, 1.08 to 1.58) and moderately (aOR, 1.35; 95%CI, 1.08 to 1.69) and very (aOR, 1.33; 95%CI, 1.07 to 1.65) long WHs in the self-employed/employer group. Shift work was a significant predictor only in the female population in the employee groups (aOR, 1.45; 95%CI, 1.23 to 1.70). Long WHs and shift work were associated with suicidal ideation when taking into account gender and employment differences. The harmful effects of exceptionally long WHs in Korea, among other Organization for Economic Co-operation and Development (OECD) countries, raise concerns about public and occupational health. To address the issue of long WHs, labor policies that reduce maximum working hours and facilitate job stability are needed.

  16. From Minimum Wage to Standard Work Hour: HKSAR Labour Politics in Regime Change

    Directory of Open Access Journals (Sweden)

    Lawrence K. K. Ho

    2013-01-01

    Full Text Available This paper aims to highlight the significance of labour issues – namely, the minimum wage (MW and standard working hours (SWH – in shaping candidates’ electoral platforms in the 2012 chief executive (CE election of the Hong Kong Special Administrative Region (HKSAR under the sovereignty of the People’s Republic of China (PRC. We first offer a brief review of labour politics regarding the MW case as a precursor to the SWH drafting and enactment process. We then provide an analytical delineation of some of the labour and socio-economic dimensions of the CE electoral contest by comparing the candidates’ campaign planks in relation to SWH. We then attempt to predict the likely course of the SWH debate under the leadership of Leung Chun-ying, who eventually won the CE election and assumed power on 1 July 2012. We conclude by examining Leung’s social engineering attempts to increase popular support amongst low- and middle-income (LMI households as part of his long-term strategy for the 2017 CE elections and his broader Beijing-entrusted political agenda.

  17. Workplace flexibility, work hours, and work-life conflict: finding an extra day or two.

    Science.gov (United States)

    Hill, E Jeffrey; Erickson, Jenet Jacob; Holmes, Erin K; Ferris, Maria

    2010-06-01

    This study explores the influence of workplace flexibility on work-life conflict for a global sample of workers from four groups of countries. Data are from the 2007 International Business Machines Global Work and Life Issues Survey administered in 75 countries (N = 24,436). We specifically examine flexibility in where (work-at-home) and when (perceived schedule flexibility) workers engage in work-related tasks. Multivariate results indicate that work-at-home and perceived schedule flexibility are generally related to less work-life conflict. Break point analyses of sub-groups reveal that employees with workplace flexibility are able to work longer hours (often equivalent to one or two 8-hr days more per week) before reporting work-life conflict. The benefit of work-at-home is increased when combined with schedule flexibility. These findings were generally consistent across all four groups of countries, supporting the case that workplace flexibility is beneficial both to individuals (in the form of reduced work-life conflict) and to businesses (in the form of capacity for longer work hours). However, work-at-home appears less beneficial in countries with collectivist cultures. (c) 2010 APA, all rights reserved.

  18. Personal satisfaction and mentorship are critical factors for today's resident surgeons to seek surgical training.

    Science.gov (United States)

    Lukish, Jeffrey; Cruess, David

    2005-11-01

    The specific aim of this study was to summarize the viewpoints of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) membership regarding current training and quality of life-related issues prior to implementation of the new duty-hour guidelines. The goal was to gain insight of the members that may be useful to recruit and guide the future training of surgical residents. An Internet-based survey was developed to evaluate the viewpoints of RAS-ACS. The survey was administered by Esurveymaker.com via the ACS Web page from 2000 to 2003. RAS-ACS member participation was voluntary and anonymous. Analyses were performed to determine the frequency of response for each survey item. Two hundred thirty-five members completed the survey representing 5 per cent of RAS-ACS. Eighty-four per cent were general surgery residents. Personal satisfaction (64%) and mentorship (49%) were top factors for respondents to pursue surgical training; discussion with colleagues and future income was less important. Forty-five per cent reported that job performance was their most important concern during residency. A rewarding surgical career and family life were ranked as the most important expectations. Eighty-six per cent reported that they were satisfied with their residency, and 66 per cent reported that work hours should be limited. Personal satisfaction and mentorship were critical factors for members of the RAS-ACS to seek surgical training. Although most of the members report that work hours should be limited, an overwhelming majority reports satisfaction with surgical training prior to institution of the new duty-hour guidelines. Further emphasis on mentorship and work-hour reform may be beneficial in recruiting medical students into surgical residencies.

  19. BASS 4: a software system for ergonomic design and evaluation of working hours

    Directory of Open Access Journals (Sweden)

    Carsten Schomann

    2004-12-01

    Full Text Available OBJECTIVE: To extend an existing computer programme for the evaluation and design of shift schedules (BASS 3 by integrating workload as well as economic aspects. METHODS: The redesigned prototype BASS 4 includes a new module with a suitable and easily applicable screening method (EBA for the assessment of the intensity of physical, emotional and cognitive workload components and their temporal patterns. Specified criterion functions based on these ratings allow for an adjustment of shift and rest duration according to the intensity of physical and mental workload. Furthermore, with regard to interactive effects both workload and temporal conditions, e.g. time of day, are taken into account. In a second new module, important economic aspects and criteria have been implemented. Different ergonomic solutions for scheduling problems can now also be evaluated with regard to their economic costs. RESULTS: The new version of the computer programme (BASS 4 can now simultaneously take into account numerous ergonomic, legal, agreed and economic criteria for the design and evaluation of working hours. CONCLUSIONS: BASS 4 can now be used as an instrument for the design and the evaluation of working hours with regard to legal, ergonomic and economic aspects at the shop floor as well as in administrative (e.g. health and safety inspection and research problems.OBJETIVOS: Expandir um programa computacional existente para planejamento e avaliação dos horários de turnos (BASS 3 por meio da incorporação da carga de trabalho e características econômicas. MÉTODOS: O protótipo BASS 4 contém um novo módulo com um método de triagem (EBA conveniente e de fácil aplicação para a avaliação da intensidade dos componentes físico, emocional e cognitivo da carga de trabalho e seus padrões temporais. O uso de critérios específicos com base nestas avaliações possibilita ajustar a duração do turno e do descanso de acordo com a intensidade da carga de

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

    Science.gov (United States)

    Roey, Steve

    2006-01-01

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

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

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Albertsen, Karen; Nabe Nielsen, Kirsten

    2012-01-01

    group. Intervention A encompassed the possibility to specify preferences for starting time and length of shift down to 15 minutes intervals. Interventions B and C included the opportunity to choose between a number of predefined duties. Questionnaires (N=840) on recovery and health and objective.......9–12.3] and long (OR 4.8, 95% CI 2.9–8.0) shifts increased in intervention A. Somatic symptoms (β= -0.10, 95% CI -0.19– -0.02) and mental distress (β= -0.13, 95% CI -0.23– -0.03) decreased, and sleep (β= 1.7, 95% CI 0.04–0.30) improved in intervention B, and need for recovery was reduced in interventions A (β= -0...

  2. Investigation of Psychophysiological and Subjective Effects of Long Working Hours – Do Age and Hearing Impairment Matter?

    Directory of Open Access Journals (Sweden)

    Verena Wagner-Hartl

    2018-01-01

    Full Text Available Following current prognosis, demographic development raises expectations of an aging of the working population. Therefore, keeping employees healthy and strengthening their ability to work, becomes more and more important. When employees become older, dealing with age-related impairments of sensory functions, such as hearing impairment, is a central issue. Recent evidence suggests that negative effects that are associated with reduced hearing can have a strong impact at work. Especially under exhausting working situations such as working overtime hours, age and hearing impairment might influence employees’ well-being. Until now, neither the problem of aged workers and long working hours, nor the problem of hearing impairment and prolonged working time has been addressed explicitly. Therefore, a laboratory study was examined to answer the research question: Do age and hearing impairment have an impact on psychophysiological and subjective effects of long working hours. In total, 51 white-collar workers, aged between 24 and 63 years, participated in the laboratory study. The results show no significant effects for age and hearing impairment on the intensity of subjective consequences (perceived recovery and fatigue, subjective emotional well-being and physical symptoms of long working hours. However, the psychophysiological response (the saliva cortisol level to long working hours differs significantly between hearing impaired and normal hearing employees. Interestingly, the results suggest that from a psychophysiological point of view long working hours were more demanding for normal hearing employees.

  3. Dose-Response Relation Between Work Hours and Cardiovascular Disease Risk: Findings From the Panel Study of Income Dynamics.

    Science.gov (United States)

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

    2016-03-01

    The aim of this study was to examine the presence of a dose-response relationship between work hours and incident cardiovascular disease (CVD) in a representative sample of U.S. workers. A retrospective cohort study of 1926 individuals from the Panel Study of Income Dynamics (1986 to 2011) employed for at least 10 years. Restricted cubic spline regression was used to estimate the dose-response relationship of work hours with CVD. A dose-response relationship was observed in which an average workweek of 46 hours or more for at least 10 years was associated with an increased risk of CVD. Compared with working 45 hours per week, working an additional 10 hours per week or more for at least 10 years increased CVD risk by at least 16%. Working more than 45 work hours per week for at least 10 years may be an independent risk factor for CVD.

  4. Attitudes toward working conditions: are European Union workers satisfied with their working hours and work-life balance?

    Science.gov (United States)

    Matilla-Santander, Nuria; Lidón-Moyano, Cristina; González-Marrón, Adrián; Bunch, Kailey; Martín-Sánchez, Juan Carlos; Martínez-Sánchez, José M

    2017-12-23

    To describe the satisfaction with working hours and satisfaction with work-life balance and their association in the European Union (EU-28). This is a cross-sectional study based on data from the Flash Eurobarometer 398 among workers of the EU-28 from 2014 (n=13,683). We calculated percentages and their 95% confidence intervals (95%CI). We also applied a multi-level generalised linear model using the Poisson family, to calculate the adjusted prevalence ratios (aPR) of satisfaction with work-life balance based on working hours. All analyses were stratified by individual, employment and welfare regime country classification. The satisfaction with working hours and work-life balance was 80.62% and 74.48%, respectively, and was significantly higher among women. The highest percentages of satisfaction were found in the Nordic welfare regime countries (90.2% and 85.3%, respectively). There was a statistically significant association between satisfaction with working hours and work-life balance (aPR: 2.63; 95%CI: 2.28-3.04), and the magnitude of the association differed in individual, employment and welfare regime country classifications. The main reasons declared for dissatisfaction were "excessive working hours" (48.7%), "shift work" (27.9%), and "inability to influence the work schedule" (28.3%). Differences were observed according to sex and type of welfare regime. The differences found in the association between satisfaction with work-life balance and working hours according to sociodemographic characteristics and welfare regime show that there are inequalities in the working conditions in the EU countries. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Age-related differences in working hours among male and female GPs: an SMS-based time use study.

    Science.gov (United States)

    van Hassel, Daniël; van der Velden, Lud; de Bakker, Dinny; Batenburg, Ronald

    2017-12-19

    In several countries, the number of hours worked by general practitioners (GPs) has decreased, raising concern about current and impending workforce shortages. This shorter working week has been ascribed both to the feminisation of the workforce and to a younger generation of GPs who prefer more flexible working arrangements. There is, however, limited insight into how the impact of these determinants interact. We investigated the relative importance of differences in GPs' working hours in relation to gender, age, and employment position. An analysis was performed on real-time monitoring data collected by sending SMS text messages to 1051 Dutch GPs, who participated during a 1-week time use study. We used descriptive statistics, independent sample t-tests, and one-way ANOVA analysis to compare the working time of different GP groups. A path analysis was conducted to examine the difference in working time by gender, age, employment position, and their combinations. Female GPs worked significantly fewer hours than their male peers. GPs in their 50s worked the highest number of hours, followed by GPs age 60 and older. GPs younger than 40 worked the lowest number of hours. This relationship between working hours and age was not significantly different for women and men. As shown by path analysis, female GPs consistently worked fewer hours than their male counterparts, regardless of their age and employment position. The relationship between age and working hours was largely influenced by gender and employment position. The variation in working hours among GPs can be explained by the combination of gender, age, and employment position. Gender appears to be the most important predictor as the largest part of the variation in working hours is explained by a direct effect of this variable. It has previously been reported that the difference in working hours between male and female GPs had decreased over time. However, our findings suggest that gender remains a critical

  6. 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.

  7. It is worth 10 million working hours a year to have your toilet paper folded?

    Science.gov (United States)

    Ljung, Rickard; Ljung, Hedvig; Ljung, Harald

    2016-01-01

    From our experience the toilet paper is folded in the bathrooms in rooms in branded hotels. We aimed to study the total time yearly spent in the world on folding hotel toilet paper. Three investigators clocked 60 folding toilet paper events and calculated the mean time. The mean folding time was 5.73 s (interquartile range 4.50-6.56). Using the calculated extra time it takes to fold the toilet paper and the number of hotel nights spent we estimated the total time spent in the world each year to fold the toilet paper. For sensitivity analyses we used different assumptions on number of hotel beds, occupancy rate and folding time. Assuming an extra 10 s spent on folding toilet paper, approximately 10 million hours are globally spent on folding toilet paper every year. This corresponds to more than 5000 man-years of work. In a hotel with yearly full coverage of 200 beds skipping folding the toilet paper corresponds to around 200 h of time that could be spent elsewhere. To take away unnecessary duties from hotel room cleaners would increase their health and well-being and save time that could be better spent. Is it really defendable and appropriate that someone else has spent time on folding the toilet paper you are just about to use?

  8. The Impact of the 80-Hour Resident Workweek on Surgical Residents and Attending Surgeons

    Science.gov (United States)

    Hutter, Matthew M.; Kellogg, Katherine C.; Ferguson, Charles M.; Abbott, William M.; Warshaw, Andrew L.

    2006-01-01

    Objective: To assess the impact of the 80-hour resident workweek restrictions on surgical residents and attending surgeons. Summary Background Data: The ACGME mandated resident duty hour restrictions have required a major workforce restructuring. The impact of these changes needs to be critically evaluated for both the resident and attending surgeons, specifically with regards to the impact on motivation, job satisfaction, the quality of surgeon training, the quality of the surgeon's life, and the quality of patient care. Methods: Four prospective studies were performed at a single academic surgical program with data collected both before the necessary workforce restructuring and 1 year after, including: 1) time cards to assess changes in components of daily activity; 2) Web-based surveys using validated instruments to assess burnout and motivation to work; 3) structured, taped, one-on-one interviews with an external PhD investigator; and 4) statistical analyses of objective, quantitative data. Results: After the work-hour changes, surgical residents have decreased “burnout” scores, with significantly less “emotional exhaustion” (Maslach Burnout Inventory: 29.1 “high” vs. 23.1 “medium,” P = 0.02). Residents have better quality of life both in and out of the hospital. They felt they got more sleep, have a lighter workload, and have increased motivation to work (Herzberg Motivation Dimensions). We found no measurable, statistically significant difference in the quality of patient care (NSQIP data). Resident training and education objectively were not statistically diminished (ACGME case logs, ABSITE scores). Attending surgeons perceived that their quality of their life inside and outside of the hospital was “somewhat worse” because of the work-hour changes, as they had anticipated. Many concerns were identified with regards to the professional development of future surgeons, including a change toward a shift-worker mentality that is not patient

  9. The impact of duty cycle workflow on sign-out practices: a qualitative study of an internal medicine residency program in Maryland, USA.

    Science.gov (United States)

    Lee, Soo-Hoon; Desai, Sanjay V; Phan, Phillip H

    2017-05-09

    Although JCAHO requires a standardised approach to handoffs, and while many standardised protocols have been tested, sign-out practices continue to vary. We believe this is due to the variability in workflow during inpatient duty cycle. We investigate the impact of such workflows on intern sign-out practices. We employed a prospective, grounded theory mixed-method design. The study was conducted at a residency programme in the mid-Atlantic USA. Two observers randomly evaluated three types of daily sign-outs for 1 week every 3 months from September 2013 to March 2014. The compliance of each observed behaviour to JCAHO's Handoff Communication Checklist was recorded. Thirty one interns conducting 134 patient sign-outs were observed randomly among the 52 in the programme. In the 06:00 to 07:00 sign-back, the night-cover focused on providing information on overnight events to the day interns. In the 11:00 to 12:00 sign-out, the night-cover focused on transferring task accountability to a day-cover intern before departure. In the 20:00 to 21:00 sign-out, the day interns focused on transferring responsibility of their patients to a night-cover. Different sign-out periods had different emphases regarding information exchange, personal responsibility and task accountability. Sign-outs are context-specific, implying that across-the-board standardised sign-out protocols are likely to have limited efficacy and compliance. Standardisation may need to be relative to the specific type and purpose of each sign-out to be supported by interns. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Pediatric resident perceptions of shift work in ward rotations.

    Science.gov (United States)

    Nomura, Osamu; Mishina, Hiroki; Jasti, Harish; Sakai, Hirokazu; Ishiguro, Akira

    2017-10-01

    Although the long working hours of physicians are considered to be a social issue, no effective policies such as duty hour regulations have so far been proposed in Japan. We implemented an overnight call shift (OCS) system for ward rotations to improve the working environment for residents in a pediatric residency program. We later conducted a cross-sectional questionnaire asking the residents to compare this system with the traditional overnight call system. Forty-one pediatric residents participated in this survey. The residents felt that the quality of patient care improved (80.4% agreed). Most felt that there was less emphasis on education (26.8%) and more emphasis on service (31.7%). Overall, the residents reported that the OCS was beneficial (90.2%). In conclusion, the pediatric residents considered the OCS system during ward rotations as beneficial. Alternative solutions are vital to balance improvements in resident work conditions with the requirement for a high quality of education. © 2017 Japan Pediatric Society.

  11. [Sleep deprivation effects on cognitive, psychomotor skills and its relationship with personal characteristics of resident doctors].

    Science.gov (United States)

    Hamui-Sutton, Liz; Barragán-Pérez, Virginia; Fuentes-García, Ruth; Monsalvo-Obregón, Erika Cristina; Fouilloux-Morales, Claudia

    2013-01-01

    In countries such as United States and European Nations changes have been proposed regarding to duty and academic structure of specialists in training, this implies adjustments in the norms concerning the number of hours a week that residents work. The main argument which has underpinned such transformations is based on the assumption that excessive working hours (more than 16 hours uninterrupted) cause cognitive and psychomotor disorders in residents. To evaluate the association between sleep deprivation and cognitive and psychomotor skills of a sample of residents of different specialties of Medicine. Longitudinal study with measurements pre and post shifts, in 31 residents of Medicine. The measured variables were: cognitive and psychomotor skills, demographic data and conditions of the shift, quality of sleep and psychopathology. 81% residents showed detriment in at least one of the tests, however, in psychomotor skills significant different results were found in CPR maneuvers between pre and post shift with an improvement in scores. Sleep deprivation causes detriment of cognitive and psychomotor skills. While our results can't be generalized, they may constitute a precedent for possible changes in the working hours of medical residencies.

  12. 48 CFR 852.222-70 - Contract Work Hours and Safety Standards Act-nursing home care contract supplement.

    Science.gov (United States)

    2010-10-01

    ... Safety Standards Act-nursing home care contract supplement. 852.222-70 Section 852.222-70 Federal...—nursing home care contract supplement. As prescribed in 822.305, for nursing home care requirements, insert the following clause: Contract Work Hours and Safety Standards Act—Nursing Home Care Contract...

  13. The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study

    NARCIS (Netherlands)

    Albrecht, S.C.; Kecklund, L.G.; Rajaleid, K.; Leineweber, C.

    2017-01-01

    Background: Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and

  14. Mothers' Working Hours and Children's Obesity: Data from the Korean National Health and Nutrition Examination Survey, 2008-2010.

    Science.gov (United States)

    Lee, Goeun; Kim, Hyoung-Ryoul

    2013-10-25

    The aim of this study is to find the association between mothers' working hours and obesity of their children according to children's age and gender. This study used data from the second and third year of KNHANES IV and the first year in KNHANES V (2008-2010). We calculate odds ratio (OR) and 95% confidence interval (CI) by using survey logistic regression to assess association of mother's working hours with overweight or obesity of her children. The model was adjusted with household income, mothers' education and obesity and mothers' job characteristics. 13-18 aged boys whose mothers worked under 40 hours per week were higher risk for obesity and overweight (including obesity) than 13-18 aged boys whose mothers worked 40-48 hours. 6-12 aged girls whose mothers worked 49-60 hours per week were more overweight (including obesity) than girls whose mothers worked 40-48 hours per week. 13-18 aged girls whose mothers worked over 60 hours were more overweight (including obesity) than the reference. This study showed that girls' obesity was associated with mothers' long working hours. Long working hours can influence health of workers' family.

  15. Combined effects of working hours, income, and leisure time on suicide in all 47 prefectures of Japan.

    Science.gov (United States)

    Takeuchi, Akito; Sakano, Noriko; Miyatake, Nobuyuki

    2014-01-01

    This study describes an ecological study that evaluated the combined effects of working hours, income, and leisure time on suicide in all 47 prefectures of Japan. In men, the age-adjusted rate of suicide (per 100,000 population) was significantly correlated with working hours (r=0.587, pincome (r=-0.517, p=0.0002) and times for the leisure activities of self-education (r=-0.447, p=0.0016) and hobbies (r=-0.511, p=0.0002). In addition, a stepwise multiple regression analysis identified time for leisure social activities as a determining factor in suicide rate, even after adjusting for working hours and income. However, the impact of time for leisure social activities on suicide rate was smaller than that of working hours and income. In contrast, none of these factors affected suicide rate in women. These results suggest that increasing leisure time may be useful for preventing suicide among men in Japan.

  16. O plantão noturno em anestesia reduz a latência ao sono El plantón nocturno en anestesia reduce la latencia al sueño Short sleep latency in residents after a period on duty in anesthesia

    Directory of Open Access Journals (Sweden)

    Lígia Andrade da Silva Telles Mathias

    2004-10-01

    ñana, después 24 horas de trabajo, sin dormir, sin plantón en los 3 días anteriores (M2; a las 13 horas de la tarde, después de 30 horas de trabajo, sin dormir, sin plantón en los 3 días anteriores (M3. En todas esas situaciones fue realizado electroencefalograma (EEG continuo, en sala apropiada para registro de los señales de sueño, evaluándose la latencia del sueño (LS. RESULTADOS: Se Verificó reducción significativa de la LS entre los residentes, después de 24 ó 30 horas de plantón sin dormir. Entre los praticantes que tuvieron noche de sueño normal en la víspera del examen, 36,4% presentaron LS en nivel considerado patológico. CONCLUSIONES: La jornada de plantón de 24 ó 30 horas lleva a valores de LS menores que 5 minutos, considerados patológicos, reflejando la fatiga extrema de residentes de Anestesiologia. Pode ser importante la reglamentación del número de horas de descanso pos-plantón.BACKGROUND AND OBJECTIVES: Physicians in general, and anesthesiologists in particular, have long working hours. Residents of Anesthesiology may present significant fatigue and stress. This study aimed at investigating first and second year residents’ sleep latency after a period on duty. METHODS: Participated in this study 11 residents in different situations: at 7:00 am, after a normal night sleep (> 7 h, without on duty period in the last 3 days (M1; at 7:00 am, after 24h of night work, without on duty period in the last 3 days (M2; and at 1:00 pm after 30h of work without on duty period in the last 3 days (M3. Continuous EEG was performed for all situations in adequate room to record sleep signals. Sleep latency (SL was evaluated. RESULTS: There has been significant shorter SL among residents after 24 or 30 hours without sleep. From residents after a normal night sleep the day before the evaluation, 36.4% presented pathological SL levels. CONCLUSIONS: Periods on duty for 24 or 30 hours lead to SL values below 5 minutes, which are considered pathologic and

  17. Working hours and incidence of metabolic syndrome and its components in a Mediterranean cohort: the SUN project.

    Science.gov (United States)

    Pimenta, Adriano M; Bes-Rastrollo, Maira; Sayon-Orea, Carmen; Gea, Alfredo; Aguinaga-Ontoso, Enrique; Lopez-Iracheta, Roberto; Martinez-Gonzalez, Miguel A

    2015-08-01

    Metabolic syndrome (MetS) is an important and priority public health problem globally. Long working hours have been proposed as a modifiable risk factor for MetS, despite sparse epidemiological evidence. Thus, the aim of this study was to prospectively evaluate the associations between working hours and incidence of MetS and each of its components. We assessed 6845 participants of a Spanish dynamic prospective cohort of university graduates (the SUN project), initially free of any specific criteria of MetS, and followed-up for a median of 8.3 years. Weekly working hours were collected at baseline and grouped into four categories: >0-24, 25-39, 40-49 and ≥50 h. MetS was defined according to the updated harmonizing criteria. We estimated multivariable adjusted Relative Risks (RR) of MetS and their 95% Confidence Intervals (95% CI), using Poisson regression models. The cumulative incidence of MetS was 6.0%. Working hours were not independently related to MetS (25-39 h/week = RR: 1.42, 95% CI 0.90-2.25; 40-49 h/week = RR: 1.45, 95% CI 0.91-2.30; ≥50 h/week = RR: 1.49, 95% CI 0.91-2.42, P for trend = 0.235) nor to any of its individual definition criteria. Our findings do not suggest that long working hours increase the risk of MetS development or each of its components. Further longitudinal studies in general population should be conducted to confirm these results. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  18. 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.

  19. Objective working hour characteristics and work-life conflict among hospital employees in the Finnish public sector study.

    Science.gov (United States)

    Karhula, Kati; Puttonen, Sampsa; Ropponen, Annina; Koskinen, Aki; Ojajärvi, Anneli; Kivimäki, Mika; Härmä, Mikko

    2017-01-01

    This epidemiological cohort study, based on Finnish public sector data, investigated the associations between objective working hour characteristics and work-life conflict in day and shift work. The comprehensive data of hospital workers (n = 8 931, 92% women, average age 45 years), consisted of survey responses from 2012, linked with the payroll data of working hour characteristics from 91 days preceding the survey. Logistic regression analysis was used to investigate the associations between working hour characteristics and experiencing work-life conflict often/very often. The analyses were adjusted for age (50 years), sex, level of education, marital status, number of small (0-6 years) and school-aged (7-18 years) children, and the overall stressfulness of the life situation. We also conducted stratified analyses of age and sex on the basis of significant interactions. Difficulties in combining work and life were more often associated with shift work without night shifts and shift work with night shifts than with day work (41% and 34 versus 27%; OR for shift work with night shifts 1.78, 95% CI 1.59-2.00, OR for shift work without night shifts 1.42, 95% CI 1.26-1.60). A high proportion (> 25%) of long (> 40h, (OR 1.26, 95% 1.14-1.39) and very long (> 48h, OR 1.31, 95% CI 1.15-1.49) weekly working hours were associated with work-life conflict, and in the stratified analysis, the latter was also true among women (OR 1.54, 95% CI 1.25-1.89). Of the unsocial working hour characteristics, a relatively large amount (> 10% of all shifts) of evening (OR 1.56, 95% CI 1.41-1.72) and night shifts (OR 1.46, 95%CI 1.32-1.61), a high proportion (> 25% of all shifts) of quick returns (work (OR 1.44, 95% CI 1.31-1.58) were associated with work-life conflict. A large amount of single days off (> 25% of all days off) was associated with work-life conflict among men (OR 1.90, 95% CI 1.11-3.25), but not in the whole sample. When the two types of shift work were analyzed separately

  20. 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.

  1. Work hours, work stress, and collaboration among ward staff in relation to risk of hospital-associated infection among patients.

    Science.gov (United States)

    Virtanen, Marianna; Kurvinen, Tiina; Terho, Kirsi; Oksanen, Tuula; Peltonen, Reijo; Vahtera, Jussi; Routamaa, Marianne; Elovainio, Marko; Kivimäki, Mika

    2009-03-01

    To examine the association between work hours, work stress, and collaboration among the ward personnel, and the risk of hospital-associated infection among patients. Cross-sectional data on hospital infections were collected between March and June 2004. These data were linked with ward-level responses to a personnel survey collected during the same time period. Medical records of patients in 60 non-psychiatric bed wards in 6 Finnish hospitals. One thousand ninety-two patients and 1159 staff survey responses. Prevalence surveillance was performed by 4 infection control nurses, using standard criteria. Data on several potential risk factors for infection were collected: sex, age, patient type (surgical vs. other), hospital type (university vs. regional hospital), unit type, number of patients in the ward, exposure to invasive devices, International Classification of Diseases version 10 diagnosis, chemotherapy, radiotherapy, and use of corticosteroids. Staff working conditions were measured by survey scales. Ninety-nine cases (9.1%) of hospital-associated infection were found. Multilevel logistic regression analyses, adjusted for hospital factors and patient-related risk factors, showed that long work hours among staff were associated with increased risk of infection [odds ratio (OR) 2.74, 95% confidence interval (CI): 1.07-7.04]. Other staff-related correlates of infection were high work stress, as indicated by high imbalance between efforts and rewards (OR: 2.47; 95% CI: 1.38-4.42), low trust between work unit members (OR: 2.37; 95% CI: 1.27-4.43), injustice in the distribution of work (OR: 1.81; 95% CI: 1.04-3.16), and poor collaboration between ward supervisors (OR: 2.46; 95% CI: 1.38-4.38). Long work hours, high work stress, and poor collaboration among the ward staff are associated with hospital-associated infection among patients.

  2. Information Meeting- Working Hours

    CERN Multimedia

    Maurin

    1972-01-01

    Mons. Maurin préside la séance et fait part des résultats aux questionnaires pour définir une ligne de conduite de l'association- ramener et harmoniser les horaires- changer les contrats de 44 à 40 heures- des gens travaillent en partie encore 48 h

  3. Scheduling the resident 80-hour work week: an operations research algorithm.

    Science.gov (United States)

    Day, T Eugene; Napoli, Joseph T; Kuo, Paul C

    2006-01-01

    The resident 80-hour work week requires that programs now schedule duty hours. Typically, scheduling is performed in an empirical "trial-and-error" fashion. However, this is a classic "scheduling" problem from the field of operations research (OR). It is similar to scheduling issues that airlines must face with pilots and planes routing through various airports at various times. The authors hypothesized that an OR approach using iterative computer algorithms could provide a rational scheduling solution. Institution-specific constraints of the residency problem were formulated. A total of 56 residents are rotating through 4 hospitals. Additional constraints were dictated by the Residency Review Committee (RRC) rules or the specific surgical service. For example, at Hospital 1, during the weekday hours between 6 am and 6 pm, there will be a PGY4 or PGY5 and a PGY2 or PGY3 on-duty to cover Service "A." A series of equations and logic statements was generated to satisfy all constraints and requirements. These were restated in the Optimization Programming Language used by the ILOG software suite for solving mixed integer programming problems. An integer programming solution was generated to this resource-constrained assignment problem. A total of 30,900 variables and 12,443 constraints were required. A total of man-hours of programming were used; computer run-time was 25.9 hours. A weekly schedule was generated for each resident that satisfied the RRC regulations while fulfilling all stated surgical service requirements. Each required between 64 and 80 weekly resident duty hours. The authors conclude that OR is a viable approach to schedule resident work hours. This technique is sufficiently robust to accommodate changes in resident numbers, service requirements, and service and hospital rotations.

  4. Analysis and Development in Method of Permissible Working Hours of Agricultural Wells in the Khorasan-e-Razavi Province- Case study: Neyshabour Plain

    Directory of Open Access Journals (Sweden)

    S.A. Haghayeghi

    2014-12-01

    Full Text Available Permissible working hours of agricultural wells in the Neyshabour plain was determined equal 4120 hours by regional water authority of Khorasan-e-Razavi. This research was conducted to introduce method of working hours of agricultural wells in the Khorasan-e-Razavi province (case study of Neyshabour plain and analyse effective parameters on working time of wells. For this purpose, the area of agronomy and horticulture crops was obtained for the years of 2001 to 2010. Water requirement of these crops was extracted from the water national document. Working hours of wells for every months would be calculated by deviding gross irrigation requirement to average hydromodul of three maximum months. The calculations to assess the effect of sowing pattern was done separately in two phases, for all crops pattern and for major crops pattern. In the thirth and forth phases, the effect of annual variation of water requirement and irrigation hydromodul were assessed on the working hours of Neyshabour plain wells. The results showed that instead of using all crops pattern, it is possible to use just major crops in calculating of working hours of wells. Annual variation of sowing pattern and water requirement in the Neyshabour plain have significant effect (95% confidence on working hours of wells. By suppose the constant area under crops in the Neyshabour plain, adjust in calculating of working hours of wells was done using measured hydromodul in the region. In adjusted method, the annual working hours showed increase averagely 440 (11% hours in compare to permissible working hours of Neyshabour plain (4120 hours. This variety in working hours of wells cause to be near to existence and realy conditions of the Neyshabour plain. In an agronomy year, it is possible to have an acceptable forcasting for working hours of regional wells by determining the sowing area of wheat and barley.

  5. A case-crossover study of sleep and work hours and the risk of road traffic accidents.

    Science.gov (United States)

    Valent, Francesca; Di Bartolomeo, Stefano; Marchetti, Riccardo; Sbrojavacca, Rodolfo; Barbone, Fabio

    2010-03-01

    Sleepiness, prolonged wakefulness, and extended work hours have been associated with increased risk of injuries and road accidents. The authors' objective was to study the relation between those factors and road accidents using a case-crossover design, effective in estimating the risk of acute events associated with transient, short effect exposures. Five hundred seventy-four injured drivers presenting for care after road accidents to the Emergency Room of Udine, Italy, were enrolled in the study from March 2007 to March 2008. Sleep, work, and driving patterns in the 48 h before the accident were assessed through an interview. The relative risk (RR) of accident associated with each exposure was estimated using the case-crossover matched pair interval approach. Sleeping > or = 11 h daily was associated with a decrease of the RR, as was sleeping less than usual. Being awake > or = 16 h and, possibly, working > 12 h daily were associated with increases in the RR. Extended work hours and prolonged wakefulness increase the risk of road accidents and suggest that awareness should be raised among drivers. The findings regarding acute sleep amount are less clear, possibly due to an effect of chronic sleep loss.

  6. Reducing Risks to Women Linked to Shift Work, Long Work Hours, and Related Workplace Sleep and Fatigue Issues.

    Science.gov (United States)

    Caruso, Claire C

    2015-10-01

    In the United States, an estimated 12% to 28% of working women are on shift work schedules, and 12% work more than 48 hours per week. Shift work and long work hours are associated with many health and safety risks, including obesity, injuries, and negative reproductive outcomes. Over time, the worker is at risk for developing a wide range of chronic diseases. These work schedules can also strain personal relationships, owing to fatigue and poor mood from sleep deprivation and reduced quality time to spend with family and friends. Worker errors from fatigue can lead to reduced quality of goods and services, negatively impacting the employer. In addition, mistakes by fatigued workers can have far-reaching negative effects on the community, ranging from medical care errors to motor vehicle crashes and industrial disasters that endanger others. To reduce the many risks that are linked to these demanding work hours, the National Institute for Occupational Safety and Health (NIOSH) conducts research, develops guidance and authoritative recommendations, and translates and disseminates scientific information to protect workers, their families, employers, and the community. The key message to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the worker's personal life. The NIOSH website has freely available online training programs with suggestions for workers and their managers to help them better cope with this workplace hazard.

  7. Recovery of Sleep or Recovery of Self? A Grounded Theory Study of Residents' Decision Making Regarding How to Spend Their Nonclinical Postcall Time.

    Science.gov (United States)

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

    2016-03-01

    As resident work hours policies evolve, residents' off-duty time remains poorly understood. Despite assumptions about how residents should be using their postcall, off-duty time, there is little research on how residents actually use this time and the reasoning underpinning their activities. This study sought to understand residents' nonclinical postcall activities when they leave the hospital, their decision-making processes, and their perspectives on the relationship between these activities and their well-being or recovery. The study took place at a Liaison Committee on Medical Education-accredited Canadian medical school from 2012 to 2014. The authors recruited a purposive and convenience sample of postgraduate year 1-5 residents from six surgical and nonsurgical specialties at three hospitals affiliated with the medical school. Using a constructivist grounded theory approach, semistructured interviews were conducted, audio-taped, transcribed, anonymized, and combined with field notes. The authors analyzed interview transcripts using constant comparative analysis and performed post hoc member checking. Twenty-four residents participated. Residents characterized their predominant approach to postcall decision making as one of making trade-offs between multiple, competing, seemingly incompatible, but equally valuable, activities. Participants exhibited two different trade-off orientations: being oriented toward maintaining a normal life or toward mitigating fatigue. The authors' findings on residents' trade-off orientations suggest a dual recovery model with postcall trade-offs motivated by the recovery of sleep or of self. This model challenges the dominant viewpoint in the current duty hours literature and suggests that the duty hours discussion must be broadened to include other recovery processes.

  8. Wanting more or wanting less? Mismatches between actual and preferred working hours in Spain, 2005-2014

    Directory of Open Access Journals (Sweden)

    Margarita Torre Fernández

    2017-05-01

    Full Text Available Mismatches between the number of hours people actually work and the hours they would prefer to work are common, and they have important consequences for individual, family and organizational life. This study contributes to prior research examining how the quality of work is affected by the economic crisis. Using data from the Spanish Labor Force Survey from 2005 to 2014, it tests three possible competing predictions for trends in working hour mismatches during the economic downturn. The study reveals that the level of mismatches has increased significantly with the economic recession due to the growing number of people who would wish to work more hours than they actually do. Findings show that the increase in hour mismatches has been particularly striking among workers employed under fixed term contracts, part-time contracts, those in low-status occupations and women. The economic crisis has widened the gap between high- and low-status workers over the last decade.

  9. The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study.

    Science.gov (United States)

    Albrecht, Sophie C; Kecklund, Göran; Rajaleid, Kristiina; Leineweber, Constanze

    2017-06-01

    Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and control over time off, was related to depressive symptoms over time and examined causal, reversed-causal, and reciprocal pathways. The study was based on four waves of the Swedish Longitudinal Occupational Survey of Health which is a follow-up of representative samples of the Swedish working population. WTC was measured using a 5-item index. Depressive symptoms were assessed with a brief subscale of the Symptom Checklist. Latent growth curve models and cross-lagged panel models were tested. Best fit was found for a model with correlated intercepts (control over daily hours) and both correlated intercepts and slopes (control over time off) between WTC and depressive symptoms, with stronger associations for control over time off. Causal models estimating impacts from WTC to subsequent depressive symptoms were best fitting, with a standardised coefficient between -0.023 and -0.048. Results were mainly based on self-report data and mean age in the study sample was relatively high. Higher WTC was related to fewer depressive symptoms over time albeit small effects. Giving workers control over working hours - especially over taking breaks and vacation - may improve working conditions and buffer against developing depression, potentially by enabling workers to recover more easily and promoting work-life balance. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Huan Zhou

    2017-10-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2009-07-01

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

  14. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. [Results of Training for Personnel Involved in Blood-Transfusion Testing Outside of Regular Work Hours at Saga University Hospital].

    Science.gov (United States)

    Yamada, Marie; Yamada, Naotomo; Higashitani, Takanori; Ohta, Shoichiro; Sueoka, Eisaburo

    2015-11-01

    Laboratory testing prior to blood transfusion outside of regular hours in many hospitals and clinics is frequently conducted by technicians without sufficient experience in such testing work. To obtain consistent test results regardless of the degree of laboratory experience with blood transfusion testing, the number of facilities introducing automated equipment for testing prior to blood transfusion is increasing. Our hospital's blood transfusion department introduced fully automated test equipment in October of 2010 for use when blood transfusions are conducted outside of regular hours. However, excessive dependence on automated testing can lead to an inability to do manual blood typing or cross-match testing when necessitated by breakdowns in the automated test equipment, in the case of abnormal specimen reactions, or other such case. In addition, even outside of normal working hours there are more than a few instances in which transfusion must take place based on urgent communications from clinical staff, with the need for prompt and flexible timing of blood transfusion test and delivery of blood products. To address this situation, in 2010 we began training after-hours laboratory personnel in blood transfusion testing to provide practice using test tubes manually and to achieve greater understanding of blood transfusion test work (especially in cases of critical blood loss). Results of the training and difficulties in its implementation for such after-hours laboratory personnel at our hospital are presented and discussed in this paper. [Original

  16. Working hours, sleep, salivary cortisol, fatigue and neuro-behavior during Mars analog mission: five crews study.

    Science.gov (United States)

    Rai, Balwant; Foing, Bernard H; Kaur, Jasdeep

    2012-05-16

    The buoyancy of humans in exploring extreme space environments has been established during missions to the moon. Long duration missions like mission to Mars however, requires humans to adapt to systemic and complex environments beyond the human body's capacity. Astronauts will encounter both physiological and psychological extremes during this trip. Very few studies are conducted on effect of long duration work and sleepiness on cognitive performance. So, this study was planned to find out effects of leadership responsibility, sleepiness and long duration working hours on cognitive performance. The 30 members (leadership: normal; 10:20) were selected from MDRS crews (Mars Desert Research Station, USA). Neurobehavioral test performance, self-ratings of fatigue and sleepiness, and salivary cortisol levels were evaluated during first day, mid and end day of mission. The leadership group did not show any signs of reduced test performance, even in elevated fatigue and sleepiness. The leadership group had faster reaction times on end of mission as compared to first and after 7 day of mission. Salivary cortisol levels were significantly higher in leadership group as compared to normal group. The results suggest that long duration work and sleepiness does not affect the cognitive performance of crew member. Further study is required while taking into account all factors and large sample size to prove this fact. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  17. Fatigue and related factors among hotel workers: the effects of emotional labor and non-standard working hours.

    Science.gov (United States)

    Lee, Ju Jong; Moon, Hyun Jey; Lee, Kyung-Jae; Kim, Joo Ja

    2014-01-01

    This study assessed fatigue and its association with emotional labor and non-standard working hours among hotel workers. A structured self-administered questionnaire was distributed to 1,320 employees of five hotels located in Seoul. The questionnaire survey included questions concerning the participants' sociodemographics, health-related behaviors, job-related factors, emotional labor, and fatigue. Fatigue was assessed using the Multidimensional Fatigue Scale (MFS). Multiple logistic regression modeling was used to determine the associations between fatigue and emotional labor. Among male workers, there was a significant association between fatigue and both emotional disharmony (OR=5.52, 95% CI=2.35-12.97) and emotional effort (OR=3.48, 95% CI=1.54-7.86). These same associations were seen among the female workers (emotional disharmony: OR=6.91, 95% CI=2.93-16.33; emotional effort: OR=2.28, 95% CI=1.00-5.16). These results indicate that fatigue is associated with emotional labor and, especially, emotional disharmony among hotel workers. Therefore, emotional disharmony management would prove helpful for the prevention of fatigue.

  18. Long work hours and physical fitness: 30-year risk of ischaemic heart disease and all-cause mortality among middle-aged Caucasian men

    DEFF Research Database (Denmark)

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann

    2010-01-01

    No previous long-term studies have examined if workers with low physical fitness have an increased risk of cardiovascular mortality due to long work hours. The aim of this study was to test this hypothesis.......No previous long-term studies have examined if workers with low physical fitness have an increased risk of cardiovascular mortality due to long work hours. The aim of this study was to test this hypothesis....

  19. Different Views about Work-Hour Limitations in Medicine: A Qualitative Content Analysis of Surgeons', Lawyers', and Pilots' Positive and Negative Arguments

    OpenAIRE

    Businger, Adrian P.; Kaderli, Reto M.

    2014-01-01

    Background Whereas work-hour regulations have been taken for granted since 1940 in other occupational settings, such as commercial aviation, they have been implemented only recently in medical professions, where they lead to a lively debate. The aim of the present study was to evaluate arguments in favour of and against work-hour limitations in medicine given by Swiss surgeons, lawyers, and pilots. Methods An electronic questionnaire survey with four free-response items addressing the questio...

  20. Associations between social ecological factors and self-reported short physical activity breaks during work hours among desk-based employees.

    Science.gov (United States)

    Bennie, Jason A; Timperio, Anna F; Crawford, David A; Dunstan, David W; Salmon, Jo L

    2011-01-01

    To examine the associations between potential social ecological correlates and self-reported short physical activity breaks during work hours (defined as any interruption in sitting time during a typical work hour) among a sample of employees who commonly sit for working tasks. 801 employed adults aged 18-70 years from metropolitan Melbourne, Australia were surveyed in 2009 about their short physical activity breaks from sitting during work hours and potential social ecological correlates of this behaviour. Men reported significantly more short physical activity breaks per work hour than did women (2.5 vs. 2.3 breaks/h, p=0.02). A multivariable linear regression analysis adjusting for clustering and meeting the public health physical activity recommendations showed that the factors associated with frequency of short physical activity breaks per work hour were perceptions of lack of time for short physical activity breaks for men (-0.31 breaks/h, 95% confidence intervals [CI] -0.52, -0.09) and lack of information about taking short physical activity breaks for women (-0.20 breaks/h, CI -0.47, -0.05). These findings suggest that providing male employees with support for short physical activity breaks during work hours, and female employees with information on benefits of this behaviour may be useful for reducing workplace sedentary time. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  1. Whether Regular Working Hours Can Minimize The Blood Bbiochemical Effects of Shift Working: Across-Sectional Study In Iran

    Directory of Open Access Journals (Sweden)

    Koroush Soleimani

    2010-02-01

    Full Text Available Background:Irregular Working hours, including night work and shift work,have been found to be associated with alteration in various levels of biochemical factors. And some studies have showed association between shift work and blood biochemical disturbances in blood. In this epidemiological study we investigated,whether regular schedule of working hours can minimize the associated biochemical effects.Methods: Atotal of 442 air traffic controllers between the ages of 21 and 59 years in this study filled out questionnaire, and triglyceride, total cholesterol, and HDL-C concentration and FBS were measured after 12- hours fasting. The correlation between shift work and the biochemical variables was measured. The SPSS software version 11.5 and STATAversion 8 were used for statistical analysis, the X2 and fisher's exact test used for comparing the qualitative variables and the parametric tests for quantitative variables with normal distribution. Odd's ratio (OR, and 95% confidence interval (95% CI were used for estimating the effect of shift work on lipid profile and high blood glucose levels. Logistic regression modeling was used for multivariable analysis and adjusting the effect of different variables.Results: sample size of this cross-sectional study was consisted of 305(69% shift workers and 137(31% day workers. The mean age of the shift workers was 40 ± 10 years old and the day workers 40 ± 9.The mean of variables in the present study for total cholesterol, LDL-C, HDL-C, triglyceride and fasting blood glucose in the shift workers were respectively: 195±37mg/dl, 116.8±34.8mg/dl, 48.2±15.1mg/dl, 154±80mg/dl, 92±20mg/dl and in the day workers were respectively: 200±40mg/dl, 125.3±38.6mg/dl, 48.8±23.3mg/dl,151± 77mg/dl, 90± 14mg/dl. Adjusted Odd's ratio for the effect of shift working on the biochemical blood factors did not change the results.Conclusion: This study showed that air traffic control workers with various shift did not

  2. Interrelationships between romance, life quality, and medical training of female residents.

    Science.gov (United States)

    Wang, Yu-Jung; Hsu, Kan-Lin; Chang, Chin-Sung; Wu, Chih-Hsing

    2012-08-01

    For the past 30 years, there has been a steady increase in the number of female physicians, but the relationship between their romantic lives and their pattern of training has been inadequately reported. This study was designed to investigate the interrelationships between medical training, quality of life, and the attitudes that female residents have toward romance. Of the 106 female medical residents at our medical center in 2009, a total of 78 residents (73.6%) were enrolled for the study. Structured questionnaires (Cronbach α = 0.878), which included questions about female resident quality of life, attitude toward spousal choice, and the impact of programmed professional medical training, were self-administered through an anonymous process. Female residents, especially ward-care specialists, were determined to have excessively long working hours (84.6% > 88 work hours/week), insufficient and irregular sleep (44.9%), and inadequate personal time (73.1% romances, 87.5% (n = 40) of romantic partners were physicians and 58.3% (n = 28) initiated their relationships when they were medical students, but exhibited no preferential dating of senior medical students or physicians. Factors affecting the choice of spouses included time limitations, a limited circle of friends, differences in values, and work-related stress. Those presumptive factors influencing romance between the assumed partner being a doctor or a "nondoctor" were significantly different with regard to lack of time (p = 0.002), values (p Romance and quality of life were significantly influenced by the pattern of medical training in female residents. Setting duty-hour limits and initiating a new hobby were determined to be potentially beneficial to their quality of life and attitudes toward romance. Copyright © 2012. Published by Elsevier B.V.

  3. Work-Related Quality of Life among Medical Residents at a University Hospital in Northeastern Thailand.

    Science.gov (United States)

    Somsila, Nattamon; Chaiear, Naesinee; Boonjaraspinyo, Sirintip; Tiamkao, Somsak

    2015-12-01

    1) To assess work-related quality of life (WRQOL) among medical residents at a university hospital in northeast Thailand. 2) To determine the strength of the association between personal and working condition components and WRQOL among medical residents. A descriptive study was used to describe the WRQOL among medical residents. The study population comprised of all 375 residents affiliated with the university hospital. The Thai version of a self-administered work-related quality of life scale-2 was used for data collection. Testing the reliability revealed a Cronbach's alpha of 0.908. Questionnaires were completed by 259 of 375 (68.3%). The study found that the mean rating by residents for overall WRQOL was 113.8 out of 170 (SD 14.8). Most rated WRQOL as moderate (76.6%). The seven sub-factors were rated as moderate to high for employee engagement and control at work, moderate for home/work interface, general well-being and working conditions, high-moderate for job career satisfaction, and low-moderate for stress at work. Relationships between the personal and working condition components and WRQOL were analyzed using binary logistic regression. Residents in minor specialties had a higher WRQOL than those in major specialties (OR 2.522, 95% CI: 1.37, 4.63). Residents who had less than eight duty shifts/week had a higher WRQOL than those with more than eight duty shifts/week (OR 2.263, 95% CI: 1.16, 4.41). Similarly, residents working with less than 80 hours/week had a higher WRQOL than those working more than 80 hours/week (OR 2.344, 95% CI: 1.17, 4.72). A subgroup analyzes of those working in minor specialties showed the trend that working less than eight shifts/month and working less than 80 hours/week had the potential association with good quality of work-life (QWL). This phenomenon is presented in the subgroup analyses of those working in major specialties. Therefore, working hours and number of shifts might have played important role in contributing good QWL

  4. Psychologic effects of residency.

    Science.gov (United States)

    Reuben, D B

    1983-03-01

    The intense situational and physiologic stresses that accompany postgraduate training may have serious psychosocial ramifications. Although only a small proportion of residents have overt psychiatric illness, virtually all display some psychologic impairment. Contributing factors include life-changes, stresses associated with providing patient care, loss of social support, long working hours, sleep deprivation, and underlying personality traits of residents. The manifestations of this impairment are variable and may be subtle. In response to these problems, residency programs have taken steps to provide psychosocial support. Unfortunately, most programs do not offer formal support groups or seminars to discuss difficulties that accompany residency. Further definition of the psychosocial effects of residency may prompt changes that make the training of physicians a more humane process.

  5. Long Work Hours, Part-Time Work, and Trends in the Gender Gap in Pay, the Motherhood Wage Penalty, and the Fatherhood Wage Premium

    Directory of Open Access Journals (Sweden)

    Kim A. Weeden

    2016-08-01

    Full Text Available We assess how changes in the social organization and compensation of work hours over the last three decades are associated with changes in wage differentials among mothers, fathers, childless women, and childless men. We find that large differences between gender and parental status groups in long work hours (fifty or more per week, coupled with sharply rising hourly wages for long work hours, contributed to rising gender gaps in wages (especially among parents, motherhood wage penalties, and fatherhood wage premiums. Changes in the representation of these groups in part-time work, by contrast, is associated with a decline in the gender gap in wages among parents and in the motherhood wage penalty, but an increase in the fatherhood wage premium. These findings offer important clues into why gender and family wage differentials still persist.

  6. Job strain associated with increases in ambulatory blood and pulse pressure during and after work hours among female hotel room cleaners.

    Science.gov (United States)

    Feaster, Matt; Krause, Niklas

    2018-03-22

    Previously documented elevated hypertension rates among Las Vegas hotel room cleaners are hypothesized to be associated with job strain. Job strain was assessed by questionnaire. Ambulatory blood pressure (ABP) was recorded among 419 female cleaners from five hotels during 18 waking hours. Multiple linear regression models assessed associations of job strain with ABP and pulse pressure for 18-h, work hours, and after work hours. Higher job strain was associated with increased 18-h systolic ABP, after work hours systolic ABP, and ambulatory pulse pressure. Dependents at home but not social support at work attenuated effects. Among hypertensive workers, job strain effects were partially buffered by anti-hypertensive medication. High job strain is positively associated with blood pressure among female hotel workers suggesting potential for primary prevention at work. Work organizational changes, stress management, and active ABP surveillance and hypertension management should be considered for integrated intervention programs. © 2018 Wiley Periodicals, Inc.

  7. Long working hours, job satisfaction, and depressive symptoms: a community-based cross-sectional study among Japanese employees in small- and medium-scale businesses.

    Science.gov (United States)

    Nakata, Akinori

    2017-08-08

    Although long working hours have been suspected to be a risk factor for depressive symptoms (DS), it is not well understood the conditions under which long working hours are associated with it. This study investigated the moderating effect of job satisfaction on the relationship between working hours and DS. A total of 2,375 full-time non-shift day workers (73% men), aged 18-79 (mean 45) years, in 296 small- and medium-scale businesses were surveyed using a self-administered questionnaire evaluating working hours, job satisfaction, DS and covariates. The Center for Epidemiologic Studies Depression scale (CES-D) was used to assess DS. Risk of DS (CES-D ≥ 16) by working hours, job satisfaction, and both combined was estimated by multivariable logistic regression analysis. Compared to participants working 6-8 hrs/day, those working 12+ hrs/day had significantly higher odds of DS (adjusted odds ratio [aOR] 1.49), while participants with low satisfaction, as opposed to high satisfaction, had increased odds of DS (aOR 1.81). Furthermore, compared to those working 6-8 hrs/day with high satisfaction (reference group), participants working 6-8 hrs/day, > 8 to 10 hrs/day, and > 10 hrs/day combined with low satisfaction had dose-response increase of DS (aOR 1.48, 2.21 and 2.31, respectively, p 8 to 10 hrs/day and > 10 hrs/day combined with high satisfaction had not (aOR 0.93 and 1.39, respectively, p > 0.10). The results suggest that long working hours are associated with increased risk of DS only under reduced job satisfaction condition, which highlights the importance of improving job satisfaction, particularly among those working excessive hours.

  8. Mothers’ Working Hours and Children’s Obesity: Data from the Korean National Health and Nutrition Examination Survey, 2008–2010

    OpenAIRE

    Lee, Goeun; Kim, Hyoung-Ryoul

    2013-01-01

    Objectives The aim of this study is to find the association between mothers’ working hours and obesity of their children according to children’s age and gender. Methods This study used data from the second and third year of KNHANES IV and the first year in KNHANES V (2008–2010). We calculate odds ratio (OR) and 95% confidence interval (CI) by using survey logistic regression to assess association of mother’s working hours with overweight or obesity of her children. The model was adjusted with...

  9. Maternal Work Hours and Adolescents' School Outcomes among Low-Income Families in Four Urban Counties. National Poverty Center Working Paper Series #07-01

    Science.gov (United States)

    Gennetian, Lisa A.; Lopoo, Leonard M.; London, Andrew S.

    2007-01-01

    We examine how changes in maternal work hours affect adolescent children's school participation and performance outcomes using data from interviews in 1998 and 2001 with 1,700 women who in May 1995 were welfare-reliant, single mothers of adolescents living in disadvantaged neighborhoods in four urban counties. We find unfavorable effects of…

  10. Different views about work-hour limitations in medicine: a qualitative content analysis of surgeons', lawyers', and pilots' positive and negative arguments.

    Science.gov (United States)

    Businger, Adrian P; Kaderli, Reto M

    2014-01-01

    Whereas work-hour regulations have been taken for granted since 1940 in other occupational settings, such as commercial aviation, they have been implemented only recently in medical professions, where they lead to a lively debate. The aim of the present study was to evaluate arguments in favour of and against work-hour limitations in medicine given by Swiss surgeons, lawyers, and pilots. An electronic questionnaire survey with four free-response items addressing the question of what arguments speak in favour of or against work-hour limitations in general and in medicine was sent to a random sample of board-certified surgeons, lawyers in labour law, and pilots from SWISS International Airlines Ltd. In all, 279/497 (56%) of the respondents answered the survey: 67/117 surgeons, 92/226 lawyers, and 120/154 pilots. Support for work-hour limitations in general and in medicine was present and higher among lawyers and pilots than it was in surgeons (plimitations in general than in medicine (plimitations were "quality and patient safety," "health and fitness," and "leisure and work-family balance," whereas the lack of "flexibility" was the most important argument against. Surgeons expected more often that their "education" and the "quality of their work" would be threatened (plimitations should be supported in medicine also, but a way must be found to reduce problems resulting from discontinuity in patient care and to minimise the work in medicine, which has no education value.

  11. Shift work, long working hours, and later risk of dementia: A long-term follow-up of the Copenhagen Male Study.

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Ishtiak-Ahmed, Kazi; Gyntelberg, Finn; Mortensen, Erik Lykke; Phung, Thien Kieu Thi; Rod, Naja Hulvej; Waldemar, Gunhild; Westendorp, Rudi Gj; Hansen, Åse Marie

    2017-11-01

    Objectives The aim of this study was to investigate the effect of shift work and long working hours in midlife on the risk of dementia in old age. Methods The present study comprised 4766 participants from the Copenhagen Male Study. We used information on shift work (collected in 1970-1971 and 1985-1986), long working hours defined as >45 hours per week (collected in 1970-1971), socioeconomic status, sleep, stress, and cardiovascular risk factors. Information about dementia diagnoses was obtained from registers. Participants were followed until 2014 (mean length of follow-up was 17.8 years). We employed Poisson regression for the survival analyses and estimated incidence rate ratios (IRR) and their 95% confidence intervals (CI). Results We found no statistically significant association between shift work (IRR 0.86, 95% CI 0.70-1.05) or long working hours (IRR 0.97, 95% CI 0.79-1.19) and dementia. Adjustment for potential confounders and mediators did not change the estimates. Working shifts at both time points of exposure assessment was not associated with a higher incidence of dementia compared with non-shift workers at both time points (IRR 0.99, 95% CI 0.69-1.42). The lowest incidence of dementia was observed among participants who reported shift work at one time point (only in 1985-1986: IRR 0.44, 95% CI 0.16-1.23 and only in 1970-1971: IRR 0.58, 95% CI 0.31-1.11). Conclusion We did not find positive evidence of an association between shift work or long working hours and the incidence of dementia, but the negative findings may reflect the crude assessment of shift work and long working hours, which is a major limitation of the present study.

  12. Sleep Disturbance and Short Sleep as Risk Factors for Depression and Perceived Medical Errors in First-Year Residents.

    Science.gov (United States)

    Kalmbach, David A; Arnedt, J Todd; Song, Peter X; Guille, Constance; Sen, Srijan

    2017-03-01

    While short and poor quality sleep among training physicians has long been recognized as problematic, the longitudinal relationships among sleep, work hours, mood, and work performance are not well understood. Here, we prospectively characterize the risk of depression and medical errors based on preinternship sleep disturbance, internship-related sleep duration, and duty hours. Survey data from 1215 nondepressed interns were collected at preinternship baseline, then 3 and 6 months into internship. We examined how preinternship sleep quality and internship sleep and work hours affected risk of depression at 3 months, per the Patient Health Questionnaire 9. We then examined the impact of sleep loss and work hours on depression persistence from 3 to 6 months. Finally, we compared self-reported errors among interns based on nightly sleep duration (≤6 hr vs. >6 hr), weekly work hours (sleeping trainees obtained less sleep and were at elevated risk of depression in the first months of internship. Short sleep (≤6 hr nightly) during internship mediated the relationship between sleep disturbance and depression risk, and sleep loss led to a chronic course for depression. Depression rates were highest among interns with both sleep disturbance and short sleep. Elevated medical error rates were reported by physicians sleeping ≤6 hr per night, working ≥ 70 weekly hours, and who were acutely or chronically depressed. Sleep disturbance and internship-enforced short sleep increase risk of depression development and chronicity and medical errors. Interventions targeting sleep problems prior to and during residency hold promise for curbing depression rates and improving patient care. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  13. Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.

    Science.gov (United States)

    Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

    2009-01-01

    To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.

  14. Are Mothers' Working Hours Associated with General and Abdominal Obesity in Children and Adolescents? The Korean National Health and Nutrition Examination Survey (2008-2012).

    Science.gov (United States)

    Kim, Juyeong; Park, Eun-Cheol; Choi, Young; Park, Sohee

    2018-04-01

    Objectives Despite an increase in the female work force and recent increase in childhood obesity, the association between working hours of mothers and childhood obesity as well as how such association differs according to mothers' weight and intake frequency of energy-dense, nutrition-poor (EDNP) foods remain unclear. Methods Data from the Korean National Health and Nutrition Examination Survey (2008-2012) that included samples from 3914 children in 2526 households were analyzed. Two-level (household-children) mixed-effects modeling was performed to investigate the association between mothers' working hours and childhood obesity based on body mass index (BMI) and waist circumference (WC). Results Long working hours (h) of mothers were associated with both BMI (β = - 0.14; P = 0.324 for 1-20 h, β = 0.10; P = 0.334 for ≤ 21-40 h; β = 0.09; P = 0.429 for 41-68 h, β = 0.51; P = 0.015 for ≥ 69 h) and WC of the child (β = 0.06; P = 0.809 for 1-20 h; β = 0.46; P = 0.017 for ≤ 21-40 h; β = 0.59; P = 0.004 for 41-68 h, β = 1.35; P mothers working ≥ 69 h compared to those working 0 h. We also observed that the association between mothers' working hours and child's BMI and WC was greater for children whose mothers were either overweight or obese and frequently consumed energy-dense, nutrient-poor foods (EDNP). Conclusions for Practice Long working hours of mothers are associated with higher BMI and WC in children. Thus, it is important to improve labor welfare for mothers who work long hours, and provide interventions to promote good health behaviors in both children and working mothers.

  15. Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

    Science.gov (United States)

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2009-01-01

    Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

  16. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals.

    Science.gov (United States)

    Kivimäki, Mika; Jokela, Markus; Nyberg, Solja T; Singh-Manoux, Archana; Fransson, Eleonor I; Alfredsson, Lars; Bjorner, Jakob B; Borritz, Marianne; Burr, Hermann; Casini, Annalisa; Clays, Els; De Bacquer, Dirk; Dragano, Nico; Erbel, Raimund; Geuskens, Goedele A; Hamer, Mark; Hooftman, Wendela E; Houtman, Irene L; Jöckel, Karl-Heinz; Kittel, France; Knutsson, Anders; Koskenvuo, Markku; Lunau, Thorsten; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Shipley, Martin J; Siegrist, Johannes; Steptoe, Andrew; Suominen, Sakari B; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; O'Reilly, Dermot; Kumari, Meena; Batty, G David; Ferrie, Jane E; Virtanen, Marianna

    2015-10-31

    Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603,838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528,908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5·1 million person-years (mean 8·5 years), in which 4768 events were recorded, and for stroke was 3·8 million person-years (mean 7·2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35-40 h per week), working long hours (≥55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1·13, 95% CI 1·02-1·26; p=0·02) and incident stroke (1·33, 1·11-1·61; p=0·002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1·30-1·42). We recorded a dose-response association for stroke, with RR estimates of 1·10 (95% CI 0·94-1·28; p=0·24) for 41-48 working hours, 1·27 (1·03-1·56; p=0·03) for 49-54 working hours, and 1·33 (1·11-1·61; p

  17. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals.

    Science.gov (United States)

    Kivimäki, Mika; Virtanen, Marianna; Kawachi, Ichiro; Nyberg, Solja T; Alfredsson, Lars; Batty, G David; Bjorner, Jakob B; Borritz, Marianne; Brunner, Eric J; Burr, Hermann; Dragano, Nico; Ferrie, Jane E; Fransson, Eleonor I; Hamer, Mark; Heikkilä, Katriina; Knutsson, Anders; Koskenvuo, Markku; Madsen, Ida E H; Nielsen, Martin L; Nordin, Maria; Oksanen, Tuula; Pejtersen, Jan H; Pentti, Jaana; Rugulies, Reiner; Salo, Paula; Siegrist, Johannes; Steptoe, Andrew; Suominen, Sakari; Theorell, Töres; Vahtera, Jussi; Westerholm, Peter J M; Westerlund, Hugo; Singh-Manoux, Archana; Jokela, Markus

    2015-01-01

    Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis. During 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). The minimally adjusted summary risk ratio for long (≥55 h per week) compared with standard working hours (35-40 h) was 1·07 (95% CI 0·89-1·27, difference in incidence three cases per 10 000 person-years) with significant heterogeneity in study-specific estimates (I(2)=53%, p=0·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06-1·57, difference in incidence 13 per 10 000 person-years, I(2)=0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80-1·25, incidence difference zero per 10 000 person-years, I(2)=15%, p=0·2464). The association in the low socioeconomic status group was robust to

  18. Observational study using the tools of lean six sigma to improve the efficiency of the resident rounding process.

    Science.gov (United States)

    Chand, David V

    2011-06-01

    Recent focus on resident work hours has challenged residency programs to modify their curricula to meet established duty hour restrictions and fulfill their mission to develop the next generation of clinicians. Simultaneously, health care systems strive to deliver efficient, high-quality care to patients and families. The primary goal of this observational study was to use a data-driven approach to eliminate examples of waste and variation identified in resident rounding using Lean Six Sigma methodology. A secondary goal was to improve the efficiency of the rounding process, as measured by the reduction in nonvalue-added time. We used the "DMAIC" methodology: define, measure, analyze, improve, and control. Pediatric and family medicine residents rotating on the pediatric hospitalist team participated in the observation phase. Residents, nurses, hospitalists, and parents of patients completed surveys to gauge their attitudes toward rounds. The Mann-Whitney test was used to test for differences in the median times measured during the preimprovement and postimprovement phases, and the Student t test was used for comparison of survey data. Collaborative, family-centered rounding with elimination of the "prerounding" process, as well as standard work instructions and pacing the process to meet customer demand (takt time), were implemented. Nonvalue-added time per patient was reduced by 64% (P  =  .005). Survey data suggested that team members preferred the collaborative, family-centered approach to the traditional model of rounding. Lean Six Sigma provides tools, a philosophy, and a structured, data-driven approach to address a problem. In our case this facilitated an effort to adhere to duty hour restrictions while promoting education and quality care. Such approaches will become increasingly useful as health care delivery and education continue to transform.

  19. Trends in neurosurgical complication rates at teaching vs nonteaching hospitals following duty-hour restrictions.

    Science.gov (United States)

    Dumont, Travis M; Tranmer, Bruce I; Horgan, Michael A; Rughani, Anand I

    2012-11-01

    In 2003 the Accreditation Council for Graduate Medical Education implemented duty-hour restrictions for residents, with an unclear impact on patient care. The authors hypothesize that implementation of duty-hour restrictions is not associated with decreased morbidity for neurosurgical patients. This hypothesis was tested with the Nationwide Inpatient Sample to examine inpatient complications associated with a common elective procedure, craniotomy for meningioma. The Nationwide Inpatient Sample was queried for all patients admitted for elective craniotomy for meningioma from 1998 to 2008, excluding the year 2003. Each case was queried for common in-hospital postoperative complications. The complication rate was compared for 5-year epochs at teaching and nonteaching hospitals before (1998-2002) and after (2004-2008) the adoption of the Accreditation Council for Graduate Medical Education work-hour restriction. Multivariate analysis was performed to control for the effects of age and medical comorbidities. We identified 21177 patients who met inclusion criteria. We identified an effect of age, preexisting medical comorbidity, and timing of surgery on postoperative complication rates. At teaching hospitals, the complication rate increased from 14% to 16% (P < .001). In contrast, this increase was not mirrored at nonteaching hospitals, which saw a nearly constant postoperative complication rate of 15% from 1998 to 2002 and 15% for the years 2004 to 2008 (P = .979). This effect remained significant in a multivariate analysis including age and existing comorbidities as covariates (P = .016). In patients undergoing craniotomy for meningioma, postoperative complication rates increased at teaching hospitals, but not at nonteaching hospitals over the 5-year epochs before and after 2003.

  20. Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice.

    Science.gov (United States)

    Jovanović, N; Podlesek, A; Volpe, U; Barrett, E; Ferrari, S; Rojnic Kuzman, M; Wuyts, P; Papp, S; Nawka, A; Vaida, A; Moscoso, A; Andlauer, O; Tateno, M; Lydall, G; Wong, V; Rujevic, J; Platz Clausen, N; Psaras, R; Delic, A; Losevich, M A; Flegar, S; Crépin, P; Shmunk, E; Kuvshinov, I; Loibl-Weiß, E; Beezhold, J

    2016-02-01

    Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout. In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8-65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (Pburnout, severe burnout remained associated with long working hours (Pburnout. Copyright © 2016. Published by Elsevier Masson SAS.

  1. Non-linear relationship between maternal work hours and child body weight: Evidence from the Western Australian Pregnancy Cohort (Raine) Study.

    Science.gov (United States)

    Li, Jianghong; Akaliyski, Plamen; Schäfer, Jakob; Kendall, Garth; Oddy, Wendy H; Stanley, Fiona; Strazdins, Lyndall

    2017-08-01

    Using longitudinal data from the Western Australia Pregnancy Cohort (Raine) Study and both random-effects and fixed-effects models, this study examined the connection between maternal work hours and child overweight or obesity. Following children in two-parent families from early childhood to early adolescence, multivariate analyses revealed a non-linear and developmentally dynamic relationship. Among preschool children (ages 2 to 5), we found lower likelihood of child overweight and obesity when mothers worked 24 h or less per week, compared to when mothers worked 35 or more hours. This effect was stronger in low-to-medium income families. For older children (ages 8 to 14), compared to working 35-40 h a week, working shorter hours (1-24, 25-34) or longer hours (41 or more) was both associated with increases in child overweight and obesity. These non-linear effects were more pronounced in low-to-medium income families, particularly when fathers also worked long hours. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. "It's tough hanging-up a call": The relationships between calling and work hours, psychological detachment, sleep quality, and morning vigor.

    Science.gov (United States)

    Clinton, Michael E; Conway, Neil; Sturges, Jane

    2017-01-01

    It has been argued that when people believe that their work is a calling, it can often be experienced as an intense and consuming passion with significant personal meaning. While callings have been demonstrated to have several positive outcomes for individuals, less is known about the potential downsides for those who experience work in this way. This study develops a multiple-meditation model proposing that, while the intensity of a calling has a positive direct effect on work-related vigor, it motivates people to work longer hours, which both directly and indirectly via longer work hours, limits their psychological detachment from work in the evenings. In turn, this process reduces sleep quality and morning vigor. Survey and diary data of 193 church ministers supported all hypotheses associated with this model. This implies that intense callings may limit the process of recovery from work experiences. The findings contribute to a more balanced theoretical understanding of callings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Cosmetology Series. Duty Task List.

    Science.gov (United States)

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

    This document contains the occupational duty/task lists for three occupations in the cosmetology series. Each occupation is divided into a number of duties. A separate page for each duty in the occupation lists the tasks in that duty along with its code number and columns to indicate whether that particular duty has been taught and to provide…

  4. Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    J. McIntosh

    2009-09-01

    Full Text Available Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration. A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11% of the total population of 400 files were audited. A random sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05 were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care.

  5. Time to talk about work-hour impact on anesthesiologists: The effects of sleep deprivation on Profile of Mood States and cognitive tasks.

    Science.gov (United States)

    Saadat, Haleh; Bissonnette, Bruno; Tumin, Dmitry; Thung, Arlyne; Rice, Julie; Barry, N'Diris; Tobias, Joseph

    2016-01-01

    A physician's fatigue raises significant concerns regarding personal and patient safety. Effects of sleep deprivation on clinical performance and the quality of patient care are major considerations of today's health care environment. To evaluate the impact of partial sleep deprivation after a 17-h overnight call (3 pm-7 am) on the mood status and cognitive skills of anesthesiologists in an academic clinical hospital setting, as compared to these parameters during regular working hours. Taking circadian rhythm into account, the following measures were assessed in 21 pediatric anesthesiologists at two time points over the course of the study; (i) between 7 and 8 am on a regular non call day, and (ii) between 7 and 8 am after a 17-h in-house call (3 pm-7 am). Six mood states were assessed using the Profile of Mood States. A Total Mood Disturbance (TMD) score was obtained as the sum of all mood scores minus vigor. The total score provides a global estimate of affective state. Simple cognitive tests were similarly administered to assess cognitive skills. A two-tailed paired t-test was used to compare data between regular and post call days. A P sleep deprivation affects the total mood status of anesthesiologists and impacts their cognitive skills. These findings are particularly relevant in a context of increased work expectation, particularly on clinical performance in our modern medical system. Such observations suggest that there may be changes that impact the safety of our patients and the quality of health care that is provided. © 2015 John Wiley & Sons Ltd.

  6. The impact of nurse working hours on patient safety culture: a cross-national survey including Japan, the United States and Chinese Taiwan using the Hospital Survey on Patient Safety Culture.

    Science.gov (United States)

    Wu, Yinghui; Fujita, Shigeru; Seto, Kanako; Ito, Shinya; Matsumoto, Kunichika; Huang, Chiu-Chin; Hasegawa, Tomonori

    2013-10-07

    A positive patient safety culture (PSC) is one of the most critical components to improve healthcare quality and safety. The Hospital Survey on Patient Safety Culture (HSOPS), developed by the US Agency for Healthcare Research and Quality, has been used to assess PSC in 31 countries. However, little is known about the impact of nurse working hours on PSC. We hypothesized that long nurse working hours would deteriorate PSC, and that the deterioration patterns would vary between countries. Moreover, the common trends observed in Japan, the US and Chinese Taiwan may be useful to improve PSC in other countries. The purpose of this study was to clarify the impact of long nurse working hours on PSC in Japan, the US, and Chinese Taiwan using HSOPS. The HSOPS questionnaire measures 12 sub-dimensions of PSC, with higher scores indicating a more positive PSC. Odds ratios (ORs) were calculated using a generalized linear mixed model to evaluate the impact of working hours on PSC outcome measures (patient safety grade and number of events reported). Tukey's test and Cohen's d values were used to verify the relationships between nurse working hours and the 12 sub-dimensions of PSC. Nurses working ≥60 h/week in Japan and the US had a significantly lower OR for patient safety grade than those working Japan and Chinese Taiwan. Patient safety grade deteriorated and the number of events reported increased with long working hours. Among the 12 sub-dimensions of PSC, long working hours had an impact on 'staffing' and 'teamwork within units' in Japan, the US and Chinese Taiwan.

  7. The ACGME case log: General surgery resident experience in pediatric surgery

    Science.gov (United States)

    Gow, Kenneth W.; Drake, F. Thurston; Aarabi, Shahram; Waldhausen, John H.

    2014-01-01

    Background General surgery (GS) residents in ACGME programs log cases performed during their residency. We reviewed designated pediatric surgery (PS) cases to assess for changes in performed cases over time. Methods The ACGME case logs for graduating GS residents were reviewed from academic year (AY) 1989–1990 to 2010–2011 for designated pediatric cases. Overall and designated PS cases were analyzed. Data were combined into five blocks: Period I (AY1989–90 to AY1993–94), Period II (AY1994–95 to AY1998–99), Period III (AY1999–00 to AY2002–03), Period IV (AY2003–04 to AY2006–07), and Period V (AY2007–08 to AY2010–11). Periods IV and V were delineated by implementation of duty hour restrictions. Student t-tests compared averages among the time periods with significance at P < .05. Results Overall GS case load remained relatively stable. Of total cases, PS cases accounted for 5.4% in Period I and 3.7% in Period V. Designated pediatric cases declined for each period from an average of 47.7 in Period I to 33.8 in Period V. These changes are due to a decline in hernia repairs, which account for half of cases. All other cases contributed only minimally to the pediatric cases. The only laparoscopic cases in the database were anti-reflux procedures, which increased over time. Conclusions GS residents perform a diminishing number of designated PS cases. This decline occurred before the onset of work-hour restrictions. These changes have implications on the capabilities of the current graduating workforce. However, the case log does not reflect all cases trainees may be exposed to, so revision of this list is recommended. PMID:23932601

  8. Exploring the Changing Landscape of Surgical Residency Training

    NARCIS (Netherlands)

    C.J. Hopmans (Niels)

    2017-01-01

    textabstractWithin the past decade, the structure and format of surgical residency training has changed radically by the introduction of competency-based training programs, the progressive fragmentation of general surgery into subspecialties, and the implementation of stringent work hour

  9. Sleep Quality Among Psychiatry Residents.

    Science.gov (United States)

    Carvalho Aguiar Melo, Matias; das Chagas Medeiros, Francisco; Meireles Sales de Bruin, Veralice; Pinheiro Santana, José Abraão; Bastos Lima, Alexandre; De Francesco Daher, Elizabeth

    2016-01-01

    Medical residency programs are traditionally known for long working hours, which can be associated with a poor quality of sleep and daytime sleepiness. However, few studies have focused on this theme. Our objective was to investigate sleep quality, daytime sleepiness, and their relation with anxiety, social phobia, and depressive symptoms. This cross-sectional observational study involved 59 psychiatry residents. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were used to measure the quality of sleep and excessive daytime sleepiness ([EDS] and ESS > 10), respectively. Among the 59 psychiatry residents, 59.3% had poor sleep quality (PSQI > 5) and 28.8% had EDS. Poor sleep quality was associated with higher EDS (P = 0.03) and the year of residency program (P = 0.03). Only 20% of residents with poor sleep had consulted at least once for sleep problems; 54.2% had used medications for sleep; and 16.9% were using medications at the time of interview. Only 30% obtained medication during medical consultations. Poor sleep was associated with irregular sleep hours (P = 0.001) and long periods lying down without sleep (P = 0.03). Poor sleep quality was also associated with high scores of anxiety symptoms (P Psychiatry residents frequently have poor sleep quality and EDS. Considering that sleep disorders can affect quality of life, predispose to metabolic syndrome, and be associated with worse performance at work, attention to this clinical problem is needed. © The Author(s) 2016.

  10. Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care.

    Science.gov (United States)

    Smalley, Hannah K; Keskinocak, Pinar

    2016-03-01

    At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms.

  11. 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 < 0.001), sleep disturbance and fatigue in the cockpit (r = 0.40, p < 0.001), and fatigue in the cockpit and microsleeps in the cockpit (r = 0.43, p < 0.001). A critical pathway from duty hours through to self-reported incidents in flight was identified. Further investigation employing both objective and subjective measures of sleep and fatigue is needed.

  12. Student midwives' duty hours: risks, standards, and recommendations.

    Science.gov (United States)

    Lawrence, Rachel; Kantrowitz-Gordon, Ira; Landis, Andrea

    2014-01-01

    A growing body of literature has emerged describing the risks of extended-duty shifts and sleep deprivation. Worldwide, midwifery organizations have not adopted standards for practitioner or student duty shifts. This project reviews the literature related to extended-duty shifts in an effort to develop evidence-based recommendations for student nurse-midwives/student midwives (SNMs/SMs). A comprehensive literature search was conducted through electronic databases, major journals, and reference lists published in English since January 2001. Primary research studies evaluating sleep deprivation and shift duration were included. Studies that did not include the target population (shift workers) and those that formed conclusions related to extended-duty shifts greater than 30 hours were excluded. In addition, an extensive worldwide review of duty-hour recommendations from more than 300 health care organizations was conducted. A total of 40 studies met the inclusion criteria. Extended-duty shifts (those greater than 12 hours) increased the risk for cognitive and physical functional errors, safety concerns, and decreased quality of life from sleep deprivation. Cognitive function errors included attention lapses, visual tracking errors, decreased mentation and immediate recall, and decreased learning capacity. Physical errors included decreased motor skills and slowed reaction times in clinical simulations. These deficits led to an increased risk of motor vehicle accidents, needle sticks, and performance equivalent to unsafe blood alcohol concentrations. An overall decrease in quality of life and job satisfaction was linked to extended-duty shifts. Seven organizations for medical residents or advanced practice nurses have developed policy statements on duty shifts, with extended-duty shift limitations between 12 and 24 hours. The risks associated with extended-duty shifts may inhibit the development of SNMs/SMs into competent practitioners and place patients at risk. It

  13. E-Learning and Medical Residents, a Qualitative Perspective

    Science.gov (United States)

    Segerman, Jill; Crable, Elaine; Brodzinski, James

    2016-01-01

    Medical education helps ensure doctors acquire skills and knowledge needed to care for patients. However, resident duty hour restrictions have impacted the time residents have available for medical education, leaving resident educators searching for alternate options for effective medical education. Classroom situated e-learning, a blended…

  14. 19 CFR 148.2 - Residence status of arriving persons.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Residence status of arriving persons. 148.2... Residence status of arriving persons. (a) General. Persons arriving from foreign countries shall be divided... established a home elsewhere. For this purpose, the residence of a wife shall be deemed to be that of her...

  15. Estate planning : the impact of estate duty and capital gains tax on offshore assets / C. Bornman

    OpenAIRE

    Bornman, Christine

    2010-01-01

    Death and taxes are unavoidable. In terms of the current legislation both estate duty and capital gains tax (hereinafter referred to as 'CGT') are levied upon death. The South African National Treasury is reconsidering taxes on death as estate duty contributes minuscule revenue, and its administration is cumbersome. Worldwide taxation is based on either source or residence. Because of the R3 500 000 exemption from estate duty, only wealthy individuals are generally subject to e...

  16. Resident resistance.

    Science.gov (United States)

    Price, J L; Cleary, B

    1999-01-01

    Clearly, faculty must work hard with residents to explore the nature of their resistance to a program's learning and growth opportunities. Initial steps to a deeper, more effective, and longer-lasting change process must be pursued. If resident resistance is mishandled or misunderstood, then learning and professional growth may be sidetracked and the purposes of residency training defeated. Listening to the whole person of the resident and avoiding the trap of getting caught up in merely responding to select resident behaviors that irritate us is critical. Every faculty member in the family practice residency program must recognize resistance as a form of defense that cannot immediately be torn down or taken away. Resident defenses have important purposes to play in stress reduction even if they are not always healthy. Residents, especially interns, use resistance to avoid a deeper and more truthful look at themselves as physicians. A family practice residency program that sees whole persons in their residents and that respects resident defenses will effectively manage the stress and disharmony inherent to the resistant resident.

  17. The Duty to Recognize Culture

    DEFF Research Database (Denmark)

    Nielsen, Morten Ebbe Juul

    2012-01-01

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

  18. Duty and Distance

    NARCIS (Netherlands)

    C. Binder (C.); C. Heilmann (Conrad)

    2017-01-01

    markdownabstractEver since the publication of Peter Singer’s article ‘‘Famine, Affluence, and Morality’’ has the question of whether the (geographical) distance to people in need affects our moral duties towards them been a hotly debated issue. Does geographical distance affect our moral

  19. Determining your duties.

    Science.gov (United States)

    Summers, J

    1989-04-01

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

  20. Confidence, knowledge, and skills at the beginning of residency. A survey of pathology residents.

    Science.gov (United States)

    Hsieh, Cindy M; Nolan, Norris J

    2015-01-01

    To document the pathology learning experiences of pathology residents prior to residency and to determine how confident they were in their knowledge and technical skills. An online survey was distributed to all pathology residency program directors in the United States, who were requested to forward the survey link to their residents. Data were obtained on pathology electives, grossing experience, and frozen section experience. Likert scale questions assessed confidence level in knowledge and skills. In total, 201 pathology residents responded (8% of residents in the United States). Prior to starting residency, most respondents had exposure to anatomic pathology through elective rotations. Few respondents had work-related experience. Most did not feel confident in their pathology-related knowledge or skills, and many did not understand what pathology resident duties entail. Respondents gained exposure to pathology primarily through elective rotations, and most felt the elective experience prepared them for pathology residency. However, elective time may be enhanced by providing opportunities for students to increase hands-on experience and understanding of resident duties. Copyright© by the American Society for Clinical Pathology.

  1. Registrar working hours in Cape Town

    African Journals Online (AJOL)

    Nicky

    In the past surgical registrars were expected to work unusual- ly long hours. This was thought to provide better patient care, and to result in better registrar training. Junior doctors in the USA worked between 95 and 136 hours per week.1. The paradigm changed in 1984 after the death of Libby Zion in a New York hospital ...

  2. What is an anesthesiology resident worth?

    Science.gov (United States)

    Ferrera, Marisa H; Beaman, Shawn T; Metro, David G; Handley, Linda J; Walker, James E

    2009-08-01

    To determine the cost of replacing an anesthesiology resident with a certified registered nurse anesthetist (CRNA) for equal operating room (OR) work. Retrospective financial analysis. Academic anesthesiology department. Clinical anesthesia (CA)-1 through CA-3 residents. Cost of replacing anesthesiology residents with CRNAs for equal OR work was determined. The cost of replacing one anesthesiology resident with a CRNA for the same number of OR hours ranged from $9,940.32 to $43,300 per month ($106,241.68 to $432,937.50 per yr). Numbers varied depending on the CRNA pay scale and whether the calculations were based on the number of OR hours worked at our residency program or OR hours worked in a maximum duty hour model. A CRNA is paid substantially more per OR hour worked, at all pay levels, than an anesthesiology resident.

  3. A Time Study of Plastic Surgery Residents.

    Science.gov (United States)

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly efficient and fragmented, with the majority of all activities requiring 4 minutes or less. Residents spent a large portion of their time waiting for other services. In light of these data, we

  4. Climate Change and Individual Duties

    OpenAIRE

    Augustin Fragnière

    2016-01-01

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

  5. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  6. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  7. Influences on the Retention of Residency-Trained and Non-Residency Trained Navy Dental Corps Officers

    Science.gov (United States)

    2004-06-01

    Temporomandibular Dysfunction 14,000 10,000 8, (Advanced C l 12,000 8,000 6,000 12 creditable service”36 or have completed their active duty obligated...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT Influences on the Retention of Residency-Trained and...SUBTITLE: Influences on the Retention of Residency-Trained and Non-Residency Trained Navy Dental Corps Officers 6. AUTHOR(S) Alan B. Christian 5

  8. Administrative circulars No. 22A (rev. 1) – Award of additional periods of membership in the Pensions Fund for long-term shift work and No. 22B (rev. 1) – Compensation for long-term shift work hours

    CERN Multimedia

    HR Department

    2011-01-01

    Administrative Circulars No. 22A (Rev. 1) entitled "Award of additional periods of membership in the Pension Fund for long-term shift work" and No. 22B (Rev.1) entitled “Compensation for long-term shift work hours”, adopted following discussion in the Standing Concertation Committee meeting of 21 September 2010 and entering into force on 1 March 2011, are available on the intranet site of the Human Resources Department: http://cern.ch/hr-docs/admincirc/admincirc.asp They cancel and replace Administrative Circulars No. 22A and 22B entitled "Award of additional periods of membership in the Pension Fund to shift workers (Early Departure)” and “Duration and special compensation for shift work” of January 2000. This new version clarifies, in particular, the compensation of effective long-term shift work hours. Department Head Office  

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

    Science.gov (United States)

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

    2015-09-01

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

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

    Science.gov (United States)

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

    2016-02-25

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

  11. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    Abstract. Background: There is a phobia among doctors for the residency training program, since the establishment of ... Materials and Methods: Structured questionnaires were administered to residents at 3 training institutions in Nigeria. Results: ... Keywords: Decentralization, motivation, perception, remuneration, residents.

  12. 19 CFR 122.28 - Private aircraft taken abroad by U.S. residents.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Private aircraft taken abroad by U.S. residents. 122.28 Section 122.28 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY AIR COMMERCE REGULATIONS Private Aircraft § 122.28 Private aircraft...

  13. The Chief Resident Role in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Hafner, John W. Jr., MD, MPH

    2010-05-01

    Full Text Available Study Objectives: Although other specialties have examined the role of the chief resident (CR, the role and training of the emergency medicine (EM CR has largely been undefined.Methods: A survey was mailed to all EM CRs and their respective program directors (PD in 124 EM residency programs. The survey consisted of questions defining demographics, duties of the typical CR, and opinions regarding the level of support and training received. Multiple choice, Likert scale (1 strong agreement, 5 strong disagreement and short-answer responses were used. We analyzed associations between CR and PD responses using Chi-square, Student’s T and Mann-Whitney U tests.Results: Seventy-six percent of CRs and 65% of PDs responded and were similar except for age (31 vs. 42 years; p<0.001. CR respondents were most often male, in year 3 of training and held the position for 12 months. CRs and PDs agreed that the assigned level of responsibility is appropriate (2.63 vs. 2.73, p=0.15; but CRs underestimate their influence in the residency program (1.94 vs. 2.34, p=0.002 and the emergency department (2.61 vs. 3.03, p=0.002. The majority of CRs (70% and PDs (77% report participating in an extramural training program, and those CRs who participated in training felt more prepared for their job duties (2.26 vs. 2.73; p=0.03.Conclusion: EM CRs feel they have appropriate job responsibility but believe they are less influential in program and department administration than PD respondents. Extramural training programs for incoming CRs are widely used and felt to be helpful. [West J Emerg Med. 2010; 11(2:120-125.

  14. Results of the 2013-2015 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States.

    Science.gov (United States)

    Nabavizadeh, Nima; Burt, Lindsay M; Mancini, Brandon R; Morris, Zachary S; Walker, Amanda J; Miller, Seth M; Bhavsar, Shripal; Mohindra, Pranshu; Kim, Miranda B; Kharofa, Jordan

    2016-02-01

    The purpose of this project was to survey radiation oncology chief residents to define their residency experience and readiness for independent practice. During the academic years 2013 to 2014 and 2014 to 2015, the Association of Residents in Radiation Oncology (ARRO) conducted an electronic survey of post-graduate year-5 radiation oncology residents in the United States during the final 3 months of training. Descriptive statistics are reported. Sixty-six chief residents completed the survey in 2013 to 2014 (53% response rate), and 69 completed the survey in 2014 to 2015 (64% response rate). Forty to 85% percent of residents reported inadequate exposure to high-dose rate and low-dose rate brachytherapy. Nearly all residents in both years (>90%) reported adequate clinical experience for the following disease sites: breast, central nervous system, gastrointestinal, genitourinary, head and neck, and lung. However, as few as 56% reported adequate experience in lymphoma or pediatric malignancies. More than 90% of residents had participated in retrospective research projects, with 20% conducting resident-led prospective clinical trials and 50% conducting basic science or translational projects. Most chief residents reported working 60 or fewer hours per week in the clinical/hospital setting and performing fewer than 15 hours per week tasks that were considered to have little or no educational value. There was more than 80% compliance with Accreditation Council for Graduate Medical Education (ACGME) work hour limits. Fifty-five percent of graduating residents intended to join an established private practice group, compared to 25% who headed for academia. Residents perceive the job market to be more competitive than previous years. This first update of the ARRO chief resident survey since the 2007 to 2008 academic year documents US radiation oncology residents' experiences and conditions over a 2-year period. This analysis may serve as a valuable tool for those seeking to

  15. Development of a Night Float Call Model for Obstetrics and Gynaecology Residency: The Process and Residents' Perceptions.

    Science.gov (United States)

    Sterling, Lynn; McCaffrey, Carmen; Secter, Michael; Rich, Rebecca; Green, Jessica; Shirreff, Lindsay; Steele, Donna

    2016-11-01

    The 2013 pan-Canadian consensus Report on Resident Duty Hours identified that traditional 24-hour duty periods pose risks to the well-being of residents and should be avoided. In anticipation of duty-hour restrictions, the Obstetrics and Gynaecology Residency Program at the University of Toronto developed and implemented a night float (NF) call model over a three-year span. Quarterly resident surveys have consistently shown that the NF system is preferred to traditional 24-hour call and has resulted in reduced fatigue and improved continuity of patient care. Through many iterations, the NF model achieved levels of resident morale, surgical experience, and impact on family relationships that are comparable to the 24-hour call system. We review here our process for developing an NF call model and the perceptions and experiences of residents, with the goal of providing insight for other residency programs that are considering or instituting NF call systems. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

  16. Education research: neurology training reassessed. The 2011 American Academy of Neurology Resident Survey results.

    Science.gov (United States)

    Johnson, Nicholas E; Maas, Matthew B; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

    2012-10-23

    To assess the strengths and weaknesses of neurology resident education using survey methodology. A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training.

  17. Supervision Duty of School Principals

    Directory of Open Access Journals (Sweden)

    Kürşat YILMAZ

    2009-04-01

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

  18. Emergency Medicine Resident Perceptions of Medical Professionalism

    Directory of Open Access Journals (Sweden)

    Joshua Jauregui

    2016-05-01

    Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in

  19. Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

    International Nuclear Information System (INIS)

    Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; Amorim Bernstein, Karen L. de; Dad, Luqman K.; Li, Linna; Poppe, Matthew M.; Strauss, Jonathan B.; Chollet, Casey T.

    2011-01-01

    Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

  20. Neurosurgical Resident Error: A Survey of U.S. Neurosurgery Residency Training Program Directors' Perceptions.

    Science.gov (United States)

    Gupta, Raghav; Moore, Justin M; Adeeb, Nimer; Griessenauer, Christoph J; Schneider, Anna M; Gandhi, Chirag D; Harsh, Griffith R; Thomas, Ajith J; Ogilvy, Christopher S

    2018-01-01

    Efforts to address resident errors and to enhance patient safety have included systemic reforms, such as the Accreditation Council for Graduate Medical Education's (ACGME's) mandated duty-hour restrictions, and specialty-specific initiatives such as the neurosurgery Milestone Project. However, there is currently little data describing the basis for these errors or outlining trends in neurosurgical resident error. An online questionnaire was distributed to program directors of 108 U.S. neurosurgery residency training programs to assess the frequency, most common forms and causes of resident error, the resulting patient outcomes, and the steps taken by residency programs to address these errors. Thirty-one (28.7%) responses were received. Procedural/surgical error was the most commonly observed type of error. Transient injury and no injury to the patient were perceived to be the 2 most frequent outcomes. Inexperience or resident mistake despite adequate training were cited as the most common causes of error. Twenty-three (74.2%) respondents stated that a lower post graduate year level correlated with an increased incidence of errors. There was a trend toward an association between an increased number of residents within a program and the number of errors attributable to a lack of supervision (r = 0.36; P = 0.06). Most (93.5%) program directors do not believe that mandated duty-hour restrictions reduce error frequency. Program directors believe that procedural error is the most commonly observed form of error, with post graduate year level believed to be an important predictor of error frequency. The perceived utility of systemic reforms that aim to reduce the incidence of resident error remains unclear. Copyright © 2017. Published by Elsevier Inc.

  1. Results of the American Academy of Neurology resident survey.

    Science.gov (United States)

    Freeman, W D; Nolte, C M; Matthews, B R; Coleman, M; Corboy, J R

    2011-03-29

    To assess the effect of neurology residency education as trainees advance into independent practice, the American Academy of Neurology (AAN) elected to survey all graduating neurology residents at time of graduation and in 3-year cycles thereafter. A 22-question survey was sent to all neurology residents completing residency training in the United States in 2007. Of 523 eligible residents, 285 (54.5%) responded. Of these, 92% reported good to excellent quality teaching of basic neurology from their faculty; however, 47% noted less than ideal training in basic neuroscience. Two-thirds indicated that the Residency In-service Training Examination was used only as a self-assessment tool, but reports of misuse were made by some residents. After residency, 78% entered fellowships (with 61% choosing a fellowship based on interactions with a mentor at their institution), whereas 20% entered practice directly. After adjustment for the proportion of residents who worked before the duty hour rules were implemented and after their implementation, more than half reported improvement in quality of life (87%), education (60%), and patient care (62%). The majority of international medical graduates reported wanting to stay in the United States to practice rather than return to their country of residence. Neurology residents are generally satisfied with training, and most entered a fellowship. Duty hour implementation may have improved resident quality of life, but reciprocal concerns were raised about impact on patient care and education. Despite the majority of international trainees wishing to stay in the United States, stricter immigration laws may limit their entry into the future neurology workforce.

  2. Heavy Duty Vehicle Futures Analysis.

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-05-01

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

  3. Residency Allocation Database

    Data.gov (United States)

    Department of Veterans Affairs — The Residency Allocation Database is used to determine allocation of funds for residency programs offered by Veterans Affairs Medical Centers (VAMCs). Information...

  4. The General Surgery Chief Resident Operative Experience

    Science.gov (United States)

    Drake, Frederick Thurston; Horvath, Karen D.; Goldin, Adam B.; Gow, Kenneth W.

    2014-01-01

    IMPORTANCE The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. OBJECTIVE To evaluate changes in operative experience for general surgery CRs. DESIGN, SETTING, AND PARTICIPANTS Review of Accreditation Council for Graduate Medical Education case logs from 1989–1990 through 2011–2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. MAIN OUTCOMES AND MEASURES Total cases and defined categories were evaluated for changes over time. RESULTS The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P general surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves. PMID:23864049

  5. Ontario Radiation Oncology Residents' Needs in the First Postgraduate Year-Residents' Perspective Survey

    International Nuclear Information System (INIS)

    Szumacher, Ewa; Warner, Eiran; Zhang Liying; Kane, Gabrielle; Ackerman, Ida; Nyhof-Young, Joyce; Agboola, Olusegun; Metz, Catherine de; Rodrigues, George; Voruganti, Sachi; Rappolt, Susan

    2007-01-01

    Purpose: To assess radiation oncology residents' needs and satisfaction in their first postgraduate year (PGY-1) in the province of Ontario. Methods and Materials: Of 62 radiation oncology residents, 58 who had completed their PGY-1 and were either enrolled or had graduated in 2006 were invited to participate in a 31-item survey. The questionnaire explored PGY-1 residents' needs and satisfaction in four domains: clinical workload, faculty/learning environment, stress level, and discrimination/harassment. The Fisher's exact and Wilcoxon nonparametric tests were used to determine relationships between covariate items and summary scores. Results: Of 58 eligible residents, 44 (75%) responded. Eighty-four percent of residents felt that their ward and call duties were appropriate. More than 50% of respondents indicated that they often felt isolated from their radiation oncology program. Only 77% agreed that they received adequate feedback, and 40% received sufficient counseling regarding career planning. More than 93% of respondents thought that faculty members had contributed significantly to their learning experience. Approximately 50% of residents experienced excessive stress and inadequate time for leisure or for reading the medical literature. Less than 10% of residents indicated that they had been harassed or experienced discrimination. Eighty-three percent agreed or strongly agreed that their PGY-1 experience had been outstanding. Conclusions: Most Ontario residents were satisfied with their PGY-1 training program. More counseling by radiation oncology faculty members should be offered to help residents with career planning. The residents might also benefit from more exposure to 'radiation oncology' and an introduction to stress management strategies

  6. Individual rights versus societal duties.

    Science.gov (United States)

    Vermeersch, E

    1999-10-29

    In 'bioethics', the rights to self-determination and to informed consent of the patient are prerequisites to every medical decision: paternalism is no longer a justifiable attitude. Hence, it seems that compulsory vaccination is an unacceptable praxis. Even John Stuart Mill. however, took into account other values: e.g. the duty not to harm others. This article is dedicated to the analysis of the historical development of these values and to their relevance for the ethics of vaccination. The acceptability of coercion is upheld, but no clear-cut answers are given in general: in every case the pros and cons of coercion are to be weighed carefully against each other.

  7. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    This study was carried out to ascertain the perception of the residency ... the time of the study. Analysis of the respondents showed similar findings for both senior and junior levels of training. Discussion. The introduction of the residency training program .... Overseas training/ attachment should be re-introduced. 12. (10.1).

  8. Proposed Rule for Modification of Federal On Board Diagnostic Regulations for: Light Duty Vehicles, Light Duty Trucks, Medium Duty Passenger Vehicles, Complete Heavy Duty Vehicles and Engines Intended for Use in Heavy Duty Vehicles Weighing 14,000 Pounds

    Science.gov (United States)

    Following is information for the proposed rule for the Modification of Federal On Board Diagnostic Regulations for Light-Duty Vehicles, Light-Duty Trucks, etc. Includes links to Federal Register and final rule.

  9. Implementation of an academic half day in a vascular surgery residency program improves trainee and faculty satisfaction with surgical indications conference.

    Science.gov (United States)

    Robbins, Riann; Sullivan, Sarah; Smith, Brigitte

    2018-02-23

    The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule. The vascular surgery conference at a single academic institution was changed from three 1-hour conferences weekly, to a single protected, 3-hour conference once weekly. Faculty and trainees were surveyed before and 5 months after implementing the new AHD schedule. Overall satisfaction improved after initiating the AHD (4 of 4 trainees, 3 of 4 faculty). All trainees (n = 4) and faculty (n = 4) believed the AHD conference format was worthwhile. Most trainees believed the AHD format improved their Vascular Surgery in Service Training Exam preparation (3 of 4), fund of knowledge (4 of 4), and operative preparation (3 of 4). More trainees than faculty tended to feel that the AHD interfered with operative participation (3 of 4 trainees vs 1 of 4 faculty). Neither group agreed that the conference was optimally scheduled. This single-institution, pilot study suggests a positive association in the attitudes of most vascular surgery trainees and faculty regarding preparation for the Vascular Surgery In-Training Exam and overall fund of knowledge after implementing a protected AHD schedule. Further research is needed to understand the impact of the AHD conference on operative experience and training exam scores. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Resident Characteristics Report

    Data.gov (United States)

    Department of Housing and Urban Development — The Resident Characteristics Report summarizes general information about households who reside in Public Housing, or who receive Section 8 assistance. The report...

  11. Saccadic eye movement metrics reflect surgical residents' fatigue.

    Science.gov (United States)

    Di Stasi, Leandro L; McCamy, Michael B; Macknik, Stephen L; Mankin, James A; Hooft, Nicole; Catena, Andrés; Martinez-Conde, Susana

    2014-04-01

    Little is known about the effects of surgical residents' fatigue on patient safety. We monitored surgical residents' fatigue levels during their call day using (1) eye movement metrics, (2) objective measures of laparoscopic surgical performance, and (3) subjective reports based on standardized questionnaires. Prior attempts to investigate the effects of fatigue on surgical performance have suffered from methodological limitations, including inconsistent definitions and lack of objective measures of fatigue, and nonstandardized measures of surgical performance. Recent research has shown that fatigue can affect the characteristics of saccadic (fast ballistic) eye movements in nonsurgical scenarios. Here we asked whether fatigue induced by time-on-duty (~24 hours) might affect saccadic metrics in surgical residents. Because saccadic velocity is not under voluntary control, a fatigue index based on saccadic velocity has the potential to provide an accurate and unbiased measure of the resident's fatigue level. We measured the eye movements of members of the general surgery resident team at St. Joseph's Hospital and Medical Center (Phoenix, AZ) (6 males and 6 females), using a head-mounted video eye tracker (similar configuration to a surgical headlight), during the performance of 3 tasks: 2 simulated laparoscopic surgery tasks (peg transfer and precision cutting) and a guided saccade task, before and after their call day. Residents rated their perceived fatigue level every 3 hours throughout their 24-hour shift, using a standardized scale. Time-on-duty decreased saccadic velocity and increased subjective fatigue but did not affect laparoscopic performance. These results support the hypothesis that saccadic indices reflect graded changes in fatigue. They also indicate that fatigue due to prolonged time-on-duty does not result necessarily in medical error, highlighting the complicated relationship among continuity of care, patient safety, and fatigued providers. Our data

  12. Forgiveness and the Limits of Duty

    NARCIS (Netherlands)

    Archer, Alfred

    2017-01-01

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

  13. 14 CFR 221.2 - Carrier's duty.

    Science.gov (United States)

    2010-01-01

    ... foreign air carrier from liability for violations of the statute, nor shall the filing of a tariff, or... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Carrier's duty. 221.2 Section 221.2... REGULATIONS TARIFFS General § 221.2 Carrier's duty. (a) Must file tariffs. (1) Except as provided in paragraph...

  14. 40 CFR 94.105 - Duty cycles.

    Science.gov (United States)

    2010-07-01

    ... EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Test Procedures § 94.105 Duty cycles. (a) Overview. For...) General cycle. Propulsion engines that are used with (or intended to be used with) fixed-pitch propellers, propeller-law auxiliary engines, and any other engines for which the other duty cycles of this section do...

  15. 34 CFR 97.403 - IRB duties.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false IRB duties. 97.403 Section 97.403 Education Office of the Secretary, Department of Education PROTECTION OF HUMAN SUBJECTS Additional ED Protections for Children Who Are Subjects in Research § 97.403 IRB duties. In addition to other responsibilities assigned...

  16. 7 CFR 930.31 - Duties.

    Science.gov (United States)

    2010-01-01

    ... Administrative Body § 930.31 Duties. The Board shall have, among others, the following duties: (a) To select such...) To adopt bylaws and to adopt such rules for the conduct of its business as it may deem advisable; (e... assessments for such period; (f) To keep minutes, books, and records which will reflect all of the acts and...

  17. 7 CFR 966.35 - Duties.

    Science.gov (United States)

    2010-01-01

    ... committee may deem necessary or as the Secretary may request. The report of such audit shall show the... Handling Committee § 966.35 Duties. It shall be, among other things, the duty of the committee: (a) At the... be necessary, to select subcommittees of committee members, and to adopt such rules and regulations...

  18. 7 CFR 945.33 - Duties.

    Science.gov (United States)

    2010-01-01

    ... committee may deem necessary or as the Secretary may request. The report of such audit shall show the... COUNTIES IN IDAHO, AND MALHEUR COUNTY, OREGON Order Regulating Handling Administrative Committee § 945.33 Duties. It shall be the duty of the committee: (a) To act as intermediary between the Secretary and any...

  19. 7 CFR 906.31 - Duties.

    Science.gov (United States)

    2010-01-01

    ... committee may deem necessary or as the Secretary may request (the report of each such audit shall show the... GRANDE VALLEY IN TEXAS Order Regulating Handling Committee § 906.31 Duties. It shall be, among other things, the duty of the committee: (a) At the beginning of each term of office, to meet and organize, to...

  20. Surgical resident learning styles: faculty and resident accuracy at identification of preferences and impact on ABSITE scores.

    Science.gov (United States)

    Kim, Roger H; Gilbert, Timothy; Ristig, Kyle; Chu, Quyen D

    2013-09-01

    As a consequence of surgical resident duty hour restrictions, there is a need for faculty to utilize novel teaching methods to convey information in a more efficient manner. The current paradigm of surgical training, which has not changed significantly since the time of Halsted, assumes that all residents assimilate information in a similar fashion. However, recent data has shown that learners have preferences for the ways in which they receive and process information. The VARK model categorizes learners as visual (V), aural (A), read/write (R), and kinesthetic (K). The VARK learning style preferences of surgical residents have not been previously evaluated. In this study, the preferred learning styles of general surgery residents were determined, along with faculty and resident perception of resident learning styles. In addition, we hypothesized that American Board of Surgery In-Training Exam (ABSITE) scores are associated with preference for a read/write (R) learning style. The Fleming VARK learning styles inventory was administered to all general surgery residents at a university hospital-based program. Responses on the inventory were scored to determine the preferred learning style for each resident. Faculty members were surveyed to determine their accuracy in identifying the preferred learning style of each resident. All residents were also surveyed to determine their accuracy in identifying their peers' VARK preferences. Resident ABSITE scores were examined for association with preferred learning styles. Twenty-nine residents completed the inventory. Most (18 of 29, 62%) had a multimodal preference, although more than a third (11 of 29, 38%) demonstrated a single-modality preference. Seventy-six percent of all residents (22 of 29) had some degree of kinesthetic (K) learning, while under 50% (14 of 29) were aural (A) learners. Although not significant, dominant (R) learners had the highest mean ABSITE scores. Faculty identified residents' learning styles

  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. Automatic control of clock duty cycle

    Science.gov (United States)

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

    2010-01-01

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

  3. Duty ratio of cooperative molecular motors.

    Science.gov (United States)

    Dharan, Nadiv; Farago, Oded

    2012-02-01

    Molecular motors are found throughout the cells of the human body and have many different and important roles. These micromachines move along filament tracks and have the ability to convert chemical energy into mechanical work that powers cellular motility. Different types of motors are characterized by different duty ratios, which is the fraction of time that a motor is attached to its filament. In the case of myosin II (a nonprocessive molecular machine with a low duty ratio), cooperativity between several motors is essential to induce motion along its actin filament track. In this work we use statistical mechanical tools to calculate the duty ratio of cooperative molecular motors. The model suggests that the effective duty ratio of nonprocessive motors that work in cooperation is lower than the duty ratio of the individual motors. The origin of this effect is the elastic tension that develops in the filament which is relieved when motors detach from the track. © 2012 American Physical Society

  4. In the line of duty.

    Science.gov (United States)

    Carlson, K

    1991-12-01

    In light of recent events that have raised ethical and legal dilemmas in the health care field, the author explains that nurses now have a duty to participate in the debate over these issues and to educate the public. The author, a staff nurse in the Abbott-Northwestern Hospital in Minneapolis, explains that the city has recently witnessed a series of events with ethical overtones that have captured national attention. In one case, the hospital sought judicial guidance on whether an 87-year-old comatose women--dependent on a ventilator for over a year--should continue to receive the costly and labor-intensive care simply because the family desired it. Although the hospital argued that continuing to provide care would only prolong a futile life, the court ruled that only the family could make the decision of whether or not to continue care. Coincidentally, around the same time as the court case, Minneapolis hosted the International Special Olympics, and event that brought together individuals with mental and physical disabilities for athletic competition. The event illustrated that there is no consensus on the definition of a futile life. In one other event that captured national headlines, 2 physicians admitted that they had continued to practice medicine despite knowing that they were infected with the AIDS virus. These disclosures heightened the debate over mandatory HIV testing for health care workers--especially for health care workers who perform invasive procedures. This debate has raised a number of issues: confidentiality, the safety of patients, as well as the safety of health care workers. The author explains that such issues of life and death are often drowned in emotionalism and public hysteria. Nurses have a duty to see that the public is educated.

  5. The impact of sleep deprivation on sleepiness, risk factors and professional performance in medical residents.

    Science.gov (United States)

    Pikovsky, Oleg; Oron, Maly; Shiyovich, Arthur; Perry, Zvi H; Nesher, Lior

    2013-12-01

    Prolonged working hours and sleep deprivation can exert negative effects on professional performance and health. To assess the relationship between sleep deprivation, key metabolic markers, and professional performance in medical residents. We compared 35 residents working the in-house night shift with 35 senior year medical students in a cross-sectional cohort study. The Epworth Sleepiness Scale (ESS) questionnaire was administered and blood tests for complete blood count (CBC), blood chemistry panel, lipid profile and C-reactive protein (CRP) were obtained from all participants. Medical students and medical residents were comparable demographically except for age, weekly working hours, reported weight gain, and physical activity. The ESS questionnaires indicated a significantly higher and abnormal mean score and higher risk of falling asleep during five of eight daily activities among medical residents as compared with medical students. Medical residents had lower high density lipoprotein levels, a trend towards higher triglyceride levels and higher monocyte count than did medical students. CRP levels and other laboratory tests were normal and similar in both groups. Among the residents, 5 (15%) were involved in a car accident during residency, and 63% and 49% reported low professional performance and judgment levels after the night shift, respectively. Medical residency service was associated with increased sleepiness, deleterious lifestyle changes, poorer lipid profile, mild CBC changes, and reduced professional performance and judgment after working the night shift. However, no significant changes were observed in CRP or in blood chemistry panel. Larger prospective cohort studies are warranted to evaluate the dynamics in sleepiness and metabolic factors overtime.

  6. The duty to care in an influenza pandemic: a qualitative study of Canadian public perspectives.

    Science.gov (United States)

    Bensimon, Cécile M; Smith, Maxwell J; Pisartchik, Dmitri; Sahni, Sachin; Upshur, Ross E G

    2012-12-01

    Ever since the emergence of SARS, when we were reminded that the nature of health care practitioners' duty to care is greatly contested, it has remained a polarizing issue. Discussions on the nature and limits of health care practitioners' duty to care during disasters and public health emergencies abounds the literature, ripe with arguments seeking to ground its foundations. However, to date there has been little public engagement on this issue. This study involved three Townhall meetings held between February 2008 and May 2010 in three urban settings in Canada in order to probe lay citizens' views about ethical issues related to pandemic influenza, including issues surrounding the duty to care. Participants included Canadian residents aged 18 and over who were fluent in English. Data were collected through day-long facilitated group discussions using case scenarios and focus group guides. Participant's views were organized according to several themes, including the following main themes (and respective sub-themes): 1. Legitimate limits; a) competing obligations; and b) appeal to personal choice; and 2. Legitimate expectations; a) reciprocity; and b) enforcement and planning. Our findings show that participants moved away from categorical notions of the duty to care towards more equivocal and often normative views throughout deliberations. Our analysis contributes a better understanding of the constitutive nature of the duty to care, defined in part by taking account of public views. This broadened understanding can further inform the articulation of acceptable norms of duty to care and policy development efforts. What is more, it illustrates the urgent need for policy-makers and regulators to get clarity on obligations, responsibilities, and accountability in the execution of HCPs' duty to care during times of universal vulnerability. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. 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.

  8. Challenges to neurology residency education in today's health care environment.

    Science.gov (United States)

    Bega, Danny; Krainc, Dimitri

    2016-09-01

    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  9. Due diligence duties for an environmental liability

    International Nuclear Information System (INIS)

    Huebsch, M.

    2000-04-01

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

  10. [Patients' rights--doctors' duties].

    Science.gov (United States)

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

    2015-06-01

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

  11. Going on holiday? Travelling on duty? Do you know what to do if your mobile phone is lost or stolen?

    CERN Document Server

    2015-01-01

    It’s summertime and many of us will be going on holiday, perhaps far away from Geneva. Duty travel also takes many of us far away from CERN from time to time. You probably know how to cancel your credit cards if they are lost or stolen, but do you know how to block your CERN mobile phone from use?   Recently, one user waited until returning to CERN to block theirs which was enough time for the thief to run up a substantial phone bill. Please make sure the same doesn’t happen to you! If your phone is lost or stolen: during working hours: call the Telecom Lab on +41 22 767 2480 or the CERN Switchboard on +41 22 767 6111 as soon as possible and provide: - your telephone number, - your name / first name / department. outside working hours: call the Swisscom hotline as soon as possible on: - +41 800 55 64 64 (in Switzerland) or, - +41 62 286 12 12 (outside Switzerland). You will also need to report the loss or theft in accordance with CERN’s offic...

  12. Impact of inpatient caseload, emergency department duties, and online learning resource on General Medicine In-Training Examination scores in Japan.

    Science.gov (United States)

    Kinoshita, Kensuke; Tsugawa, Yusuke; Shimizu, Taro; Tanoue, Yusuke; Konishi, Ryota; Nishizaki, Yuji; Shiojiri, Toshiaki; Tokuda, Yasuharu

    2015-01-01

    Both clinical workload and access to learning resource are important components of educational environment and may have effects on clinical knowledge of residents. We conducted a survey with a clinical knowledge evaluation involving postgraduate year (PGY)-1 and -2 resident physicians at teaching hospitals offering 2-year postgraduate training programs required for residents in Japan, using the General Medicine In-Training Examination (GM-ITE). An individual-level analysis was conducted to examine the impact of the number of assigned patients and emergency department (ED) duty on the residents' GM-ITE scores by fitting a multivariable generalized estimating equations. In hospital-level analysis, we evaluated the relationship between for the number of UpToDate reviews for each hospital and for the hospitals' mean GM-ITE score. A total of 431 PGY-1 and 618 PGY-2 residents participated. Residents with four or five times per month of the ED duties exhibited the highest mean scores compared to those with greater or fewer ED duties. Those with largest number of inpatients in charge exhibited the highest mean scores compared to the residents with fewer inpatients in charge. Hospitals with the greater UpToDate topic viewing showed significantly greater mean score. Appropriate ED workload and inpatient caseload, as well as use of evidence-based electronic resources, were associated with greater clinical knowledge of residents.

  13. [Burnout in nursing residents].

    Science.gov (United States)

    Franco, Gianfábio Pimentel; de Barros, Alba Lúcia Bottura Leite; Nogueira-Martins, Luiz Antônio; Zeitoun, Sandra Salloum

    2011-03-01

    Nursing residents may experience physical and emotional exhaustion from the daily life of attending the Program. The aim of this study was to determine the Burnout incidence among Nursing Residents. An investigative, descriptive, analytical, longitudinal-prospective study was conducted with 16 Residents over two years. The Maslach Burnout Inventory was used, translated and validated for Brazil, as well as a sociodemographic/occupational data tool. Of all residents, 17.2% showed high rates in Emotional Exhaustion and Depersonalization; 18.8% showed impaired commitment in Personal Accomplishment, 75% of which belonged to specialty areas, such as Emergency Nursing, Adult and Pediatric Intensive Care. Age and specialty area were positively correlated with Personal Accomplishment. One of the Residents was identified with changes in three subscales of the Maslach Burnout Inventory, thus characterized as a Burnout Syndrome patient. Nursing Residents have profiles of disease. Knowing these factors can minimize health risks of these workers.

  14. Are Self-study Procedural Teaching Methods Effective? A Pilot Study of a Family Medicine Residency Program.

    Science.gov (United States)

    Deffenbacher, Brandy; Langner, Shannon; Khodaee, Morteza

    2017-11-01

    A family medicine residency is a unique training environment where residents are exposed to care in multiple settings, across all ages. Procedures are an integral part of family medicine practice. Family medicine residency (FMR) programs are tasked with the job of teaching these skills at a level of intensity and frequency that allows a resident to achieve competency of such skills. In an environment that is limited by work hour restrictions, self-study teaching methods are one way to ensure all residents receive the fundamental knowledge of how to perform procedures. We developed and evaluated the efficacy of a self-study procedure teaching method and procedure evaluation checklist. A self-study procedure teaching intervention was created, consisting of instructional articles and videos on three procedures. To assess the efficacy of the intervention, and the competency of the residents, pre- and postintervention procedure performance sessions were completed. These sessions were reviewed and scored using a standardized procedure performance checklist. All 24 residents participated in the study. Overall, the resident procedure knowledge increased on two of the three procedures studied, and ability to perform procedure according to expert-validated checklist improved significantly on all procedures. A self-study intervention is a simple but effective way to increase and improve procedure training in a way that fits the complex scheduling needs of a residency training program. In addition, this study demonstrates that the procedure performance checklists are a simple and reliable way to increase assessment of resident procedure performance skills in a residency setting.

  15. State duties of protection and fundamental rights

    Directory of Open Access Journals (Sweden)

    C Starck

    2000-05-01

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

  16. 19 CFR 151.22 - Estimated duties on raw sugar.

    Science.gov (United States)

    2010-04-01

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

  17. 19 CFR 141.1 - Liability of importer for duties.

    Science.gov (United States)

    2010-04-01

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

  18. 19 CFR 12.62 - Enforcement; duties of Customs officers.

    Science.gov (United States)

    2010-04-01

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

  19. 19 CFR 10.625 - Refunds of excess customs duties.

    Science.gov (United States)

    2010-04-01

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

  20. Towards a Duty of Care for Biodiversity

    Science.gov (United States)

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

    2010-04-01

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

  1. Burnout during residency training: a literature review.

    Science.gov (United States)

    Ishak, Waguih William; Lederer, Sara; Mandili, Carla; Nikravesh, Rose; Seligman, Laurie; Vasa, Monisha; Ogunyemi, Dotun; Bernstein, Carol A

    2009-12-01

    Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. An examination of the burnout literature reveals that it is prevalent in medical students (28%-45%), residents (27%-75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can result in negative consequences as a working physician. Burnout also poses significant challenges during early training years in residency. Time demands, lack of control, work planning, work organization, inherently difficult job situations, and interpersonal relationships, are considered factors contributing to residents' burnout. Potential interventions include workplace-driven and individual-driven measures. Workplace interventions include education about burnout, workload modifications, increasing the diversity of work duties, stress management training, mentoring, emotional intelligence training, and wellness workshops. Individual-driven behavioral, social, and physical activities include promoting interpersonal professional relations, meditation, counseling, and exercise. Educators need to develop an active awareness of burnout and ought to consider incorporating relevant instruction and interventions during the process of training resident physicians.

  2. National Survey of Burnout among US General Surgery Residents

    Science.gov (United States)

    Elmore, Leisha C; Jeffe, Donna B; Jin, Linda; Awad, Michael M; Turnbull, Isaiah R

    2017-01-01

    Background Burnout is a complex syndrome of emotional distress that can disproportionately affect individuals who work in healthcare professions. Study Design For a national survey of burnout in US general surgery residents, we asked all Accreditation Council for Graduate Medical Education-accredited general surgery program directors to email their general surgery residents an invitation to complete an anonymous, online survey. Burnout was assessed with the Maslach Burnout Inventory; total scores for Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscales were calculated. Burnout was defined as having a score in the highest tertile for EE or DP or lowest tertile for PA. Chi-square tests and one-way analyses of variance were used to test associations between burnout tertiles for each subscale and various resident and training-program characteristics as appropriate. Results From April–December, 2014, 665 residents actively engaged in clinical training had data for analysis; 69% met the criterion for burnout on at least one subscale. Higher burnout on each subscale was reported by residents planning private practice compared with academic careers. A greater proportion of women than men reported burnout on EE and PA. Higher burnout on EE and DP was associated with greater work hours per week. Having a structured mentoring program was associated with lower burnout on each subscale. Conclusions The high rates of burnout among general surgery residents are concerning given the potential impact of burnout on the quality of patient care. Efforts to identify at-risk populations and to design targeted interventions to mitigate burnout in surgical trainees are warranted. PMID:27238875

  3. Facility Focus: Residence Halls.

    Science.gov (United States)

    College Planning & Management, 2003

    2003-01-01

    Describes four examples of residence hall design, one renovation and three new residence halls, that exemplify design principles that meet student and institutional requirements. The examples are at (1) the University of Illinois at Chicago; (2) Bowdoin College; (3) Muhlenberg College; and (4) Spring Arbor University. (SLD)

  4. Rain Forest Dance Residency.

    Science.gov (United States)

    Watson, Dawn

    1997-01-01

    Outlines the author's experience as a dancer and choreographer artist-in-residence with third graders at a public elementary school, providing a cultural arts experience to tie in with a theme study of the rain forest. Details the residency and the insights she gained working with students, teachers, and theme. (SR)

  5. Multinationals versus domestic firms: wages, working hours and industrial relations

    NARCIS (Netherlands)

    van Klaveren, M.; Tijdens, K.

    2011-01-01

    This Working Paper aims to present and discuss recent evidence on the effect of Foreign Direct Investment (FDI) on wages, working conditions and industrial relations. It presents a. an overview of the available literature on the effects of FDI on wages, particularly in developed countries; b. the

  6. 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

    .003). There was no significant heterogeneity between the cohort-specific effect estimates (I2=0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential...

  7. Globalization and working time: working hours and flexibility in Germany

    NARCIS (Netherlands)

    Burgoon, B.; Raess, D.

    2009-01-01

    This article challenges popular wisdom that economic globalization uniformly increases working time in industrialized countries. International investment and trade, they argue, have uneven effects for workplace bargaining over standard hours and over work-time flexibility, such as use of temporary

  8. 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

  9. The Effect of CHIP on Pediatricians Work Hours

    Data.gov (United States)

    U.S. Department of Health & Human Services — Enrollment in public health insurance coverage will expand significantly beginning in 2014. We have only a limited understanding of what happens when an influx of...

  10. Child Care during Nonstandard Work Hours: Research to Policy Resources

    Science.gov (United States)

    Ferguson, Daniel

    2016-01-01

    In November 2014, the Child Care and Development Block Grant (CCDBG) Act of 2014 was signed into law, reauthorizing the Child Care and Development Fund (CCDF)--the federal child care subsidy program--for the first time since 1996. In December 2015, the U.S. Office of Child Care issued a Notice of Proposed Rulemaking, which updated CCDF regulations…

  11. Vital working hour schemes: The dynamic balance between various interests

    NARCIS (Netherlands)

    Kerkhof, G.A.; Jansen, B.; van Amelsvoort, L.G.P.M.

    2006-01-01

    "Balancing Interests", the theme of the 17th International Symposium on Shift Work and Working Time held in Hoofddorp, The Netherlands (September 2005), refers to the ambition to reach an optimal balance between the various aspects of shift work. Economic, ergonomic, physical, and psychosocial

  12. Residents in difficulty

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; O'Neill, Lotte; Hansen, Dorthe Høgh

    2016-01-01

    Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world such as the Scand......Background The majority of studies on prevalence and characteristics of residents in difficulty have been conducted in English-speaking countries and the existing literature may not reflect the prevalence and characteristics of residents in difficulty in other parts of the world...... such as the Scandinavian countries, where healthcare systems are slightly different. The aim of this study was to examine prevalence and characteristics of residents in difficulty in one out of three postgraduate medical training regions in Denmark, and to produce both a quantifiable overview and in-depth understanding...... of the topic. Methods We performed a mixed methods study. All regional residency program directors (N = 157) were invited to participate in an e-survey about residents in difficulty. Survey data were combined with database data on demographical characteristics of the background population (N = 2399...

  13. Fitness for duty - a regulator's view

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  14. 40 CFR 86.1811-09 - Emission standards for light-duty vehicles, light-duty trucks and medium-duty passenger vehicles.

    Science.gov (United States)

    2010-07-01

    ... AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) General Compliance Provisions for Control of Air Pollution From New and In-Use Light-Duty Vehicles, Light-Duty Trucks, and Complete Otto-Cycle Heavy-Duty.... Additionally, this section applies to hybrid electric vehicles (HEVs) and zero emission vehicles (ZEVs). Unless...

  15. Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence.

    Science.gov (United States)

    Weber, Erin L; Leland, Hyuma A; Azadgoli, Beina; Minneti, Michael; Carey, Joseph N

    2017-08-01

    Rehearsal is an essential part of mastering any technical skill. The efficacy of surgical rehearsal is currently limited by low fidelity simulation models. Fresh cadaver models, however, offer maximal surgical simulation. We hypothesize that preoperative surgical rehearsal using fresh tissue surgical simulation will improve resident confidence and serve as an important adjunct to current training methods. Preoperative rehearsal of surgical procedures was performed by plastic surgery residents using fresh cadavers in a simulated operative environment. Rehearsal was designed to mimic the clinical operation, complete with a surgical technician to assist. A retrospective, web-based survey was used to assess resident perception of pre- and post-procedure confidence, preparation, technique, speed, safety, and anatomical knowledge on a 5-point scale (1= not confident, 5= very confident). Twenty-six rehearsals were performed by 9 residents (PGY 1-7) an average of 4.7±2.1 days prior to performance of the scheduled operation. Surveys demonstrated a median pre-simulation confidence score of 2 and a post-rehearsal score of 4 (Psafety, and anatomical knowledge improved as a result of simulation. Fresh tissue-based preoperative surgical rehearsal was effectively implemented in the residency program. Resident confidence and perception of technique improved. Survey results suggest that cadaveric simulation is beneficial for all levels of residents. We believe that implementation of preoperative surgical rehearsal is an effective adjunct to surgical training at all skill levels in the current environment of decreased work hours.

  16. Comparison of Plastic Surgery Residency Training in United States and China.

    Science.gov (United States)

    Zheng, Jianmin; Zhang, Boheng; Yin, Yiqing; Fang, Taolin; Wei, Ning; Lineaweaver, William C; Zhang, Feng

    2015-12-01

    Residency training is internationally recognized as the only way for the physicians to be qualified to practice independently. China has instituted a new residency training program for the specialty of plastic surgery. Meanwhile, plastic surgery residency training programs in the United States are presently in a transition because of restricted work hours. The purpose of this study is to compare the current characteristics of plastic surgery residency training in 2 countries. Flow path, structure, curriculum, operative experience, research, and evaluation of training in 2 countries were measured. The number of required cases was compared quantitatively whereas other aspects were compared qualitatively. Plastic surgery residency training programs in 2 countries differ regarding specific characteristics. Requirements to become a plastic surgery resident in the United States are more rigorous. Ownership structure of the regulatory agency for residency training in 2 countries is diverse. Training duration in the United States is more flexible. Clinical and research training is more practical and the method of evaluation of residency training is more reasonable in the United States. The job opportunities after residency differ substantially between 2 countries. Not every resident has a chance to be an independent surgeon and would require much more training time in China than it does in the United States. Plastic surgery residency training programs in the United States and China have their unique characteristics. The training programs in the United States are more standardized. Both the United States and China may complement each other to create training programs that will ultimately provide high-quality care for all people.

  17. Technology in Residence.

    Science.gov (United States)

    Fox, Jordan

    1999-01-01

    Discusses the necessity for incorporating current technology in today's college residence halls to meet the more diverse and continued activities of its students. Technology addressed covers data networking and telecommunications, heating and cooling systems, and fire-safety systems. (GR)

  18. Factors associated with residents' satisfaction with their training as specialists.

    Science.gov (United States)

    Ayala-Morillas, L E; Fuentes-Ferrer, M E; Sánchez-Díaz, J; Rumayor-Zarzuelo, M; Fernández-Pérez, C; Marco-Martínez, F

    2014-05-01

    We do not know what factors influence residents' perceived satisfaction during their training. The aim of this study was to analyze the satisfaction of specialists with their training and its associated factors. This was a cross-sectional study using self-completion surveys of residents in training at the Clinic Hospital San Carlos for the courses conducted in 2006, 2009, 2010 and 2012. The study's dependent variable was overall satisfaction with the training; the independent factors were demographic and occupational characteristics, variables related to healthcare, teaching and research activity. The total participation percentage was 83.7% (1,424/1,701), and the mean age was 28.4 years (SD, 3.2 years). The overall satisfaction percentage was 75.2%. The factors statistically associated with overall satisfaction in the multivariate analysis were the involvement of the teaching staff (tutors and assistants) in the training, greater satisfaction in medical versus surgical specialties, the year of residence, the facilities for completing the thesis, working less than 40 h a week, adequate time to perform daily tasks, appropriate number of department meetings and not having a previous specialty. the activities related to research and teaching are associated with the overall satisfaction of residents. The routine activity factors most closely associated with satisfaction were the time available and the work hours. More studies are necessary to understand the impact of resident satisfaction on care quality and in their activity as future specialists. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  19. Satisfaction among residents in ASHP-accredited pharmacy residency programs.

    Science.gov (United States)

    VanDenBerg, C; Murphy, J E

    1997-07-01

    The level of work satisfaction among pharmacists in ASHP-accredited residencies was studied. In March 1996 a questionnaire designed to measure residency satisfaction was mailed to 697 individuals in ASHP-accredited pharmacy practice and specialty practice residencies. Subjects responded to 16 statements relating to intrinsic and extrinsic determinants of work satisfaction on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. Questionnaires were returned by 413 (59%) of the residents. The respondents were predominantly women (76%), and most (86%) had at least a Pharm. D. degree. Hospitals were the primary work setting (88%). Of the 413 residents, 305 were in pharmacy practice residencies and 108 were in specialized residencies. None of the mean scores indicated disagreement (scores 3) with the negatively worded statements. The median and mode were equal to 2 (disagree) for the three negatively worded items and 4 (agree) for all but three positively worded items. Only 8% of the residents indicated that they would not accept the residency again if given the chance. Specialized residents tended to rate positively worded statements higher and negatively worded statements lower than pharmacy practice residents. Female residents indicated greater satisfaction than male residents. Pay and benefits were rated slightly better than neutral. Pharmacy residents appeared generally satisfied with their residencies. Specialized pharmacy residents were more satisfied than pharmacy practice residents, and women were more satisfied than men.

  20. Burnout Syndrome During Residency.

    Science.gov (United States)

    Turgut, Namigar; Karacalar, Serap; Polat, Cengiz; Kıran, Özlem; Gültop, Fethi; Kalyon, Seray Türkmen; Sinoğlu, Betül; Zincirci, Mehmet; Kaya, Ender

    2016-10-01

    The aim of this study is identified the degree of Burnout Syndrome (BOS) and find out its correlation with years of recidency and sociodemograpfic chareacteristics, training, sleeping habits, such as smoking and alcohol consumption. After approval from the Hospital Ethics Committee and obtaining informed consent, First, second, third, fourth and fifth year of recidency staff (n=127) working in our hospital were involved in this study. The standardized Maslach Burnout Inventory (MBI) was used in this study. Fifty six male (44.1%) and seventy one female (55.9%) residents were enroled in this study (Coranbach Alfa(α)=0.873). 57% of the first year residents smokes cigaret and 54% of them use alcohol. 2% of them gets one day off after hospital night shift, 61% of them suffers from disturbed sleep. 60% of them had been stated that they willingly selected their profession. 61% of them prefers talking to friends and 32% of them prefers shopping to overcome stress. There were statistical difference acording to years of recidency in MBI, Emotional Burnout (EB) and desensitisation scale (DS) points. EB scale points of the second year of residency group was statisticaly higher than fourth year of residency group. DS points of second year of residency group was also statisticaly higher than the third and fourth year of residency group. There was no statistical difference between any groups in Personal Success. BOS is a frequent problem during residency in anaesthesia. Appropriate definition and awareness are the first important steps to prevent this syndrome. Further administrative approaches should be evaluated with regard to their effects.

  1. Analysis of Resident Case Logs in an Anesthesiology Residency Program

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias Vested

    2016-01-01

    Our goal in this study was to examine Accreditation Council for Graduate Medical Education case logs for Stanford anesthesia residents graduating in 2013 (25 residents) and 2014 (26 residents). The resident with the fewest recorded patients in 2013 had 43% the number of patients compared with the...

  2. Residents as teachers: survey of Canadian family medicine residents.

    Science.gov (United States)

    Ng, Victor K; Burke, Clarissa A; Narula, Archna

    2013-09-01

    To examine Canadian family medicine residents' perspectives surrounding teaching opportunities and mentorship in teaching. A 16-question online survey. Canadian family medicine residency programs. Between May and June 2011, all first- and second-year family medicine residents registered in 1 of the 17 Canadian residency programs as of September 2010 were invited to participate. A total of 568 of 2266 residents responded. Demographic characteristics, teaching opportunities during residency, and resident perceptions about teaching. A total of 77.7% of family medicine residents indicated that they were either interested or highly interested in teaching as part of their future careers, and 78.9% of family medicine residents had had opportunities to teach in various settings. However, only 60.1% of respondents were aware of programs within residency intended to support residents as teachers, and 33.0% of residents had been observed during teaching encounters. It appears that most Canadian family medicine residents have the opportunity to teach during their residency training. Many are interested in integrating teaching as part of their future career goals. Family medicine residencies should strongly consider programs to support and further develop resident teaching skills.

  3. Light duty utility arm software requirements specification

    International Nuclear Information System (INIS)

    Kiebel, G.R.

    1995-01-01

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

  4. 7 CFR 1215.30 - Duties.

    Science.gov (United States)

    2010-01-01

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

  5. 7 CFR 1209.39 - Duties.

    Science.gov (United States)

    2010-01-01

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

  6. 7 CFR 1210.328 - Duties.

    Science.gov (United States)

    2010-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE WATERMELON RESEARCH AND PROMOTION PLAN Watermelon Research and Promotion Plan National Watermelon Promotion Board § 1210.328 Duties. The... Secretary may request; (m) To notify watermelon producers, handlers, and importers of all Board meetings...

  7. Light duty utility arm startup plan

    International Nuclear Information System (INIS)

    Barnes, G.A.

    1998-01-01

    This plan details the methods and procedures necessary to ensure a safe transition in the operation of the Light Duty Utility Arm (LDUA) System. The steps identified here outline the work scope and identify responsibilities to complete startup, and turnover of the LDUA to Characterization Project Operations (CPO)

  8. NGO Duties in Relation to Human Rights

    NARCIS (Netherlands)

    Philips, J.P.M.

    2010-01-01

    This paper investigates the moral duties that human rights NGOs, such as Amnesty International, and development NGOs, such as Oxfam, have in relation to human rights – especially in relation to the human right to a decent standard of living. The mentioned NGOs are powerful new agents on the global

  9. 7 CFR 1207.328 - Duties.

    Science.gov (United States)

    2010-01-01

    ... Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.328 Duties. The Board shall...

  10. Light Duty Truck Characteristics, Historical Data Base

    Science.gov (United States)

    1979-12-01

    The report is a collection of data concerning physical, operating, performance, and market characteristics of light duty trucks for the model years 1972 and 1975 thru 1977. The data is stored on tape in DOT/TSC DEC System 10 computer system. Informat...

  11. Duties of care on the Internet

    NARCIS (Netherlands)

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

    2011-01-01

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

  12. Precautionary rights and duties of states

    NARCIS (Netherlands)

    Trouwborst, A.

    2006-01-01

    This study concerns the definition and implementation of the precautionary principle under general, or customary, international law. A search for patterns and common denominators in state practice resulted in the following definitions of a right and a duty which states are deemed to have under

  13. 7 CFR 983.45 - Duties.

    Science.gov (United States)

    2010-01-01

    ... of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and... NEW MEXICO Administrative Committee § 983.45 Duties. The committee shall have, among others, the... of this part; (i) To investigate and assemble data on the growing, handling, shipping and marketing...

  14. 7 CFR 993.36 - Duties.

    Science.gov (United States)

    2010-01-01

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

  15. Shifting perceptions: a pre-post study to assess the impact of a senior resident rotation bundle.

    Science.gov (United States)

    Fabreau, Gabriel; Elliott, Meghan; Khanna, Suneil; Minty, Evan; Wallace, Jean E; de Grood, Jill; Lewin, Adriane; Brown, Garielle; Bharwani, Aleem; Gilmour, Janet; Lemaire, Jane B

    2013-08-29

    Extended duty hours for residents are associated with negative consequences. Strategies to accommodate duty hour restrictions may also have unintended impacts. To eliminate extended duty hours and potentially lessen these impacts, we developed a senior resident rotation bundle that integrates a night float system, educational sessions on sleep hygiene, an electronic handover tool, and a simulation-based medical education curriculum. The aim of this study was to assess internal medicine residents' perceptions of the impact of the bundle on three domains: the senior residents' wellness, ability to deliver quality health care, and medical education experience. This prospective study compared eligible residents' experiences (N = 67) before and after a six-month trial of the bundle at a training program in western Canada. Data was collected using an on-line survey. Pre- and post-intervention scores for the final sample (N = 50) were presented as means and compared using the t-test for paired samples. Participants felt that most aspects of the three domains were unaffected by the introduction of the bundle. Four improved and two worsened perception shifts emerged post-intervention: less exposure to personal harm, reduced potential for medical error, more successful teaching, fewer disruptions to other rotations, increased conflicting role demands and less staff physician supervision. The rotation bundle integrates components that potentially ease some of the perceived negative consequences of night float rotations and duty hour restrictions. Future areas of study should include objective measures of the three domains to validate our study participants' perceptions.

  16. Performance concerns for high duty fuel cycle

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  17. 78 FR 79662 - Stainless Steel Plate in Coils From Belgium: Final Results of Antidumping Duty Administrative...

    Science.gov (United States)

    2013-12-31

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

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

    Science.gov (United States)

    Gass, J. Ric

    1990-01-01

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

  19. 7 CFR 58.230 - Heavy duty vacuum cleaners.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Heavy duty vacuum cleaners. 58.230 Section 58.230....230 Heavy duty vacuum cleaners. Each plant handling dry milk products shall be equipped with a heavy duty industrial vacuum cleaner. The vacuum cleaner shall be of a type that has a collector or...

  20. Setting standards for planning off duty and audit of practice.

    Science.gov (United States)

    Walker, Linda; Minchin, Anne; Pickard, Jane

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

  1. 38 CFR 17.31 - Duty periods defined.

    Science.gov (United States)

    2010-07-01

    ... Definitions and Active Duty § 17.31 Duty periods defined. Full-time duty as a member of the Women's Army Auxiliary Corps, Women's Reserve of the Navy and Marine Corps and Women's Reserve of the Coast Guard... Patient Rights ...

  2. 76 FR 13982 - Antidumping Duty Order: Polyvinyl Alcohol From Taiwan

    Science.gov (United States)

    2011-03-15

    ... International Trade Administration Antidumping Duty Order: Polyvinyl Alcohol From Taiwan AGENCY: Import... Department is issuing an antidumping duty order on polyvinyl alcohol (PVA) from Taiwan. DATES: Effective Date... value in the antidumping duty investigation of PVA from Taiwan. See Polyvinyl Alcohol From Taiwan: Final...

  3. 10 CFR 26.21 - Fitness-for-duty program.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Fitness-for-duty program. 26.21 Section 26.21 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.21 Fitness-for-duty program. The licensees and other entities specified in § 26.3(a) through (c) shall establish, implement, and...

  4. 29 CFR 825.312 - Fitness-for-duty certification.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Fitness-for-duty certification. 825.312 Section 825.312... § 825.312 Fitness-for-duty certification. (a) As a condition of restoring an employee whose FMLA leave... provider to provide the information directly to the employer) in the fitness-for-duty certification process...

  5. A "Resident-as-Teacher" Curriculum Using a Flipped Classroom Approach: Can a Model Designed for Efficiency Also Be Effective?

    Science.gov (United States)

    Chokshi, Binny D; Schumacher, Heidi K; Reese, Kristen; Bhansali, Priti; Kern, Jeremy R; Simmens, Samuel J; Blatt, Benjamin; Greenberg, Larrie W

    2017-04-01

    The Accreditation Council for Graduate Medical Education requires training that enhances resident teaching skills. Despite this requirement, many residency training programs struggle to implement effective resident-as-teacher (RAT) curricula, particularly within the context of the 80-hour resident workweek. In 2013, the authors developed and evaluated an intensive one-day RAT curriculum using a flipped classroom approach. Twenty-nine second-year residents participated in daylong RAT sessions. The curriculum included four 1-hour workshops focusing on adult learning principles, giving feedback, teaching a skill, and orienting a learner. Each workshop, preceded by independent reading, featured peer co-teaching, application, and feedback. The authors evaluated the curriculum using pre- and postworkshop objective structured teaching examinations (OSTEs) and attitudinal and self-efficacy teaching questionnaires. Residents demonstrated statistically significant improvements in performance between pre- and postworkshop OSTEs on each of three core skills: giving feedback (P = .005), orienting a learner (P flipped classroom approach is an efficient and effective method for training residents to improve teaching skills, especially in an era of work hour restrictions. They have committed to the continuation of this curriculum and are planning to include assessment of its long-term effects on resident behavior change and educational outcomes.

  6. Electrofishing power requirements in relation to duty cycle

    Science.gov (United States)

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

    2004-01-01

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

  7. 40 CFR Appendix Xii to Part 86 - Tables for Production Compliance Auditing of Heavy-Duty Engines and Heavy-Duty Vehicles...

    Science.gov (United States)

    2010-07-01

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

  8. Psychiatric aspects of fitness for duty.

    Science.gov (United States)

    Brodsky, C M

    1996-01-01

    The above examples illustrate the complex of biologic, psychological, and social factors that result in a fitness for duty referral. Workplace needs set the tolerance limits within which the worker must operate. They are different for a police officer, for a correctional officer, for a schoolteacher, and for a school custodian. Tolerance limits are affected by factors out of the employer's control, e.g., civil service rules, union contracts, and by the culture of the workplace, the latter being a set of unwritten rules. Ideally, the psychiatrist who performs the fitness for duty examination would have all of the information described above, but in most cases does not. The psychiatrist who has this information can begin to put in place one part of the mosaic that is the ethnography of work.

  9. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  10. [Assessment of a residency training program in endocrinology and nutrition by physicians: results of a survey].

    Science.gov (United States)

    Moreno-Fernández, Jesús; Gutiérrez-Alcántara, Carmen; Palomares-Ortega, Rafael; García-Manzanares, Alvaro; Benito-López, Pedro

    2011-12-01

    The current training program for resident physicians in endocrinology and nutrition (EN) organizes their medical learning. Program evaluation by physicians was assessed using a survey. The survey asked about demographic variables, EN training methods, working time and center, and opinion on training program contents. Fifty-one members of Sociedad Castellano-Manchega de Endocrinología, Nutrición y Diabetes, and Sociedad Andaluza de Endocrinología y Nutrición completed the survey. Forty-percent of them disagreed with the compulsory nature of internal medicine, cardiology, nephrology and, especially, neurology rotations (60%); a majority (>50%) were against several recommended rotations included in the program. The fourth year of residence was considered by 37.8% of respondents as the optimum time for outpatient and inpatient control and monitoring without direct supervision. The recommended monthly number of on-call duties was 3.8±1.2. We detected a positive opinion about extension of residence duration to 4.4±0.5 years. Doctoral thesis development during the residence period was not considered convenient by 66.7% of physicians. Finally, 97.8% of resident physicians would recommend residency in EN to other colleagues. Endocrinologists surveyed disagreed with different training program aspects such as the rotation system, skill acquisition timing, and on-call duties. Therefore, an adaptation of the current training program in EN would be required. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

  11. Working memory capacity is decreased in sleep-deprived internal medicine residents.

    Science.gov (United States)

    Gohar, Ashraf; Adams, Alexander; Gertner, Elie; Sackett-Lundeen, Linda; Heitz, Richard; Engle, Randall; Haus, Erhard; Bijwadia, Jagdeep

    2009-06-15

    Concerns about medical errors due to sleep deprivation during residency training led the Accreditation Council for Graduate Medical Education to mandate reductions in work schedules. Although call rotations with extended shifts continue, effects on resident sleep-wake times and working memory capacity (WMC) have not been investigated. The objective of this study was to measure effects of call rotations on sleep-wake times and WMC in internal medicine residents. During 2 months of an internal medicine training program adhering to ACGME work-hour restrictions (between April 2006 and June 2007), residents completed daily WMC tests, wore actigraphy watches, and logged their sleep hours. This observational study was conducted during a call month requiring 30-hour call rotations every fourth night, whereas the noncall month, which allowed sleep/wake cycle freedom, was used as the control. Sleep hours per night and WMC testing. Thirty-nine residents completing the study had less sleep per night during their call month (6.4 vs 7.3 h per night noncall, p errors occurred when on call (+1.07/test, p error rates were not evaluated.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-03-02

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

  13. The Civic Duty to Report Crime and Corruption

    Directory of Open Access Journals (Sweden)

    Candice Delmas

    2014-01-01

    Full Text Available Is the civic duty to report crime and corruption a genuine moral duty? After clarifying the nature of the duty, I consider a couple of negative answers to the question, and turn to an attractive and commonly held view, according to which this civic duty is a genuine moral duty. On this view, crime and corruption threaten political stability, and citizens have a moral duty to report crime and corruption to the government in order to help the government’s law enforcement efforts. The resulting duty is triply general in that it applies to everyone, everywhere, and covers all criminal and corrupt activity. In this paper, I challenge the general scope of this argument. I argue that that the civic duty to report crime and corruption to the authorities is much narrower than the government claims and people might think, for it only arises when the state (i condemns genuine wrongdoing and serious ethical offenses as “crime” and “corruption,” and (ii constitutes a dependable “disclosure recipient,” showing the will and power to hold wrongdoers accountable. I further defend a robust duty to directly report to the public—one that is weightier and wider than people usually assume. When condition (ii fails to obtain, I submit, citizens are released of the duty to report crime and corruption to the authorities, but are bound to report to the public, even when the denunciation targets the government and is risky or illegal.

  14. Lawful Permanent Residents - Annual Report

    Data.gov (United States)

    Department of Homeland Security — A lawful permanent resident (LPR) or 'green card' recipient is defined by immigration law as a person who has been granted lawful permanent residence in the United...

  15. 40 CFR 86.1818-12 - Greenhouse gas emission standards for light-duty vehicles, light-duty trucks, and medium-duty...

    Science.gov (United States)

    2010-07-01

    ... Provisions for Control of Air Pollution From New and In-Use Light-Duty Vehicles, Light-Duty Trucks, and..., including multi-fuel vehicles, vehicles fueled with alternative fuels, hybrid electric vehicles, plug-in hybrid electric vehicles, electric vehicles, and fuel cell vehicles. Unless otherwise specified, multi...

  16. Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study

    Directory of Open Access Journals (Sweden)

    Atefe Kamaloo

    2017-06-01

    Full Text Available Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome.Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software.Results: Data were categorized in 4 themes as follow: (1 the characteristics of emergency medicine; (2 ambiguity in residents’ duties; (3 educational planning; and (4 careers.Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1 changes in personal life; (2 arrangement in shifts; and  (3 educational issues.Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out.

  17. Neurohospitalists enhance resident perception of the educational and clinical value of a night float rotation.

    Science.gov (United States)

    Greene, James G

    2013-10-01

    Neurology residency training programs have been profoundly impacted by recent changes in resident duty hours, workloads, and supervisory requirements. In response, many programs have adopted a night float coverage system to minimize the requirements for overnight call. The majority involves residents working a block of night shifts in what is typically a service-oriented rotation. Recently, concerns have arisen regarding the impact of this design on resident education and patient care. We have developed a novel on-site nighttime neurohospitalist model for the explicit purpose of steepening the initial learning curve for neurology residents in an effort to rapidly improve their neurological skills and, in conjunction, overnight patient care. We surveyed residents after the initiation of this system to assess their perception of the impact of direct overnight supervision on education and patient care. As part of ongoing quality improvement efforts, surveys were administered to neurology house staff at a tertiary academic medical center after they had completed service on the night float rotation both with and without an attending in the hospital using a retrospective pre/postdesign. There was a robust positive impact on resident's perception of overall quality, educational value, and clinical quality on the night float rotation with an attending on-site. Despite an overall perception that their autonomy was maintained, residents believed barriers to contact the attending were lower, and attending interaction during critical decision making was more frequent. Direct overnight supervision by a neurohospitalist enhances the educational value and care quality on overnight resident rotations.

  18. Nitrous oxide emissions from light duty vehicles

    Science.gov (United States)

    Graham, Lisa A.; Belisle, Sheri L.; Rieger, Paul

    Nitrous oxide (N 2O) emissions measurements were made on light duty gasoline and light duty diesel vehicles during chassis dynamometer testing conducted at the Environment Canada and California Air Resources Board vehicle emissions laboratories between 2001 and 2007. Per phase and composite FTP emission rates were measured. A subset of vehicles was also tested using other driving cycles to characterize emissions as a function of different driving conditions. Vehicles were both new (automobile and light duty truck is not significant for any of the emission standards represented by the test fleet and the distinction between new and aged catalyst is significant for vehicles meeting all emission standards but Tier 2. This is likely due to the relatively low mileage accumulated by the Tier 2 vehicles in this study as compared to the durability requirement of the standard. The FTP composite N 2O emission factors for gasoline vehicles meeting emission standards more stringent than Tier 1 are substantially lower than those currently used by both Canada and the US for the 2005 inventories. N 2O emission factors from test cycles other than the FTP illustrate the variability of emission factors as a function of driving conditions. N 2O emission factors are shown to strongly correlate with NMHC/NMOG emission standards and less strongly with NO X and CO emission standards. A review of several published reports on the effect of gasoline sulfur content on N 2O emissions suggests that additional research is needed to adequately quantify the increase in N 2O emissions as a function of fuel sulfur.

  19. How Do Stamp Duties Affect the Housing Market?

    OpenAIRE

    Davidoff, Ian; Leigh, Andrew

    2013-01-01

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

  20. 29 CFR 2550.404a-1 - Investment duties.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Investment duties. 2550.404a-1 Section 2550.404a-1 Labor... FIDUCIARY RESPONSIBILITY § 2550.404a-1 Investment duties. (a) In general. Section 404(a)(1)(B) of the... use in the conduct of an enterprise of a like character and with like aims. (b) Investment duties. (1...

  1. 48 CFR 252.225-7013 - Duty-free entry.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Duty-free entry. 252.225... Clauses 252.225-7013 Duty-free entry. As prescribed in 225.1101(4), use the following clause: Duty-Free Entry (DEC 2009) (a) Definitions. As used in this clause— (1) “Component” means any item supplied to the...

  2. Norwegian NOx emissions excise duty hits shipping and offshore industry

    International Nuclear Information System (INIS)

    Gulseth, Oeystein Arff; Fjeld-Nielsen, Siri

    2007-01-01

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

  3. National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform.

    Science.gov (United States)

    Vadera, Sumeet; Griffith, Sandra D; Rosenbaum, Benjamin P; Chan, Alvin Y; Thompson, Nicolas R; Kshettry, Varun R; Kelly, Michael L; Weil, Robert J; Bingaman, William; Jehi, Lara

    2015-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) established duty-hour regulations for accredited residency programs on July 1, 2003. It is unclear what changes occurred in the national incidence of medication errors in surgical patients before and after ACGME regulations. Patient and hospital characteristics for pre- and post-duty-hour reform were evaluated, comparing teaching and nonteaching hospitals. A difference-in-differences study design was used to assess the association between duty-hour reform and medication errors in teaching hospitals. We used the Nationwide Inpatient Sample database, which consists of approximately annual 20% stratified sample of all the United States nonfederal hospital inpatient admissions. A query of the database, including 4 years before (2000-2003) and 8 years after (2003-2011) the ACGME duty-hour reform of July 2003, was performed to extract surgical inpatient hospitalizations (N = 13,933,326). The years 2003 and 2004 were discarded in the analysis to allow for a wash-out period during duty-hour reform (though we still provide medication error rates). The Nationwide Inpatient Sample estimated the total national surgical inpatients (N = 135,092,013) in nonfederal hospitals during these time periods with 68,736,863 patients in teaching hospitals and 66,355,150 in nonteaching hospitals. Shortly after duty-hour reform (2004 and 2006), teaching hospitals had a statistically significant increase in rate of medication error (p = 0.019 and 0.006, respectively) when compared with nonteaching hospitals even after accounting for trends across all hospitals during this period. After 2007, no further statistically significant difference was noted. After ACGME duty-hour reform, medication error rates increased in teaching hospitals, which diminished over time. This decrease in errors may be related to changes in training program structure to accommodate duty-hour reform. Copyright © 2015 Association of Program Directors in

  4. Critical component wear in heavy duty engines

    CERN Document Server

    Lakshminarayanan, P A

    2011-01-01

    The critical parts of a heavy duty engine are theoretically designed for infinite life without mechanical fatigue failure. Yet the life of an engine is in reality determined by wear of the critical parts. Even if an engine is designed and built to have normal wear life, abnormal wear takes place either due to special working conditions or increased loading.  Understanding abnormal and normal wear enables the engineer to control the external conditions leading to premature wear, or to design the critical parts that have longer wear life and hence lower costs. The literature on wear phenomenon r

  5. Epistemic duties and failure to understand one’s evidence

    Directory of Open Access Journals (Sweden)

    Scott Stapleford

    2012-04-01

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

  6. Epistemic Duties and Failure to Understand one's Evidence

    Directory of Open Access Journals (Sweden)

    Scott Stapleford

    2012-08-01

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

  7. "A Kantian care ethics suicide duty".

    Science.gov (United States)

    Cooley, Dennis R

    2013-01-01

    Standard arguments for a duty to die or to commit suicide generally rely upon contractarian or other form of justice or the Principle of Beneficence. Even though some of these arguments might appear deontological, there is an explicit or implicit consequentialist common thread in all of them in which utility of some sort is maximized only through the taking of one's own life. Hence, most arguments for a suicide duty are consequentialist in nature. There are a number of relatively unexplored deontological arguments that make plausible cases for the mandatory taking of one's own life. For example, although Kant is widely thought to prohibit all suicides, a careful reading of his work can show a plausible case based on the Categorical Imperative. If it is necessary to preserve the individual's moral life, then everyone could will the generalized maxim governing the situation as a law of nature. Unfortunately, Kant's argument is weakened by his poor understanding of moral psychology. To strengthen Kant's case, care-relationship ethics can be combined with the argument to produce a plausible case that people are obligated to kill themselves if a number of criteria are satisfied. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Rights and duties in parenting practices

    Directory of Open Access Journals (Sweden)

    Ana Paula Solans

    2015-10-01

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

  9. The role of laboratory dissection training in neurosurgical residency: results of a national survey.

    Science.gov (United States)

    Kshettry, Varun R; Mullin, Jeffrey P; Schlenk, Richard; Recinos, Pablo F; Benzel, Edward C

    2014-11-01

    Work hour restrictions and current quality, financial, and legal concerns have reduced resident operative volume and autonomy. Although laboratory (cadaveric or animal) dissection has a rich history in neurosurgery, its current role in resident training is unclear. Recent literature suggests educators have looked to simulation to accelerate the learning curve of acquiring neurosurgical technical skills. The purpose of this study was to determine the prevalence, characteristics, and extent of laboratory dissection in neurosurgical residency programs in the United States. A survey was sent to program directors of all 100 neurosurgical residency programs in the United States. Response rate was 65%. Most programs (93.8%) incorporate laboratory dissection into resident training. Most programs have 1-3 (36.1%) or 4-6 (39.3%) sessions annually. Residents in postgraduate years 2-6 (85.2%-93.4%) most commonly participate. The most common topics are cranial approaches (100%), spinal approaches (88.5%), spine instrumentation (80.3%), and endoscopy (50.8%). Thirty-one (47.7%) programs use artificial physical model or virtual reality simulators; the most common simulators are endoscopy (15.4%), microvascular anastomosis (13.8%), and endovascular (10.8%). Only 8 programs (13.1%) formally grade dissection skills. Educators (95.4%) believe laboratory dissection is an integral component of training and no respondent believed simulation could currently provide greater educational benefit than laboratory dissection. Most (89.2%) respondents would support a national "suggested" dissection curriculum and manual. In neurosurgical resident education, laboratory dissection is widely used; however, significant variation exists. Nonetheless, program directors believe laboratory dissection plays an integral role in neurosurgical training and is currently associated with greater educational benefit than simulation. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Trainee satisfaction in surgery residency programs: modern management tools ensure trainee motivation and success.

    Science.gov (United States)

    von Websky, Martin W; Oberkofler, Christian E; Rufibach, Kaspar; Raptis, Dimitri A; Lehmann, Kuno; Hahnloser, Dieter; Clavien, Pierre-Alain

    2012-11-01

    To assess trainee satisfaction in their surgery residency with a validated instrument and identify the contributing factors. Currently, surgery is deemed unattractive by medical students and ignored by many candidates planning to enter an academic career. New insights on the rational for such lack of interest are needed. Job satisfaction is a central concept in organizational and behavioral research that is well understood by large companies such as Google, IBM, and Toyota. Similar assessment can likewise be used to improve trainee satisfaction in surgery residency. A survey among 2039 surgery residents was conducted in three European countries analyzing satisfaction at work using the Global Job Satisfaction Instrument (validated in Emergency Room physicians). Crucial factors covering different aspects of surgery residency where identified using the GJS instrument combined with multiple logistic regression analysis. With an overall response rate of 23%, we identified trainee dissatisfaction in one third of residents. Factors affecting satisfaction related almost exclusively to training issues, such as assignment of surgery procedures according to skills (OR 4.2), training courses (OR 2.7), availability of a structured training curriculum (OR 2.4), bedside teaching, and availability of morbidity-mortality conferences (OR 2.3). A good working climate among residents (OR 3.7) and the option for part time work (OR 2.1) were also significant factors for trainee satisfaction. Increased working hours had a modest (OR 0.98)-though cumulative- negative effect. The sex of the trainee was not related to trainee satisfaction. Validated measurement of job satisfaction as used in the industry appears to be an efficient tool to assess trainee satisfaction in surgery residency and thereby identify the key contributing factors. Improvement of conceptual training structures and working conditions might facilitate recruitment, decrease drop-out, and attract motivated candidates with

  11. Comparison of microbial load in immersion chilling water and poultry carcasses after 8, 16 and 24 working hours Comparação da carga microbiana em águas de pré-resfriamento e carcaças de frangos, após jornadas de trabalho de 8, 16 e 24 horas

    Directory of Open Access Journals (Sweden)

    Ricardo Cavani

    2010-07-01

    Full Text Available Poultry processing facilities are known for using a great amount of water, which is mainly used on carcasses chilling stage. In Brazil, meat regulations state that each chiller tank must be emptied, cleaned and sanitized every 8 working hours. The aim of the current study was to assess the microbial load of chiller water used in poultry immersion chilling system after 8, 16 and 24 working hours in order to evaluate the reduction of water changes and chiller sanitization. Conventional physicochemical and microbiological assays were done in water supply samples (n=69 to suppress interferences caused by freshwater addition; pre chilled (n=345 post chilled carcasses (n=345 and chiller water samples of the last stage (n=69. The results showed no significant differences on microbial load samples between the three shifts suggesting that the proposed reduction may be secure and reduces the volume of wastewater that would impact the environment, besides improving the rational use of processing time.As atividades dos estabelecimentos de abate de frangos são conhecidas por utilizarem grandes volumes de água durante seus processos, principalmente no processo de resfriamento das carcaças de frangos. Parte desse volume utilizado se faz necessário, em cumprimento à legislação que determina que cada tanque do sistema de pré-resfriadores contínuos por imersão deve ser completamente esvaziado, limpo e desinfetado no final de cada período de trabalho (oito horas. O objetivo deste estudo foi comparar a carga microbiana das águas do sistema de resfriamento e das carcaças de frango ao final de oito, dezesseis e vinte e quatro horas de trabalho do abatedouro, para possível redução do número de vezes do completo esvaziamento dos tanques do sistema de resfriamento. Foram avaliadas, por meio de métodos convencionais microbiológicos e físico-químicos, amostras da água de abastecimento (n=69, visando a evitar possível interferência nas contagens das

  12. Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center

    Directory of Open Access Journals (Sweden)

    Chelsea R. Mehr MD

    2017-11-01

    Full Text Available Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

  13. Factors Influencing Residency Program Selection by Medical Students Pursuing Obstetrics and Gynecology

    Science.gov (United States)

    Alston, Meredith J.; Metz, Torri D.; Fothergill, Russell; (Meg) Autry, Amy; Wagner, Sarah A.; Allshouse, Amanda A.; Stephenson-Famy, Alyssa

    2017-01-01

    Background  Little is known about the factors that influence medical student selection of obstetrics and gynecology (ob-gyn) residency programs. Objective  We assessed the factors influencing residency program selection by fourth-year medical students pursuing ob-gyn training. Methods  A voluntary, anonymous, 19-question survey of residency selection factors was distributed to all fourth-year medical students interviewing at 1 of 5 academic ob-gyn departments for a residency position during the 2013–2014 interview season. Participants were surveyed about the relative importance (not important, somewhat important, important) of various residency selection factors, including operative experience, exposure to subspecialties, curricular experience, access to fellowships, and administrative aspects of residency, including adherence to duty hour restrictions. Results  Of 322 potential respondents, 262 (81%) completed the survey. Surgical training and training in laparoscopic surgery were deemed “important” by nearly all respondents (98%, 258 of 262, and 97%, 253 of 262, respectively). Factors that were considered “not important” by a significant group of respondents included maternity/paternity leave policies (22%, 58 of 259); opportunity for international rotations/electives (20%, 51 of 259); exposure to quality and safety initiatives (13%, 34 of 259); and training in abortion (13%, 34 of 262). Conclusions  Fourth-year medical students identified surgical training as the most important factor in selecting an ob-gyn residency, a finding that is particularly relevant as decreasing and changing surgical volumes affect residency training in this specialty. PMID:28261407

  14. Communication skills in pediatric training program: National-based survey of residents' perspectives in Saudi Arabia.

    Science.gov (United States)

    Alofisan, Tariq; Al-Alaiyan, Saleh; Al-Abdulsalam, Moath; Siddiqui, Khawar; Hussain, Ibrahim Bin; Al-Qahtani, Mohammad H

    2016-01-01

    Good communication skills and rapport building are considered the cardinal tools for developing a patient-doctor relationship. A positive, healthy competition among different health care organizations in Saudi Arabia underlines an ever increasing emphasis on effective patient-doctor relationship. Despite the numerous guidelines provided and programs available, there is a significant variation in the acceptance and approach to the use of this important tool among pediatric residents in this part of the world. To determine pediatric residents' attitude toward communication skills, their perception of important communication skills, and their confidence in the use of their communication skills in the performance of their primary duties. A cross-sectional study was conducted among all pediatrics trainee residents working in 13 different hospitals in Saudi Arabia. A standardized self-administered questionnaire developed by the Harvard Medical School was used. A total of 297 residents out of all trainees in these centers participated in the data collection. The 283 (95%) residents considered learning communication skills a priority in establishing a good patient-doctor relationship. Thirty four percent reported being very confident with regard to their communication skills. Few residents had the skills, and the confidence to communicate with children with serious diseases, discuss end-of-life issues, and deal with difficult patients and parents. Pediatric residents perceive the importance of communication skills and competencies as crucial components in their training. A proper comprehensive communication skills training should be incorporated into the pediatric resident training curriculum.

  15. 40 CFR Appendix X to Part 86 - Sampling Plans for Selective Enforcement Auditing of Heavy-Duty Engines and Light-Duty Trucks

    Science.gov (United States)

    2010-07-01

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

  16. 48 CFR 1333.212 - Contracting officer's duties upon appeals.

    Science.gov (United States)

    2010-10-01

    ... duties upon appeals. 1333.212 Section 1333.212 Federal Acquisition Regulations System DEPARTMENT OF... Contracting officer's duties upon appeals. Only Procurement Counsel will communicate with the Civilian Board of Contract Appeals or the Department of Justice regarding appeals of contracting officer decisions...

  17. 46 CFR 111.25-15 - Duty cycle.

    Science.gov (United States)

    2010-10-01

    ... REQUIREMENTS Motors § 111.25-15 Duty cycle. Each motor must be rated for continuous duty, except a motor for an... table. Table 111.25-15 Application of motor Minimum short-time rating of motor, in hours Deck winch and... idle pump operation, followed by 1/4 hr. full load operation. Steering gear, direct acting One...

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

    NARCIS (Netherlands)

    Kamminga, Menno R.

    2018-01-01

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

  19. 12 CFR 905.4 - Duties of the Finance Board.

    Science.gov (United States)

    2010-01-01

    ... Duties of the Finance Board. (a) Bank System. The Finance Board supervises and regulates the Banks and... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Duties of the Finance Board. 905.4 Section 905.4 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOUSING FINANCE BOARD ORGANIZATION AND...

  20. 40 CFR 1065.610 - Duty cycle generation.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Duty cycle generation. 1065.610 Section 1065.610 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS ENGINE-TESTING PROCEDURES Calculations and Data Requirements § 1065.610 Duty cycle generation...

  1. 7 CFR 46.32 - Duties of growers' agents.

    Science.gov (United States)

    2010-01-01

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

  2. 45 CFR 1603.5 - Council purpose and duties.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Council purpose and duties. 1603.5 Section 1603.5 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION STATE ADVISORY COUNCILS § 1603.5 Council purpose and duties. (a) The purpose of the council shall be to notify...

  3. Stamp duties in Indian states - a case for reform

    OpenAIRE

    Alm, James; Annez, Patricia; Modi, Arbind

    2004-01-01

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

  4. 28 CFR 549.13 - Programming, duty, and housing restrictions.

    Science.gov (United States)

    2010-07-01

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

  5. 25 CFR 11.706 - Appointment and duties of appraiser.

    Science.gov (United States)

    2010-04-01

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

  6. 21 CFR 812.60 - IRB composition, duties, and functions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false IRB composition, duties, and functions. 812.60 Section 812.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... composition, duties, and functions. An IRB reviewing and approving investigations under this part shall comply...

  7. 15 CFR 270.105 - Duties of a Team.

    Science.gov (United States)

    2010-01-01

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

  8. 31 CFR 401.4 - Duties of Bureau of Customs.

    Science.gov (United States)

    2010-07-01

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

  9. 31 CFR 406.4 - Duties of customs officers.

    Science.gov (United States)

    2010-07-01

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

  10. 42 CFR 440.80 - Private duty nursing services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Private duty nursing services. 440.80 Section 440... nursing services. Private duty nursing services means nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing...

  11. The Burden of Disability among Active Duty Air Force Members

    Science.gov (United States)

    2006-09-01

    football , and soccer. The authors conducted searches of computerized databases of published literature regarding disability and exercise as it relates to...and 5% of servicewomen aged 40 to 65 years have osteoarthritis . Adjustment reaction affects 4% of active-duty women and 2% of active-duty men, and

  12. Student Drivers and the Fiduciary Duty of School Boards

    Science.gov (United States)

    Donlevy, James Kent; Gereluk, Dianne; Brandon, Jim; Patterson, Peggy

    2017-01-01

    Following "E.D.G. v. Hammer", Canadian law has held that school boards, although they have a fiduciary duty to their students, do not guarantee the safety of their students from the acts of their employees. The scope of that fiduciary duty is narrow, restricted to a board acting with disloyalty, in bad faith, or in a conflict of interest…

  13. Principals' Leadership Styles and Teachers' Motivation to Duty in ...

    African Journals Online (AJOL)

    This study was aimed at articulating principals' leadership styles and teachers' motivation to duty in Cross River State, Nigeria. Discussions have been focused on motivation of teachers to duty, and how leadership styles can enhance goal achievement and performance on the part of the teacher. Two research hypotheses ...

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

    African Journals Online (AJOL)

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

  15. Education Research: Neurology resident education

    Science.gov (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

    2016-01-01

    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  16. Lightweight Composite Materials for Heavy Duty Vehicles

    Energy Technology Data Exchange (ETDEWEB)

    Pruez, Jacky; Shoukry, Samir; Williams, Gergis; Shoukry, Mark

    2013-08-31

    The main objective of this project is to develop, analyze and validate data, methodologies and tools that support widespread applications of automotive lightweighting technologies. Two underlying principles are guiding the research efforts towards this objective: • Seamless integration between the lightweight materials selected for certain vehicle systems, cost-effective methods for their design and manufacturing, and practical means to enhance their durability while reducing their Life-Cycle-Costs (LCC). • Smooth migration of the experience and findings accumulated so far at WVU in the areas of designing with lightweight materials, innovative joining concepts and durability predictions, from applications to the area of weight savings for heavy vehicle systems and hydrogen storage tanks, to lightweighting applications of selected systems or assemblies in light–duty vehicles.

  17. Australia slaps duties on PVC imports

    International Nuclear Information System (INIS)

    Young, I.

    1992-01-01

    The Australian Anti-Dumping Authority (ADA0) has imposed dumping duties on imports of polyvinyl chloride (PVC) resin from seven countries and on certain expanded polystyrene (EPS) beads from Korea and Singapore. The decisions come at the end of two separate investigations begun earlier this year. In its first finding, the ADA concluded that there has been dumping of PVC resin from Canada, China, France, Japan, Norway, Saudi Arabia, and Thailand, which has caused and threatens to cause material injury to the domestic PVC industry. An eighth country, Romania, was found not to have been exporting PVC to Australia. The case is the second of its kind in Australia focusing on PVC. In December 1991 the ADA found in favor of local producer sin a dumping complaint against Argentina, Brazil, Hungary, Israel, Korea, Mexico, Poland, Singapore, Taiwan, and the US

  18. Malignant Hyperthermia Susceptibility and Fitness for Duty.

    Science.gov (United States)

    Lee, Michael A; McGlinch, Erin B; McGlinch, Maria C; Capacchione, John F

    2017-03-01

    Malignant hyperthermia (MH) is an inherited hypermetabolic condition characterized by uncontrolled calcium release from the sarcoplasmic reticulum of skeletal muscle, usually from exposure to inhaled general anesthetics and/or the depolarizing neuromuscular blocking agent succinylcholine. Multiple case reports now reveal that crises may be precipitated by environmental factors such as exercise or high ambient temperatures. Common signs of an MH crisis include life-threatening hyperthermia, metabolic acidosis, muscle rigidity, and tachycardia. Treatment consists of stopping triggering agents, administering dantrolene, and actively cooling the patient. MH is a medically disqualifying condition for service in the U.S. Armed Forces. However, patients with MH-causative mutations may never have experienced an MH episode. If they previously have had an event concerning for MH, details are often sparse and a formal evaluation is absent. We present 2 case reports with military service implications, one as a formal applicant to the service academies and the other as the father of an active duty Navy chief. Both patients experienced prior MH-like reactions to anesthesia but had not undergone testing with a caffeine-halothane contracture test (CHCT) or genetic analysis. Both patients underwent skeletal muscle biopsies of the left vastus lateralis with nontriggering anesthetics at Children's National Medical Center in Washington, DC, and MH diagnostic CHCT at the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland. The CHCT was performed according to the North American MH Registry Protocol. With USUHS Institutional Review Board approval, ryanodine receptor type 1 gene (RYR1) and L-type calcium channel α-1 subunit gene (CACNA1S) sequencing was performed on the remaining muscle at USUHS. Each subject was CHCT positive, confirming a diagnosis of MH. One was found to have a known MH-causative gene mutation. The applicant to the service academy was

  19. [On the moral dutifulness of using vaccinations].

    Science.gov (United States)

    Refolo, P; González-Melado, F J; Di Pietro, M L

    2015-01-01

    People had contradictory opinions on using vaccinations over time: an initial opposition, later large favour and then doubts and perplexities. In recent times, some movements, blogs and associations stigmatize the use of vaccinations and they are increasingly asking to remove mandatory vaccinations in countries where they are active. The impact of the antivaccination campaigns should not be underestimated, considering that, for example, in Italy, due to these campaigns, adhesions to vaccinations are decreasing by 1% per year, and in reference to rubella and measles, adhesions decreased by 25% in some regions of the country. Overcoming the choice between mandatory and recommended vaccinations, the paper deals with the topic of using preventive immunization starting from the concept of "moral dutifulness".

  20. Medium Duty Electric Vehicle Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-31

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

  1. Resident Load Influence Analysis Method for Price Based on Non-intrusive Load Monitoring and Decomposition Data

    Science.gov (United States)

    Jiang, Wenqian; Zeng, Bo; Yang, Zhou; Li, Gang

    2018-01-01

    In the non-invasive load monitoring mode, the load decomposition can reflect the running state of each load, which will help the user reduce unnecessary energy costs. With the demand side management measures of time of using price, a resident load influence analysis method for time of using price (TOU) based on non-intrusive load monitoring data are proposed in the paper. Relying on the current signal of the resident load classification, the user equipment type, and different time series of self-elasticity and cross-elasticity of the situation could be obtained. Through the actual household load data test with the impact of TOU, part of the equipment will be transferred to the working hours, and users in the peak price of electricity has been reduced, and in the electricity at the time of the increase Electrical equipment, with a certain regularity.

  2. Factors associated with the subspecialty choices of internal medicine residents in Canada

    Directory of Open Access Journals (Sweden)

    Thorpe Kevin

    2008-06-01

    Full Text Available Abstract Background Currently, there are more residents enrolled in cardiology training programs in Canada than in immunology, pharmacology, rheumatology, infectious diseases, geriatrics and endocrinology combined. There is no published data regarding the proportion of Canadian internal medicine residents applying to the various subspecialties, or the factors that residents consider important when deciding which subspecialty to pursue. To address the concern about physician imbalances in internal medicine subspecialties, we need to examine the factors that motivate residents when making career decisions. Methods In this two-phase study, Canadian internal medicine residents participating in the post graduate year 4 (PGY4 subspecialty match were invited to participate in a web-based survey and focus group discussions. The focus group discussions were based on issues identified from the survey results. Analysis of focus group transcripts grew on grounded theory. Results 110 PGY3 residents participating in the PGY4 subspecialty match from 10 participating Canadian universities participated in the web-based survey (54% response rate. 22 residents from 3 different training programs participated in 4 focus groups held across Canada. Our study found that residents are choosing careers that provide intellectual stimulation, are consistent with their personality, and that provide a challenge in diagnosis. From our focus group discussions it appears that lifestyle, role models, mentorship and the experience of the resident with the specialty appear to be equally important in career decisions. Males are more likely to choose procedure based specialties and are more concerned with the reputation of the specialty as well as the anticipated salary. In contrast, residents choosing non-procedure based specialties are more concerned with issues related to lifestyle, including work-related stress, work hours and time for leisure as well as the patient populations

  3. Factors Influencing Resident Choice of Prosthodontic Residency Program.

    Science.gov (United States)

    Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas

    2017-06-01

    The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most

  4. 75 FR 7426 - Tier 2 Light-Duty Vehicle and Light-Duty Truck Emission Standards and Gasoline Sulfur Control...

    Science.gov (United States)

    2010-02-19

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

  5. Adaptation of occupants with its environment in the official residence (case study: Housing of TNI AD Gaperta)

    Science.gov (United States)

    Nirfalini Aulia, Dwira; Aritonang, Cindy

    2018-03-01

    An official residence is a housing provided by the state and used as a residence occupied by the official duties of officials and civil servants during their service in the city. The property rights of the official residence have limit, only valid while the residents serve in the city. The process of adaptation becomes indispensable because, in the early days of occupying the housing, residents will face a new social environment, which may be different from their previous environment. Furthermore, backgrounds such as economic, cultural, and social factors of each occupant will also determine the adaptation process that occurs. This research aims to find out and analyze adaptation process of the official residence’s dwellers to its environment. This study used the descriptive-qualitative method by interviewing ten occupants who selected by purposive sampling method. Results of research indicated that the most adaptation process occurs adaptation by the reaction such as adding the number of room and service area.

  6. Pathology Informatics Essentials for Residents

    Science.gov (United States)

    Karcher, Donald S.; Harrison, James H.; Sinard, John H.; Riben, Michael W.; Boyer, Philip J.; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron

    2016-01-01

    Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:28725772

  7. Pathology Informatics Essentials for Residents

    Directory of Open Access Journals (Sweden)

    Walter H. Henricks MD

    2016-07-01

    Full Text Available Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics has been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: To develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills, and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016. Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time.

  8. Incorporating resident research into the dermatology residency program

    Science.gov (United States)

    Wagner, Richard F; Raimer, Sharon S; Kelly, Brent C

    2013-01-01

    Programmatic changes for the dermatology residency program at The University of Texas Medical Branch were first introduced in 2005, with the faculty goal incorporating formal dermatology research projects into the 3-year postgraduate training period. This curriculum initially developed as a recommendation for voluntary scholarly project activity by residents, but it evolved into a program requirement for all residents in 2009. Departmental support for this activity includes assignment of a faculty mentor with similar interest about the research topic, financial support from the department for needed supplies, materials, and statistical consultation with the Office of Biostatistics for study design and data analysis, a 2-week elective that provides protected time from clinical activities for the purpose of preparing research for publication and submission to a peer-reviewed medical journal, and a departmental award in recognition for the best resident scholarly project each year. Since the inception of this program, five classes have graduated a total of 16 residents. Ten residents submitted their research studies for peer review and published their scholarly projects in seven dermatology journals through the current academic year. These articles included three prospective investigations, three surveys, one article related to dermatology education, one retrospective chart review, one case series, and one article about dermatopathology. An additional article from a 2012 graduate about dermatology education has also been submitted to a journal. This new program for residents was adapted from our historically successful Dermatology Honors Research Program for medical students at The University of Texas Medical Branch. Our experience with this academic initiative to promote dermatology research by residents is outlined. It is recommended that additional residency programs should consider adopting similar research programs to enrich resident education. PMID:23901305

  9. Schedule Control and Nursing Home Quality: Exploratory Evidence of a Psychosocial Predictor of Resident Care.

    Science.gov (United States)

    Hurtado, David A; Berkman, Lisa F; Buxton, Orfeu M; Okechukwu, Cassandra A

    2016-02-01

    To examine whether nursing homes' quality of care was predicted by schedule control (workers' ability to decide work hours), independently of other staffing characteristics. Prospective ecological study of 30 nursing homes in New England. Schedule control was self-reported via survey in 2011-2012 (N = 1,045). Quality measures included the prevalence of decline in activities of daily living, residents' weight loss, and pressure ulcers, indicators systematically linked with staffing characteristics. Outcomes data for 2012 were retrieved from Medicare.gov. Robust Linear Regressions showed that higher schedule control predicted lower prevalence of pressure ulcers (β = -0.51, p job satisfaction, and turnover intentions. Higher schedule control might enhance the planning and delivery of strategies to prevent or cure pressure ulcers. Further research is needed to identify potential causal mechanisms by which schedule control could improve quality of care. © The Author(s) 2014.

  10. Burnout among Dutch medical residents

    NARCIS (Netherlands)

    Prins, J.T.; Hoekstra-Weebers, J.E.; Van De Wiel, H.B.; Gazendam-Donofrio, S.M.; Sprangers, F.; Jaspers, F.C.; van der Heijden, F.M.

    2007-01-01

    We examined levels of burnout and relationships between burnout, gender, age, years in training, and medical specialty in 158 medical residents working at the University Medical Center Groningen, the Netherlands. Thirteen percent of the residents met the criteria for burnout, with the highest

  11. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  12. Early resident-to-resident physics education in diagnostic radiology.

    Science.gov (United States)

    Kansagra, Akash P

    2014-01-01

    The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  13. Working and training conditions of residents in pediatric surgery: a nationwide survey in Germany.

    Science.gov (United States)

    Reismann, M; Ellerkamp, V; Dingemann, J

    2010-09-01

    As in other surgical specialties, increasing concern has been expressed worldwide about the shortage of trainees in pediatric surgery training programs. We performed a nationwide survey to investigate the current situation in Germany. An internet-based nationwide survey comprising 36 questions on training conditions in pediatric surgery was linked to the homepage of the German Society of Pediatric Surgery from June to September 2008. Statements on the following aspects were evaluated by responding residents using a scale from 1 (I do not agree at all) to 5 (I fully agree): workplace, cooperation with colleagues, head of the department, cooperation with other specialties, training and research conditions. A median value of 3 indicated an unsatisfactory assessment, with at least 50% of respondents giving an indifferent or negative response. 70 questionnaires were completed. Some of the evaluations revealed problematic areas. In particular, statements regarding working hours revealed dissatisfaction among the responding doctors. The median value accorded the statement "I am satisfied with the current working time regulation" was 2.9. With regard to departmental heads, some criticisms were directed against a perceived lack of soft skills. According to the respondents, their involvement in decision-making processes was insufficient ("We are involved in decision-making processes affecting our working conditions" - median value 2.4). Residents were also dissatisfied with the feedback they received for their work ("I get enough feedback regarding my achievement" - median value 2.6). Another problem area was career development ("I will finish my specialist training in time" - median value 2.9). However, these points did not affect overall satisfaction. Trainee satisfaction with regulations on working hours is low. Despite a general satisfaction with all fields appraised, improvements in various individual areas, e. g., the attitude of departmental heads and strategies of

  14. CRIMES AGAINST OFFICIAL DUTY IN THE REPUBLIC OF MACEDONIA

    Directory of Open Access Journals (Sweden)

    Darko Majhosev

    2015-07-01

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

  15. Needs Assessment for Incoming PGY-1 Residents in Neurosurgical Residency.

    Science.gov (United States)

    Brandman, David M; Haji, Faizal A; Matte, Marie C; Clarke, David B

    2015-01-01

    Residents must develop a diverse range of skills in order to practice neurosurgery safely and effectively. The purpose of this study was to identify the foundational skills required for neurosurgical trainees as they transition from medical school to residency. Based on the CanMEDS competency framework, a web-based survey was distributed to all Canadian academic neurosurgical centers, targeting incoming and current PGY-1 neurosurgical residents as well as program directors. Using Likert scale and free-text responses, respondents rated the importance of various cognitive (e.g. management of raised intracranial pressure), technical (e.g. performing a lumbar puncture) and behavioral skills (e.g. obtaining informed consent) required for a PGY-1 neurosurgical resident. Of 52 individuals contacted, 38 responses were received. Of these, 10 were from program directors (71%), 11 from current PGY-1 residents (58%) and 17 from incoming PGY-1 residents (89%). Respondents emphasized operative skills such as proper sterile technique and patient positioning; clinical skills such as lesion localization and interpreting neuro-imaging; management skills for common scenarios such as raised intracranial pressure and status epilepticus; and technical skills such as lumbar puncture and external ventricular drain placement. Free text answers were concordant with the Likert scale results. We surveyed Canadian neurosurgical program directors and PGY-1 residents to identify areas perceived as foundational to neurosurgical residency education and training. This information is valuable for evaluating the appropriateness of a training program's goals and objectives, as well as for generating a national educational curriculum for incoming PGY-1 residents.

  16. Health promotion in active-duty military women with children.

    Science.gov (United States)

    Agazio, Janice G; Ephraim, Paula M; Flaherty, Norma B; Gurney, Cynthia A

    2002-01-01

    The purpose of this study was to determine the extent to which selected demographic characteristics, definition of health, perceived health status, perceived self-efficacy, and resources are related to the health promoting behaviors of active-duty women with children and to describe qualitatively the experience of being an active-duty mother. Grounded in Pender's (1996) Health Promotion Model, this study used methodological triangulation to test a hypothesized model. A sample of 141 active-duty women with children using military health services participated. Resource availability and commitment were key components of being successful at balancing home and work demands.

  17. IMPACT OF CPO EXPORT DUTIES ON MALAYSIAN PALM OIL INDUSTRY

    OpenAIRE

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

    2014-01-01

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

  18. Design of a continuous duty cryopump

    International Nuclear Information System (INIS)

    Sedgley, D.W.

    1985-05-01

    A continuous duty cryopump system was designed and developed that comprises a self-contained cryopump for installation into a vacuum chamber, and a microprocessor controller for automatic operation. This deuterium pump has two units in a single housing, arranged so that one is pumping while the other is being regenerated. Liquid helium-cooled, finned sections in each unit pump deuterium by condensation, and a third pump integral within the cryopump housing collects the regenerated gas. A microprocessor unit controls distribution of liquid and gaseous helium, used for conditioning the pumping units, and operates remote actuators for the regeneration. Software provides fully automatic, timed sequencing of the repetitive cryopump events which include: cooldown of the pumping units, opening of the louvers isolating the unit from the vacuum chamber, closing of the louvers, and warming up of the unit for regeneration. Default values in the software can be reprogrammed by the operator through the keyboard in response to prompts displayed on the computer. An override allows the operator to control the cryopump manually by activating switches on a control panel. Interlocks to prevent cryogen lockup are included in the software

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ying-Yi Ho

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

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

    Science.gov (United States)

    Crisp, Roger

    2015-03-01

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

  2. Evolution of high duty cycle echolocation in bats

    DEFF Research Database (Denmark)

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

    2012-01-01

    Duty cycle describes the relative 'on time' of a periodic signal. In bats, we argue that high duty cycle (HDC) echolocation was selected for and evolved from low duty cycle (LDC) echolocation because increasing call duty cycle enhanced the ability of echolocating bats to detect, lock onto and track...... fluttering insects. Most echolocators (most bats and all birds and odontocete cetaceans) use LDC echolocation, separating pulse and echo in time to avoid forward masking. They emit short duration, broadband, downward frequency modulated (FM) signals separated by relatively long periods of silence....... In contrast, bats using HDC echolocation emit long duration, narrowband calls dominated by a single constant frequency (CF) separated by relatively short periods of silence. HDC bats separate pulse and echo in frequency by exploiting information contained in Doppler-shifted echoes arising from their movements...

  3. The Perceived Importance of HR duties to Danish line managers

    DEFF Research Database (Denmark)

    Brandl, Julia; Madsen, Mona Toft; Madsen, Henning

    2009-01-01

    Today, HR scholars widely acknowledge that realising HRM requires the involvement of all managers and that the personal motivation of line managers plays an important role in their successful involvement. Yet, previous research has neglected to study how line managers rate the importance...... of particular HR duties and how the importance assigned to HR duties varies across managers. Based on a survey of 1,500 Danish managers, we find that 'motivating others' is considered the most important HR duty whereas 'team building', 'handling conflicts' and 'coaching' are considered the least important HR...... duties. Female top managers in the public sector exhibit the greatest interest in HR whereas men at lower managerial levels in the private sector give lowest priority to HR work. We conclude with possible explanations for the observed differences in a Danish context and beyond and provide suggestions...

  4. Light-Duty Vehicle CO2 and Fuel Economy Trends

    Science.gov (United States)

    This report provides data on the fuel economy, carbon dioxide (CO2) emissions, and technology trends of new light-duty vehicles (cars, minivans, sport utility vehicles, and pickup trucks) for model years 1975 to present in the United States.

  5. 7 CFR 917.34 - Duties of Control Committee.

    Science.gov (United States)

    2010-01-01

    ... CALIFORNIA Order Regulating Handling Administrative Bodies § 917.34 Duties of Control Committee. The Control... develop and provide the commodity committees data on shared expenses to facilitate equitable apportionment...

  6. Sleep and Other Activities of Off Duty Pilots

    National Research Council Canada - National Science Library

    Crabtree, Mark S; Eddy, Douglas R

    2005-01-01

    An exhaustive search of archives, reports, databases and publications was performed to locate research data that describe the activities of off-duty pilots as they prepare for night or long duration missions...

  7. Decontamination trade study for the Light Duty Utility Arm

    International Nuclear Information System (INIS)

    Rieck, R.H.

    1994-01-01

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

  8. Family medicine residents' reactions to introducing a reflective exercise into training.

    Science.gov (United States)

    Shaughnessy, Allen F; Duggan, Ashley P

    2013-01-01

    Teaching residents how to reflect and providing ongoing experience in reflection may aid their development into adaptable, life-long learning professionals. We introduced an ongoing reflective exercise into the curriculum of a family medicine residency program. Residents were provided 15 minutes, three times a week, to complete these reflective exercises. We termed these reflective exercises "clinical blogs" since they were entered into a web-based computer portfolio, though they were not publicly available. The aim of this study is to explore family medicine residents' responses to the introduction of an ongoing reflective exercise and examine strengths and challenges of the reflective process. We invited a cohort of family medicine residents (8 residents) who had all participated in the reflective exercises as part of their residency to participate in one of two offered focus groups to share their experience with the reflective exercise. An investigator not connected to the training program led each focus group using minimal structure in order to allow for the breadth of residents' experiences to be revealed. The focus groups were audio recorded, and the recordings were transcribed verbatim without identifying participants. We used a grounded theory approach, using open coding to analyze the focus group transcripts and to identify themes. Four residents participated in each focus group. We identified four main themes regarding family medicine residents' responses of the reflective practice exercises: (1) Residents viewed blogging (reflecting) as a method of enhanced personal and professional self-development; (2) Despite the reflective exercises being valued as self-development, residents see an inherent conflict between self-development and professional duties; (3) Residents recognize their emotional responses, but writing about emotional issues is difficult for some residents; and (4) Clinical blogging in our residency has not reached its potential due to the

  9. Helping Residents Protect Water Sources

    Science.gov (United States)

    Building on the successful early engagement of the Plain Sect agricultural community, the Eastern Lancaster County Source Water Protection Collaborative is expanding its efforts to involve local residents in the work of protecting drinking water sources.

  10. The ethanol heavy-duty truck fleet demonstration project

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

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

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

    African Journals Online (AJOL)

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

  12. 75 FR 33772 - Polyethylene Retail Carrier Bags From Malaysia: Preliminary Results of Antidumping Duty...

    Science.gov (United States)

    2010-06-15

    ... Bags From Malaysia: Preliminary Results of Antidumping Duty Administrative Review AGENCY: Import... antidumping duty order on polyethylene retail carrier bags (PRCBs) from Malaysia. The review covers one... published in the Federal Register the antidumping duty order on PRCBs from Malaysia. See Antidumping Duty...

  13. 76 FR 5332 - Honey From Argentina: Notice of Initiation of Antidumping Duty New Shipper Review

    Science.gov (United States)

    2011-01-31

    ... International Trade Administration Honey From Argentina: Notice of Initiation of Antidumping Duty New Shipper... antidumping duty order on honey from Argentina. See Notice of Antidumping Duty Order: Honey From Argentina, 66...: Background On December 10, 2001, the Department published the antidumping duty order on honey from Argentina...

  14. 77 FR 21968 - Honey From Argentina: Rescission of Countervailing Duty Administrative Review

    Science.gov (United States)

    2012-04-12

    ... International Trade Administration Honey From Argentina: Rescission of Countervailing Duty Administrative Review... countervailing duty order on honey ] from Argentina. See Notice of Countervailing Duty Order: Honey From... opportunity to request an administrative review of the countervailing duty order on honey from Argentina for...

  15. 77 FR 4763 - Honey From Argentina: Notice of Initiation of Antidumping Duty New Shipper Review

    Science.gov (United States)

    2012-01-31

    ... International Trade Administration Honey From Argentina: Notice of Initiation of Antidumping Duty New Shipper... ] antidumping duty order on honey from Argentina. See Notice of Antidumping Duty Order: Honey From Argentina, 66...: Background On December 10, 2001, the Department published the antidumping duty order on honey from Argentina...

  16. Graduating general surgery resident operative confidence: perspective from a national survey.

    Science.gov (United States)

    Fonseca, Annabelle L; Reddy, Vikram; Longo, Walter E; Gusberg, Richard J

    2014-08-01

    General surgical training has changed significantly over the last decade with work hour restrictions, increasing subspecialization, the expanding use of minimally invasive techniques, and nonoperative management for solid organ trauma. Given these changes, this study was undertaken to assess the confidence of graduating general surgery residents in performing open surgical operations and to determine factors associated with increased confidence. A survey was developed and sent to general surgery residents nationally. We queried them regarding demographics and program characteristics, asked them to rate their confidence (rated 1-5 on a Likert scale) in performing open surgical procedures and compared those who indicated confidence with those who did not. We received 653 responses from the fifth year (postgraduate year 5) surgical residents: 69% male, 68% from university programs, and 51% from programs affiliated with a Veterans Affairs hospital; 22% from small programs, 34% from medium programs, and 44% from large programs. Anticipated postresidency operative confidence was 72%. More than 25% of residents reported a lack of confidence in performing eight of the 13 operations they were queried about. Training at a university program, a large program, dedicated research years, future fellowship plans, and training at a program that performed a large percentage of operations laparoscopically was associated with decreased confidence in performing a number of open surgical procedures. Increased surgical volume was associated with increased operative confidence. Confidence in performing open surgery also varied regionally. Graduating surgical residents indicated a significant lack of confidence in performing a variety of open surgical procedures. This decreased confidence was associated with age, operative volume as well as type, and location of training program. Analyzing and addressing this confidence deficit merits further study. Copyright © 2014 Elsevier Inc. All

  17. the contribution of resident physicians

    OpenAIRE

    Trusch, Klaus

    2011-01-01

    A telephone survey of resident physicians to the basic conditions in which they work has been conducted in 14 of the 16 federal states. In the center of the survey stood the general medicine within the prisons. This limitation was necessary in order to achieve comparability to primary medical care outside of correctional services. There are 140 salaried and tenured resident pysicians and 97 contract doctors in the general medical care of approx. 70000 prisoners in 185 independent prisons ...

  18. Minimum Data Set Active Resident Information Report

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS Active Resident Report summarizes information for residents currently in nursing homes. The source of these counts is the residents MDS assessment record....

  19. Fitness for duty: a no-nonsense approach

    International Nuclear Information System (INIS)

    Dew, S.M.; Hill, A.O.

    1987-01-01

    In formulating the fitness-for-duty program at Houston Lighting and Power (HL and P), the project and plant staffs followed program guidelines developed by the Edison Electric Institute and considered the performance criteria for the fitness-for-duty programs developed by the Institute of Nuclear Power Operations. The staff visited utilities involved in fitness-for-duty implementation to review the problems and successes experienced by those utilities. On November 1, 1985, the nuclear group vice-president instituted the South Texas Project Fitness-for-Duty Policy to become effective on January 1, 1986. It was important to implement the program at that time, as the project moved to the final stages of construction and preparation for plant operations. The South Texas Project has made a firm commitment to the industry with our fitness-for-duty program. The no-nonsense approach to illegal drug and alcohol use enables to assure a high level of employee health, productivity, and safety in a drug- and alcohol-free environment. The cost of the fitness-for-duty program is minimal when compared to the increase in productivity and the heightened confidence in workers by the US Nuclear Regulatory Commission since implementation of this program

  20. Wi-Fi Coexistence with Duty Cycled LTE-U

    Directory of Open Access Journals (Sweden)

    Yimin Pang

    2017-01-01

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

  1. Selection criteria of residents for residency programs in Kuwait.

    Science.gov (United States)

    Marwan, Yousef; Ayed, Adel

    2013-01-19

    In Kuwait, 21 residency training programs were offered in the year 2011; however, no data is available regarding the criteria of selecting residents for these programs. This study aims to provide information about the importance of these criteria. A self-administered questionnaire was used to collect data from members (e.g. chairmen, directors, assistants …etc.) of residency programs in Kuwait. A total of 108 members were invited to participate. They were asked to rate the importance level (scale from 1 to 5) of criteria that may affect the acceptance of an applicant to their residency programs. Average scores were calculated for each criterion. Of the 108 members invited to participate, only 12 (11.1%) declined to participate. Interview performance was ranked as the most important criteria for selecting residents (average score: 4.63/5.00), followed by grade point average (average score: 3.78/5.00) and honors during medical school (average score: 3.67/5.00). On the other hand, receiving disciplinary action during medical school and failure in a required clerkship were considered as the most concerning among other criteria used to reject applicants (average scores: 3.83/5.00 and 3.54/5.00 respectively). Minor differences regarding the importance level of each criterion were noted across different programs. This study provided general information about the criteria that are used to accept/reject applicants to residency programs in Kuwait. Future studies should be conducted to investigate each criterion individually, and to assess if these criteria are related to residents' success during their training.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-11-01

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

  3. Light duty utility arm walkdown report

    Energy Technology Data Exchange (ETDEWEB)

    Smalley, J.L.

    1998-09-25

    This document is a report of the Light Duty Utility Arm (LDUA) drawing walkdown. The purpose of this walkdown was to validate the essential configuration of the LDUA in preparation of deploying the equipment in a Hanford waste tank. The LDUA system has, over the course of its development, caused the generation of a considerable number of design drawings. The number of drawings is estimated to be well over 1,000. A large number consist of vendor type drawings, furnished by both Pacific Northwest National Laboratory (PNNL) and SPAR Aerospace Limited (SPAR). A smaller number, approximately 200, are H-6 type drawing sheets in the Project Hanford Management Contract (PHMC) document control system. A preliminary inspection of the drawings showed that the physical configuration of the LDUA did not match the documented configuration. As a result of these findings, a scoping walkdown of 20 critical drawing sheets was performed to determine if a problem existed in configuration management of the LDUA system. The results of this activity showed that 18 of the 20 drawing sheets were found to contain errors or omissions of varying concern. Given this, Characterization Engineering determined that a walkdown of the drawings necessary and sufficient to enable safe operation and maintenance of the LDUA should be performed. A review team was assembled to perform a review of all of the drawings and determine the set which would need to be verified through an engineering walkdown. The team determined that approximately 150 H-6 type drawing sheets would need to be verified, 12 SPAR/PNNL drawing sheets would need to be verified and converted to H-6 drawings, and three to six new drawings would be created (see Appendix A). This report documents the results of that walkdown.

  4. Light duty utility arm walkdown report

    International Nuclear Information System (INIS)

    Smalley, J.L.

    1998-01-01

    This document is a report of the Light Duty Utility Arm (LDUA) drawing walkdown. The purpose of this walkdown was to validate the essential configuration of the LDUA in preparation of deploying the equipment in a Hanford waste tank. The LDUA system has, over the course of its development, caused the generation of a considerable number of design drawings. The number of drawings is estimated to be well over 1,000. A large number consist of vendor type drawings, furnished by both Pacific Northwest National Laboratory (PNNL) and SPAR Aerospace Limited (SPAR). A smaller number, approximately 200, are H-6 type drawing sheets in the Project Hanford Management Contract (PHMC) document control system. A preliminary inspection of the drawings showed that the physical configuration of the LDUA did not match the documented configuration. As a result of these findings, a scoping walkdown of 20 critical drawing sheets was performed to determine if a problem existed in configuration management of the LDUA system. The results of this activity showed that 18 of the 20 drawing sheets were found to contain errors or omissions of varying concern. Given this, Characterization Engineering determined that a walkdown of the drawings necessary and sufficient to enable safe operation and maintenance of the LDUA should be performed. A review team was assembled to perform a review of all of the drawings and determine the set which would need to be verified through an engineering walkdown. The team determined that approximately 150 H-6 type drawing sheets would need to be verified, 12 SPAR/PNNL drawing sheets would need to be verified and converted to H-6 drawings, and three to six new drawings would be created (see Appendix A). This report documents the results of that walkdown

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

    OpenAIRE

    Wood, Gavin A.

    1994-01-01

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

  6. Future Career Plans and Practice Patterns of Canadian Obstetrics and Gynaecology Residents in 2011.

    Science.gov (United States)

    Burrows, Jason; Coolen, Jillian

    2016-01-01

    The practice patterns of Obstetricians and Gynaecologists continue to evolve with each new generation of physicians. Diversifying subspecialties, changes in resident duty hours, job market saturation, and desire for work-life balance are playing stronger roles. Professional practice direction and needs assessment may be aided by awareness of future Obstetrics and Gynaecology physician career plans and expectations. The objective of this study was to determine the expected career plans and practice patterns of Canadian Obstetrics and Gynaecology residents following residency. The SOGC Junior Member Committee administered its third career planning survey to Canadian Obstetrics and Gynaecology residents electronically in December 2011. The data collected was statistically analyzed and compared to previous surveys. There were 183 responses giving a response rate of 43%. More than one half of all residents were considering postgraduate training (58%). Projected practice patterns included: 84% maintaining obstetrical practice, 60% locuming, and 50% job-sharing. The majority of residents expected to work in a 6 to 10 person call group (48%), work 3 to 5 call shifts per month (72%), work 41 to 60 hours weekly (69%), and practise in a city with a population greater than 500 000 (45%). Only 18% of residents surveyed were in favour of streaming residency programs in Obstetrics and Gynaecology. Canadian resident career plan and expected practice pattern assessment remains an important tool for aiding in resource allocation and strategic development of care and training in Obstetrics and Gynaecology in Canada. Copyright © 2016 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  7. Applying Expectancy Theory to residency training: proposing opportunities to understand resident motivation and enhance residency training

    Directory of Open Access Journals (Sweden)

    Shweiki E

    2015-04-01

    Full Text Available Ehyal Shweiki,1 Niels D Martin,2 Alec C Beekley,1 Jay S Jenoff,1 George J Koenig,1 Kris R Kaulback,1 Gary A Lindenbaum,1 Pankaj H Patel,1 Matthew M Rosen,1 Michael S Weinstein,1 Muhammad H Zubair,2 Murray J Cohen1 1Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA; 2Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA Abstract: Medical resident education in the United States has been a matter of national priority for decades, exemplified initially through the Liaison Committee for Graduate Medical Education and then superseded by the Accreditation Council for Graduate Medical Education. A recent Special Report in the New England Journal of Medicine, however, has described resident educational programs to date as prescriptive, noting an absence of innovation in education. Current aims of contemporary medical resident education are thus being directed at ensuring quality in learning as well as in patient care. Achievement and work-motivation theories attempt to explain people's choice, performance, and persistence in tasks. Expectancy Theory as one such theory was reviewed in detail, appearing particularly applicable to surgical residency training. Correlations between Expectancy Theory as a work-motivation theory and residency education were explored. Understanding achievement and work-motivation theories affords an opportunity to gain insight into resident motivation in training. The application of Expectancy Theory in particular provides an innovative perspective into residency education. Afforded are opportunities to promote the development of programmatic methods facilitating surgical resident motivation in education. Keywords: learning, education, achievement

  8. Evaluating Dermatology Residency Program Websites.

    Science.gov (United States)

    Ashack, Kurt A; Burton, Kyle A; Soh, Jonathan M; Lanoue, Julien; Boyd, Anne H; Milford, Emily E; Dunnick, Cory; Dellavalle, Robert P

    2016-03-16

    Internet resources play an important role in how medical students access information related to residency programs.Evaluating program websites is necessary in order to provide accurate information for applicants and provide information regarding areas of website improvement for programs. To date, dermatology residency websites (D  WS) have not been evaluated.This paper evaluates dermatology residency websites based on availability of predefined measures. Using the FREIDA (Fellowship and Residency Electronic Interactive Database) Online database, authors searched forall accredited dermatology program websites. Eligible programs were identified through the FREIDA Online database and had a functioning website. Two authors independently extracted data with consensus or third researcher resolution of differences. This data was accessed and archived from July 15th to July 17th, 2015.Primary outcomes measured were presence of content on education, resident and faculty information, program environment, applicant recruitment, schedule, salary, and website quality evaluated using an online tool (WooRank.com). Out of 117 accredited dermatology residencies, 115 had functioning webpages. Of these, 76.5% (75) had direct links found on the FRIEDA Online database. Most programs contained information on education, faculty, program environment, and applicant recruitment. However, website quality and marketing effectiveness were highly variable; most programs were deemed to need improvements in the functioning of their webpages. Also, additional information on current residents and about potential away rotations were lacking from most websites with only 52.2% (60) and 41.7% (48) of programs providing this content, respectively. A majority of dermatology residency websites contained adequate information on many of the factors we evaluated. However, many were lacking in areas that matter to applicants. We hope this report will encourage dermatology residencyprograms

  9. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  10. Plagiarism in residency application essays.

    Science.gov (United States)

    Segal, Scott; Gelfand, Brian J; Hurwitz, Shelley; Berkowitz, Lori; Ashley, Stanley W; Nadel, Eric S; Katz, Joel T

    2010-07-20

    Anecdotal reports suggest that some residency application essays contain plagiarized content. To determine the prevalence of plagiarism in a large cohort of residency application essays. Retrospective cohort study. 4975 application essays submitted to residency programs at a single large academic medical center between 1 September 2005 and 22 March 2007. Specialized software was used to compare residency application essays with a database of Internet pages, published works, and previously submitted essays and the percentage of the submission matching another source was calculated. A match of more than 10% to an existing work was defined as evidence of plagiarism. Evidence of plagiarism was found in 5.2% (95% CI, 4.6% to 5.9%) of essays. The essays of non-U.S. citizens were more likely to demonstrate evidence of plagiarism. Other characteristics associated with the prevalence of plagiarism included medical school location outside the United States and Canada; previous residency or fellowship; lack of research experience, volunteer experience, or publications; a low United States Medical Licensing Examination Step 1 score; and non-membership in the Alpha Omega Alpha Honor Medical Society. The software database is probably incomplete, the 10%-match threshold for defining plagiarism has not been statistically validated, and the study was confined to applicants to 1 institution. Evidence of matching content in an essay cannot be used to infer the applicant's intent and is not sensitive to variations in the cultural context of copying in some societies. Evidence of plagiarism in residency application essays is more common in international applicants but was found in those by applicants to all specialty programs, from all medical school types, and even among applicants with significant academic honors. No external funding.

  11. 38 CFR 51.70 - Resident rights.

    Science.gov (United States)

    2010-07-01

    ... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.70 Resident rights. The resident has a... legal representative. (5) Conveyance upon death. Upon the death of a resident with a personal fund...; (iii) Physicians of the resident's choice (to provide care in the nursing home, physicians must meet...

  12. Mentorship in orthopaedic and trauma residency training ...

    African Journals Online (AJOL)

    Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

  13. Surgery resident learning styles and academic achievement.

    Science.gov (United States)

    Contessa, Jack; Ciardiello, Kenneth A; Perlman, Stacie

    2005-01-01

    To determine if surgical residents share a preferred learning style as measured by Kolb's Learning Style Inventory (LSI) and if a relationship exists between resident learning style and achievement as measured by a standardized examination (AME). Also, core faculty learning styles were assessed to determine if faculty and residents share a preferred learning style. Kolb's LSI, Version 3, was administered to 16 surgical residents and the residency program's core faculty of 6 attending physicians. To measure academic achievement, the American Medical Education (AME) examination was administered to residents. The Hospital of Saint Raphael, General Surgery Residency Program, New Haven, Connecticut. Both instruments were administered to residents during protected core curriculum time. Core faculty were administered the LSI on an individual basis. Surgical residents of the Hospital of Saint Raphael's General Surgery Residency Program and 6 core faculty members Analysis of resident learning style preference revealed Converging as the most commonly occurring style for residents (7) followed by Accommodating (5), Assimilating (3), and Diverging (1). The predominant learning style for core faculty was also Converging (4) with 2 Divergers. The average score for the Convergers on the AME was 62.6 compared with 42 for the next most frequently occurring learning style, Accommodators. In this surgical residency program, a preferred learning style for residents seems to exist (Converging), which confirms what previous studies have found. Additionally, residents with this learning style attained a higher average achievement score as measured by the AME. Also, core faculty share the same preferential learning style as this subset of residents.

  14. The resident's view of residency training in Canada.

    Science.gov (United States)

    Fish, D G

    1966-04-09

    In the view of residents in their last year of specialty training, the Fellowship is now becoming the operative standard for obtaining hospital privileges in urban centres and they felt that this implied that the two standards, the Certificate and the Fellowship of the Royal College, were not achieving the purpose for which they were designed. Although 80% of the residents intended to write the Fellowship, few viewed a year in a basic science department or in research as of intrinsic value in terms of their future practice.The examinations of the Royal College were the subject of criticism, most residents feeling that the examinations did not test the knowledge and ability gained in training. Most expressed a desire for ongoing evaluation during the training period.Service responsibilities were generally regarded as too heavy.Despite the criticism of both training and examination, most residents felt that their training had provided them with the experience and background they needed to practise as specialists.

  15. Evolution of high duty cycle echolocation in bats.

    Science.gov (United States)

    Fenton, M Brock; Faure, Paul A; Ratcliffe, John M

    2012-09-01

    Duty cycle describes the relative 'on time' of a periodic signal. In bats, we argue that high duty cycle (HDC) echolocation was selected for and evolved from low duty cycle (LDC) echolocation because increasing call duty cycle enhanced the ability of echolocating bats to detect, lock onto and track fluttering insects. Most echolocators (most bats and all birds and odontocete cetaceans) use LDC echolocation, separating pulse and echo in time to avoid forward masking. They emit short duration, broadband, downward frequency modulated (FM) signals separated by relatively long periods of silence. In contrast, bats using HDC echolocation emit long duration, narrowband calls dominated by a single constant frequency (CF) separated by relatively short periods of silence. HDC bats separate pulse and echo in frequency by exploiting information contained in Doppler-shifted echoes arising from their movements relative to background objects and their prey. HDC echolocators are particularly sensitive to amplitude and frequency glints generated by the wings of fluttering insects. We hypothesize that narrowband/CF calls produced at high duty cycle, and combined with neurobiological specializations for processing Doppler-shifted echoes, were essential to the evolution of HDC echolocation because they allowed bats to detect, lock onto and track fluttering targets. This advantage was especially important in habitats with dense vegetation that produce overlapping, time-smeared echoes (i.e. background acoustic clutter). We make four specific, testable predictions arising from this hypothesis.

  16. THE EVOLUTION AND COMPLEXITY OF DIRECTORS' DUTY OF CARE

    Directory of Open Access Journals (Sweden)

    Adina Ponta

    2015-11-01

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

  17. Conversations with Holocaust survivor residents.

    Science.gov (United States)

    Hirst, Sandra P; LeNavenec, Carole Lynne; Aldiabat, Khaldoun

    2011-03-01

    Traumatic events in one's younger years can have an impact on how an individual copes with later life. One traumatic experience for Jewish individuals was the Holocaust. Some of these people are moving into long-term care facilities. It was within this context that the research question emerged: What are Holocaust survivor residents' perceptions of a life lived as they move into a long-term care facility? For this qualitative study, Holocaust survivors were individually interviewed. Findings emphasize that nursing care needs to ensure that Holocaust survivor residents participate in activities, receive timely health care, and receive recognition of their life experiences. Copyright 2011, SLACK Incorporated.

  18. Development of a novel sports medicine rotation for emergency medicine residents

    Directory of Open Access Journals (Sweden)

    Waterbrook AL

    2016-04-01

    total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents. Keywords: musculoskeletal medicine, musculoskeletal education, medical education, orthopedics

  19. Development of a novel sports medicine rotation for emergency medicine residents.

    Science.gov (United States)

    Waterbrook, Anna L; Pritchard, T Gail; Lane, Allison D; Stoneking, Lisa R; Koch, Bryna; McAtee, Robert; Grall, Kristi H; Min, Alice A; Prior, Jessica; Farrell, Isaac; McNulty, Holly G; Stolz, Uwe

    2016-01-01

    experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.

  20. Accreditation Council for Graduate Medical Education Case Log: General Surgery Resident Thoracic Surgery Experience

    Science.gov (United States)

    Kansier, Nicole; Varghese, Thomas K.; Verrier, Edward D.; Drake, F. Thurston; Gow, Kenneth W.

    2014-01-01

    Background General surgery resident training has changed dramatically over the past 2 decades, with likely impact on specialty exposure. We sought to assess trends in general surgery resident exposure to thoracic surgery using the Accreditation Council for Graduate Medical Education (ACGME) case logs over time. Methods The ACGME case logs for graduating general surgery residents were reviewed from academic year (AY) 1989–1990 to 2011–2012 for defined thoracic surgery cases. Data were divided into 5 eras of training for comparison: I, AY89 to 93; II, AY93 to 98; III, AY98 to 03; IV, AY03 to 08; V, AY08 to 12. We analyzed quantity and types of cases per time period. Student t tests compared averages among the time periods with significance at a p values less than 0.05. Results A total of 21,803,843 general surgery cases were reviewed over the 23-year period. Residents averaged 33.6 thoracic cases each in period I and 39.7 in period V. Thoracic cases accounted for nearly 4% of total cases performed annually (period I 3.7% [134,550 of 3,598,574]; period V 4.1% [167,957 of 4,077,939]). For the 3 most frequently performed procedures there was a statistically significant increase in thoracoscopic approach from period II to period V. Conclusions General surgery trainees today have the same volume of thoracic surgery exposure as their counterparts over the last 2 decades. This maintenance in caseload has occurred in spite of work-hour restrictions. However, general surgery graduates have a different thoracic surgery skill set at the end of their training, due to the predominance of minimally invasive techniques. Thoracic surgery educators should take into account these differences when training future cardiothoracic surgeons. PMID:24968766

  1. Improving skills development in residency using a deliberate-practice and learner-centered model.

    Science.gov (United States)

    Bhatti, Nasir I; Ahmed, Aadil

    2015-10-01

    Work-hour restrictions, increased workload, and subjective assessment of competency are major threats to the efficacy of the traditional apprenticeship model of surgical training in modern surgical practice. In response, medical educators are developing time- and resource-efficient competency-based models of surgical training. The purpose of our project was to develop, implement, and measure the outcomes of such objective and structured programs in otolaryngology. We also investigated factors affecting the learning curve, especially deliberate practice, formative feedback, and learners' autonomy. Prospective, longitudinal study. To measure the surgical skills of residents, we first developed and tested objective tools for otolaryngology procedures. Based on these instruments, we identified milestones of the procedures. Training on a virtual-reality simulator was validated to shorten the learning curve. We also studied a learner-centered approach of training, factors affecting the learning curve, and barriers to a competency-based model. The objective tools were found to be a feasible, reliable, and valid opportunity for measuring competency in both the laboratory and operating room. With the formative assessment from these tools, residents had a remediation target to be achieved by deliberate practice. The milestones helped identify the threshold of competency, and deliberate practice on the simulator gave an opportunity for improving skills. The learner-centered approach allowed flexibility and personalized learning by shifting the responsibility of the learning process to the learners. The competency-based model of residency, based on the principles of deliberate practice and a learner-centered approach, is a feasible model of residency training that allows development of competent surgeons and hence improves patient outcomes. Despite these advantages, challenges to this model require a concerted effort to overcome and fully implement these principles of training

  2. Classification of Gait Types Based on the Duty-factor

    DEFF Research Database (Denmark)

    Fihl, Preben; Moeslund, Thomas B.

    2007-01-01

    This paper deals with classification of human gait types based on the notion that different gait types are in fact different types of locomotion, i.e., running is not simply walking done faster. We present the duty-factor, which is a descriptor based on this notion. The duty-factor is independent...... on the speed of the human, the cameras setup etc. and hence a robust descriptor for gait classification. The dutyfactor is basically a matter of measuring the ground support of the feet with respect to the stride. We estimate this by comparing the incoming silhouettes to a database of silhouettes with known...... ground support. Silhouettes are extracted using the Codebook method and represented using Shape Contexts. The matching with database silhouettes is done using the Hungarian method. While manually estimated duty-factors show a clear classification the presented system contains misclassifications due...

  3. Family victim advocates: the importance of critical job duties

    Directory of Open Access Journals (Sweden)

    Teresa H. Young

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

  4. Medium and Heavy Duty Vehicle Field Evaluations (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Walkowicz, K.

    2014-06-01

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

  5. Model Legislation on Student Residency.

    Science.gov (United States)

    Higher Education in the States, 1971

    1971-01-01

    Because of the radical variance in residency requirements from state to state and sometimes from institution to institution, and because of several court cases involving this issue, the Education Commission of the States appointed a Committee to develop (1) a statement of principles for consideration in drafting legislation in connection with…

  6. From Residency to Lifelong Learning.

    Science.gov (United States)

    Brandt, Keith

    2015-11-01

    The residency training experience is the perfect environment for learning. The university/institution patient population provides a never-ending supply of patients with unique management challenges. Resources abound that allow the discovery of knowledge about similar situations. Senior teachers provide counseling and help direct appropriate care. Periodic testing and evaluations identify deficiencies, which can be corrected with future study. What happens, however, when the resident graduates? Do they possess all the knowledge they'll need for the rest of their career? Will medical discovery stand still limiting the need for future study? If initial certification establishes that the physician has the skills and knowledge to function as an independent physician and surgeon, how do we assure the public that plastic surgeons will practice lifelong learning and remain safe throughout their career? Enter Maintenance of Certification (MOC). In an ideal world, MOC would provide many of the same tools as residency training: identification of gaps in knowledge, resources to correct those deficiencies, overall assessment of knowledge, feedback about communication skills and professionalism, and methods to evaluate and improve one's practice. This article discusses the need; for education and self-assessment that extends beyond residency training and a commitment to lifelong learning. The American Board of Plastic Surgery MOC program is described to demonstrate how it helps the diplomate reach the goal of continuous practice improvement.

  7. The general surgery chief resident operative experience: 23 years of national ACGME case logs.

    Science.gov (United States)

    Drake, Frederick Thurston; Horvath, Karen D; Goldin, Adam B; Gow, Kenneth W

    2013-09-01

    The chief resident (CR) year is a pivotal experience in surgical training. Changes in case volume and diversity may impact the educational quality of this important year. To evaluate changes in operative experience for general surgery CRs. Review of Accreditation Council for Graduate Medical Education case logs from 1989-1990 through 2011-2012 divided into 5 periods. Graduates in period 3 were the last to train with unrestricted work hours; those in period 4 were part of a transition period and trained under both systems; and those in period 5 trained fully under the 80-hour work week. Diversity of cases was assessed based on Accreditation Council for Graduate Medical Education defined categories. Total cases and defined categories were evaluated for changes over time. The average total CR case numbers have fallen (271 in period 1 vs 242 in period 5, P surgery training may be jeopardized by reduced case diversity. Chief resident cases are crucial in surgical training and educators should consider these findings as surgical training evolves.

  8. Student Expenses in Residency Interviewing.

    Science.gov (United States)

    Walling, Anne; Nilsen, Kari; Callaway, Paul; Grothusen, Jill; Gillenwater, Cole; King, Samantha; Unruh, Gregory

    2017-08-01

    The student costs of residency interviewing are of increasing concern but limited current information is available. Updated, more detailed information would assist students and residency programs in decisions about residency selection. The study objective was to measure the expenses and time spent in residency interviewing by the 2016 graduating class of the University of Kansas School of Medicine and assess the impact of gender, regional campus location, and primary care application. All 195 students who participated in the 2016 National Residency Matching Program (NRMP) received a 33 item questionnaire addressing interviewing activity, expenses incurred, time invested and related factors. Main measures were self-reported estimates of expenses and time spent interviewing. Descriptive analyses were applied to participant characteristics and responses. Multivariate analysis of variance (MANOVA) and chi-square tests compared students by gender, campus (main/regional), and primary care/other specialties. Analyses of variance (ANOVA) on the dependent variables provided follow-up tests on significant MANOVA results. A total of 163 students (84%) completed the survey. The average student reported 38 (1-124) applications, 16 (1-54) invitations, 11 (1-28) completed interviews, and spent $3,500 ($20-$12,000) and 26 (1-90) days interviewing. No significant differences were found by gender. After MANOVA and ANOVA analyses, non-primary care applicants reported significantly more applications, interviews, and expenditures, but less program financial support. Regional campus students reported significantly fewer invitations, interviews, and days interviewing, but equivalent costs when controlled for primary care application. Cost was a limiting factor in accepting interviews for 63% and time for 53% of study respondents. Students reported investing significant time and money in interviewing. After controlling for other variables, primary care was associated with significantly

  9. Tanggung Jawab Direksi Perseroan Terbatas dalam Pelanggaran Fiduciary Duty

    Directory of Open Access Journals (Sweden)

    Siti Hapsah Isfardiyana

    2015-04-01

    Full Text Available Abstrak Direksi merupakan organ perseroan terbatas yang bertanggungjawab terhadap pengurusan dan perwakilan perseroan, sesuai maksud dan tujuan perseroan berdasarkan Anggaran Dasar Rumah Tangga perseroan terbatas. Pengurusan dan perwakilan oleh direksi harus dijalankan sesuai prinsip fiduciary duty. Tulisan ini menekankan pada persoalan kecerobohan direksi sehingga melakukan pelanggaran fiduciary duty, yang berakibat pada penerapan piercing the corporate vielpada direksi. Dasar hukum utama yang digunakan di penelitian ini termasuk Kitab Undang-Undang Hukum Perdata (KUHP dan Undang-Undang Nomor 40 Tahun 2007 tentang Perseroan Terbatas. Direksi dalam menjalankan kepengurusannya harus didasarkan dengan itikad baik dan penuh tanggung jawab karena direksi memegang fiduciary duty dari perseroan. Apabila direksi lalai dalam tugasnya,direksi dapat dikenakan piercing the corporate viel yaitu pertanggungjawaban pribadi sampai kepada harta pribadi direksi atas kerugian yang diterima oleh perseroan, pemegang saham, atau pihak ketiga. Hal ini digunakan untuk melindungi kepentingan pemegang saham atau pihak ketiga yang dirugikan atas tindakan direksi yang sewenang-wenang atau tidak layak yang dilakukan atas nama perseroan. Abstract The company's directors is the organ responsible for the maintenance and as a representative of the company based on the purpose and objectives of the articles of association. Management and representationby the directors must be executed according to the principle of fiduciary duty. This study emphasized the issue of directors’negligence that leads to the breach of fiduciary duty, whichresultsto the application of piercing the coporate viel by the directors. Primary legal materials used in this study including the Code of Civil Law (Civil Code and Law No. 40 of 2007 on Limited Company. The directors should be implemented in good faith and full responsibility in carrying out its duty, because the directors hold fiduciary duty of

  10. Light Duty Utility Arm computer software configuration management plan

    International Nuclear Information System (INIS)

    Philipp, B.L.

    1998-01-01

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

  11. Legal rights and duties in the AIDS epidemic.

    Science.gov (United States)

    Dickens, B M

    1988-02-05

    This article provides an overview of some major areas of legal concern in which the AIDS epidemic is having an impact. The rights of infected individuals to testing, treatment, and confidentiality are reviewed, and emphasis is given to their claims to nondiscrimination regarding access to health care, employment, housing, education, insurance, and related interests. Infected persons' duties to contain transmission of AIDS are outlined under principles of criminal and civil law, including liability for provision of contaminated blood products. Uninfected people's general rights to protection are considered, and health professionals' and authorities' rights and duties are given more detailed attention. In conclusion, some legal developments outside the United States are reviewed.

  12. Bookmakers and a Duty of Care: Customers' Views in England.

    Science.gov (United States)

    Brooks, Graham; Sparrow, Paul

    2016-06-01

    This paper focuses on customers' views on the extent that bookmakers and individuals are responsible for a duty of care. 72 participants from seven bookmakers in one city in England were interviewed that illustrates customers expect bookmakers to take 'reasonable steps' to avoid exploiting all customers. However, the customers' views recorded in this paper illustrate a range of views on what a duty of care should actually comprise with differences of opinion on the level of bookmakers and individuals level of responsibility, dealing with intoxicated customers, illegal gambling, prevention of excessive and problem gambling and self-exclusion.

  13. Light-duty diesel engine development status and engine needs

    Energy Technology Data Exchange (ETDEWEB)

    1980-08-01

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

  14. Assessment of open operative vascular surgical experience among general surgery residents.

    Science.gov (United States)

    Krafcik, Brianna M; Sachs, Teviah E; Farber, Alik; Eslami, Mohammad H; Kalish, Jeffrey A; Shah, Nishant K; Peacock, Matthew R; Siracuse, Jeffrey J

    2016-04-01

    General surgeons have traditionally performed open vascular operations. However, endovascular interventions, vascular residencies, and work-hour limitations may have had an impact on open vascular surgery training among general surgery residents. We evaluated the temporal trend of open vascular operations performed by general surgery residents to assess any changes that have occurred. The Accreditation Council for Graduate Medical Education's database was used to evaluate graduating general surgery residents' cases from 1999 to 2013. Mean and median case volumes were analyzed for carotid endarterectomy, open aortoiliac aneurysm repair, and lower extremity bypass. Significance of temporal trends were identified using the R(2) test. The average number of carotid endarterectomies performed by general surgery residents decreased from 23.1 ± 14 (11.6 ± 9 chief, 11.4 + 10 junior) cases per resident in 1999 to 10.7 ± 9 (3.4 ± 5 chief, 7.3 ± 6 junior) in 2012 (R(2) = 0.98). Similarly, elective open aortoiliac aneurysm repairs decreased from 7.4 ± 5 (4 ± 4 chief, 3.4 ± 4 junior) in 1999 to 1.3 ± 2 (0.4 ± 1 chief, 0.8 ± 1 junior) in 2012 (R(2) = 0.98). The number of lower extremity bypasses decreased from 21 ± 12 (9.5 ± 7 chief, 11.8 ± 9 junior) in 1999 to 7.6 ± 2.6 (2.4 ± 1.3 chief, 5.2 + 1.8 junior) in 2012 (R(2) = 0.94). Infrapopliteal bypasses decreased from 8.1 ± 3.8 (3.5 ± 2.2 chief, 4.5 ± 2.9 junior) in 2001 to 3 ± 2.2 (1 ± 1.6 chief, 2 ± 1.6 junior) in 2012 (R(2) = 0.94). General surgery resident exposure to open vascular surgery has significantly decreased. Current and future graduates may not have adequate exposure to open vascular operations to be safely credentialed to perform these procedures in future practice without advanced vascular surgical training. Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  15. Teaching residents to write a research paper.

    Science.gov (United States)

    Coleridge, S T

    1993-09-01

    Medical writing and publications are important in developing a scholarly basis for residency programs and in providing a learning experience for both resident and faculty mentors. Residency directors must provide the stimulus and support for both faculty and residents' varied creative activities. This support manifests itself in a commitment to scholarly activity (including a dedicated research person), the procurement of available research materials, the establishment of a process or plan for beginning a research project, and the development of a method for rewarding or recognizing faculty and residents who produce scholarly works. Some osteopathic residency programs may need to train faculty in research skills at the same time that residents are learning to write. Trained faculty are better models and coaches for residents engaged in research. Beginning with a fundamental, but disciplined, writing program, both faculty and residents may learn methods for sharing new knowledge or acquiring those skills necessary to critically analyze the medical literature.

  16. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational

  17. Fleet average NOx emission performance of 2007 model year light-duty vehicles, light-duty trucks and medium-duty passenger vehicles

    International Nuclear Information System (INIS)

    2009-09-01

    This report summarized the regulatory requirements related to nitrous oxide (NO x ) fleet averaging for light-duty vehicles, light-duty trucks, and medium-duty passenger vehicles under the On-Road Vehicle and Engine Emission Regulations. The regulations introduced more stringent national emission standards for on-road vehicles and engines and include technical standards that establish maximum limits on vehicle exhaust emissions. The fleet average NO x emission performance of individual companies and the overall Canadian fleet for 2007 was summarized, and the effectiveness of the Canadian fleet average NO x emission program was evaluated in relation to its environmental performance objectives. A total of 22 companies submitted reports for 294 test groups comprising 1,599,051 vehicles of the 2007 model year. The average NO x value for the entire LDV/LLDT fleet was 0.06897630 grams per mile. The average value for the HLDT/MDPV fleet was 0.160668 grams per mile. NO x values for both overall fleets remained better than the corresponding fleet average NO x standards, and were consistent with the environmental performance objectives of the regulations. 9 tabs., 3 figs.

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

    International Nuclear Information System (INIS)

    2006-05-01

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

  19. Comparing Anesthesiology Residency Training Structure and Requirements in Seven Different Countries on Three Continents

    DEFF Research Database (Denmark)

    Yamamoto, Satoshi; Tanaka, Pedro; Madsen, Matias V

    2017-01-01

    , for example, the duration of post-medical school training and national requirements for certain rotations, a number of cases, faculty supervision, national in-training written exams, and duty hour limits. These data were augmented by review of each country's publicly available residency training documents...... as available on the internet. Post-medical school anesthesia residency duration varied: three years (Brazil), four years (USA), five years (Canada and Switzerland), six years (Japan and Denmark) to nine years (UK), as did the number of explicitly required clinical rotations of a defined duration: zero (Denmark......), one (Switzerland and UK), four (Brazil), six (Canada), and 12 (USA). Minimum case requirements exist in the USA, Japan, and Brazil, but not in the other countries. National written exams taken during training exist for all countries studied except Japan and Denmark. The countries studied increasingly...

  20. 75 FR 7563 - Certain Lined Paper Products from India: Notice of Final Results of Antidumping Duty...

    Science.gov (United States)

    2010-02-22

    ... 1930, as amended (the Act), the Department preliminarily determined that the use of facts available for...: Offset of Countervailing Duty Duties Comment 5: Levels of Trade Comment 6: Treatment of Merchandising...

  1. 78 FR 33345 - Certain Frozen Warmwater Shrimp From Malaysia: Preliminary Countervailing Duty Determination

    Science.gov (United States)

    2013-06-04

    ... Shrimp From Malaysia: Preliminary Countervailing Duty Determination AGENCY: Import Administration... the Countervailing Duty Investigation of Certain Frozen Warmwater Shrimp from Malaysia,'' dated... frozen warmwater shrimp (frozen shrimp) from Malaysia. The period of investigation (POI) is January 1...

  2. 77 FR 25684 - Polyethylene Retail Carrier Bags From Thailand: Rescission of Antidumping Duty Administrative Review

    Science.gov (United States)

    2012-05-01

    ... Bags From Thailand: Rescission of Antidumping Duty Administrative Review AGENCY: Import Administration... duty order on polyethylene retail carrier bags from Thailand. The period of review is August 1, 2010... 25685

  3. 75 FR 32747 - Prestressed Concrete Steel Wire Strand from Mexico: Rescission of Antidumping Duty Administrative...

    Science.gov (United States)

    2010-06-09

    ... DEPARTMENT OF COMMERCE INTERNATIONAL TRADE ADMINISTRATION [A-201-831] Prestressed Concrete Steel Wire Strand from Mexico: Rescission of Antidumping Duty Administrative Review AGENCY: Import... request an administrative review of the antidumping duty order on prestressed concrete steel wire strand...

  4. The Legal Duty to Incorporate Mistakes of the Victim

    NARCIS (Netherlands)

    L.T. Visscher (Louis)

    2008-01-01

    textabstractAbstract: In many jurisdictions, potential injurers are under a legal duty to incorporate possible mistakes of the potential victim. I distinguish three types of mistakes. First, victims might make mistakes because it is too costly to avoid them (e.g. little children in traffic). Second,

  5. State duties of protection and fundamental rights | Starck ...

    African Journals Online (AJOL)

    In its reaching its decision, the German Federal Constitutional Court is responsible for preserving the political discretion of the legislature in protecting interests and remembering the structural distinction between "hard" defensive rights and "soft" protective duties in order to prevent the erosion of the directly binding nature of ...

  6. 49 CFR 592.6 - Duties of a registered importer.

    Science.gov (United States)

    2010-10-01

    ... highways for any purpose other than: (i) Transportation to and from a franchised dealership of the vehicle... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) REGISTERED IMPORTERS OF VEHICLES NOT ORIGINALLY MANUFACTURED TO CONFORM TO THE FEDERAL MOTOR VEHICLE SAFETY STANDARDS § 592.6 Duties of a...

  7. 40 CFR 1065.512 - Duty cycle generation.

    Science.gov (United States)

    2010-07-01

    ... at least 5 Hz. Use these recorded values to calculate cycle-validation statistics and total work. (d... sequence of paired values for speed and torque or for speed and power. (b) Transform normalized values of... describes how to transform these normalized values into a sequence of reference speeds, f nref. Running duty...

  8. [Sport injuries during duty sport--a risk assessment].

    Science.gov (United States)

    Sammito, S

    2011-03-01

    Daily physical activity ist a predictive factor for cardio-vascular disease and for obesity. In military, police and firefighter service duty sport is used to increase and to keep a work specifical physical fitness. Till today no study data with direct data acquisition exists for a risk assessment of the injury rates in duty sport. In this one-year study in a German Armed Forces armoured brigade with 22 companies, every sport-related injury on duty and the following sick days were recorded. Apart from the sport type, the duration of the athletic activity and the number of soldiers that took part in it were monitored. 275 sport injuries were recorded. Soccer was the sport with the highest risk of injuries. Team sports proved to be more dangerous than individual physical activity. The author has demonstrated a reduction of the total injury rate by 39 %, of sick days by 50 %, and of the days with partial unfitness for duty by 42 % when team sports are reduced in favour to other physical activities. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 75 FR 32099 - Enterprise Duty To Serve Underserved Markets

    Science.gov (United States)

    2010-06-07

    ... 2590-AA27 Enterprise Duty To Serve Underserved Markets AGENCY: Federal Housing Finance Agency. ACTION... Recovery Act of 2008 (HERA) amended section 1335 of the Federal Housing Enterprises Financial Safety and... Enterprises) to serve three specified underserved markets--manufactured housing, affordable housing...

  10. AMMONIA EMISSIONS FROM THE EPA'S LIGHT DUTY TEST VEHICLE

    Science.gov (United States)

    The paper discusses measurements of ammonia (NH3) emissions from EPA's light duty test vehicle while operated on a dynamometer. The vehicle's (1993 Chevrolet equipped with a three-way catalyst) emissions were measured for three transient (urban driving, highway fuel economy, and ...

  11. 21 CFR 1316.73 - Custody and other duties.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Custody and other duties. 1316.73 Section 1316.73 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE ADMINISTRATIVE FUNCTIONS, PRACTICES, AND PROCEDURES Seizure, Forfeiture, and Disposition of Property § 1316.73 Custody and other...

  12. Academic Entrepreneurship and Traditional Academic Duties: Synergy or Rivalry?

    Science.gov (United States)

    De Silva, Muthu

    2016-01-01

    This study investigates the influence of academic entrepreneurship on traditional academic duties carried out in a resource-constrained environment, particularly focusing on whether there is synergy or rivalry between these two activities. Using qualitative evidence, we discover that there are funding, resource, knowledge and skill and networking…

  13. Single bank NOx adsorber for heavy duty diesel engines

    NARCIS (Netherlands)

    Genderen, M. van; Aken, M.G. van

    2003-01-01

    In a NOx adsorber programme the feasibility for applying this technology to heavy duty diesel engines was investigated. After modelling and simulations for realising best λ < 1 engine conditions a platform was build which was used to obtain good NOx adsorber regeneration settings in a number of

  14. 7 CFR 1260.150 - Duties of the Board.

    Science.gov (United States)

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE BEEF PROMOTION AND RESEARCH Beef Promotion and Research Order Cattlemen's Beef Promotion and Research Board § 1260.150 Duties of the Board...

  15. 49 CFR 199.217 - On-duty use.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.217 On-duty use. Each operator shall prohibit a covered employee from using alcohol... alcohol while performing covered functions shall permit the employee to perform or continue to perform...

  16. 77 FR 28763 - Flightcrew Member Duty and Rest Requirements; Correction

    Science.gov (United States)

    2012-05-16

    ... holders and their flightcrew members operating certain domestic, flag, and supplemental operations. This... exceeded to the extent necessary to allow the flightcrew to fly to the closest destination where they can... follows: Sec. 121.467 Flight attendant duty period limitations and rest requirements: Domestic, flag, and...

  17. 49 CFR 199.219 - Pre-duty use.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.219 Pre-duty use. Each operator shall prohibit a covered employee from using alcohol... operator having actual knowledge that a covered employee has used alcohol within four hours prior to...

  18. Differential Perception of Counselling Psychologists' Duties to Oyo ...

    African Journals Online (AJOL)

    This descriptive survey study investigated the differences that exist in the perception of the relevance of counselling psychologists' duties to broadcasting corporation. The participants consisted of one hundred and two (54 males and 48 females) purposively selected staff of Oyo State Broadcasting Corporation.

  19. 47 CFR 51.301 - Duty to negotiate.

    Science.gov (United States)

    2010-10-01

    ... identify the network elements that it needs in order to serve a particular customer; and (ii) Refusal by an... 47 Telecommunication 3 2010-10-01 2010-10-01 false Duty to negotiate. 51.301 Section 51.301 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) INTERCONNECTION...

  20. Conflicting duties over confidentiality in Argentina and Peru.

    Science.gov (United States)

    Cavallo, Mercedes

    2011-02-01

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

  1. 75 FR 63184 - Temporary Duty (TDY) Travel Allowances

    Science.gov (United States)

    2010-10-14

    ... agency travel programs, save money on travel costs, better protect the environment, and conserve natural... GENERAL SERVICES ADMINISTRATION [Docket 2010-0009, Sequence 4] Temporary Duty (TDY) Travel Allowances AGENCY: Office of Governmentwide Policy, General Services Administration (GSA). ACTION: Notice of...

  2. Operation Duties on the F-15B Research Testbed

    Science.gov (United States)

    Truong, Samson S.

    2010-01-01

    This presentation entails what I have done this past summer for my Co-op tour in the Operations Engineering Branch. Activities included supporting the F-15B Research Testbed, supporting the incoming F-15D models, design work, and other operations engineering duties.

  3. Duty-to-Warn Guidelines for Mental Health Counselors.

    Science.gov (United States)

    Costa, Luann; Altekruse, Michael

    1994-01-01

    Summarizes legal cases in which duty-to-warn was an issue. Suggests that guidelines for counselors are few and lack definition. Offers a model to guide counselors in making clinical judgments in cases and case examples to exemplify possible ethical dilemmas in the practice of counseling. Includes 36 citations. (Author/CRR)

  4. The Mental Health Counselor and "Duty to Warn."

    Science.gov (United States)

    Pietrofesa, John J.; And Others

    1990-01-01

    Reviews background and case histories surrounding legal concept of "duty to warn" and confidentiality limits of counseling. Discusses professional, ethical, and legal responsibilities of mental health counselors and identifies steps to follow for counselors who have to warn potential victims of danger from their clients. (Author/ABL)

  5. Unregulated emissions from light-duty hybrid electric vehicles

    Science.gov (United States)

    Suarez-Bertoa, R.; Astorga, C.

    2016-07-01

    The number of registrations of light duty hybrid electric vehicles has systematically increased over the last years and it is expected to keep growing. Hence, evaluation of their emissions becomes very important in order to be able to anticipate their impact and share in the total emissions from the transport sector. For that reason the emissions from a Euro 5 compliant hybrid electric vehicle (HV2) and a Euro 5 plug-in hybrid electric vehicle (PHV1) were investigated with special interest on exhaust emissions of ammonia, acetaldehyde and ethanol. Vehicles were tested over the World harmonized Light-duty Test Cycle (WLTC) at 23 and -7 °C using two different commercial fuels E5 and E10 (gasoline containing 5% and 10% vol/vol of ethanol, respectively). PHV1 resulted in lower emissions than HV2 due to the pure electric strategy used by the former. PHV1 and HV2 showed lower regulated emissions than conventional Euro 5 gasoline light duty vehicles. However, emissions of ammonia (2-8 and 6-15 mg km-1 at 22 and -7 °C, respectively), ethanol (0.3-0.8 and 2.6-7.2 mg km-1 at 22 and -7 °C, respectively) and acetaldehyde (∼0.2 and 0.8-2.7 mg km-1 at 22 and -7 °C, respectively) were in the same range of those recently reported for conventional gasoline light duty vehicles.

  6. 75 FR 55851 - Flightcrew Member Duty and Rest Requirements

    Science.gov (United States)

    2010-09-14

    ... facilities. All carriers would have to develop training programs to educate all employees responsible for... consequences of actions, Reduced situational awareness, and Low motivation to perform optional activities. A... length of time left in the duty period. If a flightcrew member (or any other employee) believes another...

  7. 32 CFR 516.59 - Duties and procedures.

    Science.gov (United States)

    2010-07-01

    ... PUBLIC RELATIONS LITIGATION Remedies in Procurement Fraud and Corruption § 516.59 Duties and procedures... agencies; contracting officers; inspectors general of the executive branch; correspondence from the public... indications of fraud or corruption relating to Army contracts or Army administered contracts are reported...

  8. 34 CFR 601.30 - Duties of institutions.

    Science.gov (United States)

    2010-07-01

    ... the institution provides information regarding a private education loan to a prospective borrower... 34 Education 3 2010-07-01 2010-07-01 false Duties of institutions. 601.30 Section 601.30 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION...

  9. Feminization of poverty: A reading of Okpewho's the last duty ...

    African Journals Online (AJOL)

    This work examines patriarchy's ability to deform the woman in Okpewho's The Last Duty and affirms the centrality of choice as the basic weapon in her struggle for meaningful existence in the new millennium. Since the fundamental structures in the society have pushed her to the periphery of existence, whenever she ...

  10. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study.

    Science.gov (United States)

    Kolade, Victor O; Staton, Lisa J; Jayarajan, Ramesh; Bentley, Nanette K; Huang, Xiangke

    2014-01-01

    The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Thirteen junior (first- or second-year) resident responses reported that the chief residents elicited input from others (mean rating 6.8), were committed to the team (6.8), resolved conflict (6.7), ensured efficiency, organization and productivity of the team (6.7), participated actively (7.0), and managed resources (6.6). Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4) than with being chief resident (5.8). The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year) chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  11. How easy is it to contact the duty medical doctor responsible for acute admissions?

    OpenAIRE

    Bakhai, A; Goodman, F; Juchniewichz, H; Martin, A; Porter, G; White, C; Williams, L; Hopkins, A

    1990-01-01

    OBJECTIVE--To ascertain ease or difficulty of contacting duty junior doctors responsible for acute medical admissions by telephone. DESIGN--Telephone survey of hospitals in six health regions in England and Wales. SETTING--70 Randomly selected hospitals, 15 of which were excluded because of non-acceptance of acute medical admissions. PARTICIPANTS--71 Duty doctors (duty house physicians, senior house officers, or registrars responsible for acute medical admissions) in 48 hospitals; seven duty ...

  12. Independent consultants : fiduciary duties, trade secrets and confidential information

    International Nuclear Information System (INIS)

    Fraser, B.; Wilhelmson, M.

    1999-01-01

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

  13. Burnout syndrome and job satisfaction in Greek residents: exploring differences between trainees inside and outside the country.

    Science.gov (United States)

    Salpigktidis, Ilias I; Paliouras, Dimitrios; Gogakos, Apostolos S; Rallis, Thomas; Schizas, Nikolaos C; Chatzinikolaou, Fotios; Niakas, Dimitrios; Sarafis, Pavlos; Bamidis, Panagiotis; Lazopoulos, Achilleas; Triadafyllidou, Sophia; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-11-01

    The purpose of this study is to investigate the levels of burnout among Greek residents, highlighting potential differences between those practicing at home and abroad, as well as to investigate correlations with demographic, individual and labor factors. The research was conducted on a sample of 131 residents, using an anonymous questionnaire which included demographic, individual and labor characteristics, Maslach's Burnout Inventory, questions regarding job and life satisfaction levels, working conditions and the impacts of the economic recession. Fifty two point seven percent of the sample were training in the Greek National Health Service (N.H.S.), 27.5% in Germany and 19.8% in the United Kingdom. One out of three residents in the Greek system showed high levels of burnout in all three dimensions of the syndrome, while 51.1%, 72.2% and 30.8% of the Greek, British and German team, respectively, appeared burnt out simultaneously in two dimensions. Levels of job and life satisfactions ranged on average, while workload appeared heavy. The occurrence of burnout was associated with gender, specialty, employment characteristics (working hours, autonomy, support etc.), proneness to accidents, country, job satisfaction and quality of life, but was not associated with age or marital status. No correlation was found with susceptibility to medical errors.

  14. 20 CFR 670.920 - When are non-resident students considered to be in the performance of duty?

    Science.gov (United States)

    2010-04-01

    ... ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Administrative... are engaged in any authorized Job Corps activity, from the time they arrive at any scheduled center... travel to and from work apply. These rules are described in guidance issued by the Secretary. ...

  15. Lawful Permanent Residents Fiscal Year 2011 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  16. Lawful Permanent Residents Fiscal Year 2014 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  17. Lawful Permanent Residents Fiscal Year 2015 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  18. Lawful Permanent Residents Fiscal Year 2014 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  19. Lawful Permanent Residents Fiscal Year 2011 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  20. Lawful Permanent Residents Fiscal Year 2016 State

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  1. Lawful Permanent Residents Fiscal Year 2015 Country

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  2. 77 FR 75257 - Proposed Collection of Information: Medium- and Heavy-Duty Truck Fleet Survey

    Science.gov (United States)

    2012-12-19

    ...-0170] Proposed Collection of Information: Medium- and Heavy-Duty Truck Fleet Survey AGENCY: National... collection of information will be in the form of a one-time survey of medium- and heavy-duty truck fleet... collection. OMB Control Number: To be issued at time of approval. Title: Medium- and Heavy-Duty Truck Fleet...

  3. 7 CFR 917.35 - Powers and duties of each commodity committee.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Powers and duties of each commodity committee. 917.35... duties of each commodity committee. Each commodity committee shall have the following powers and duties..., That the Peach and Pear Commodity Committee shall each approve actions under § 917.39 and make said...

  4. 75 FR 77305 - Security-Based Swap Data Repository Registration, Duties, and Core Principles

    Science.gov (United States)

    2010-12-10

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

  5. 7 CFR 1230.39 - Powers and duties of the Delegate Body.

    Science.gov (United States)

    2010-01-01

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

  6. 77 FR 54384 - Nonconformance Penalties for On-Highway Heavy-Duty Diesel Engines

    Science.gov (United States)

    2012-09-05

    ...-Highway Heavy-Duty Diesel Engines AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule... heavy heavy-duty diesel engines (HHDDE) in model years 2012 and later for emissions of oxides of... production engines). EPA proposed NCPs for medium heavy duty diesel engines. However, EPA is not taking final...

  7. 77 FR 4678 - Nonconformance Penalties for On-Highway Heavy Heavy-Duty Diesel Engines

    Science.gov (United States)

    2012-01-31

    ...-Highway Heavy Heavy-Duty Diesel Engines AGENCY: Environmental Protection Agency (EPA). ACTION: Interim... manufacturers of heavy heavy-duty diesel engines in model years 2012 and 2013 for emissions of oxides of...-duty trucks (6,000-8,500 pounds gross vehicle weight) to the largest diesel truck and urban bus engines...

  8. 77 FR 4736 - Nonconformance Penalties for On-Highway Heavy-Duty Diesel Engines

    Science.gov (United States)

    2012-01-31

    ...-Highway Heavy-Duty Diesel Engines AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of... manufacturers of heavy-duty diesel engines in model years 2012 and later for emissions of oxides of nitrogen... Entities This proposed action would affect you if you produce or import new heavy-duty diesel engines which...

  9. 34 CFR 7.1 - Duty of employee to report inventions.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Duty of employee to report inventions. 7.1 Section 7.1 Education Office of the Secretary, Department of Education EMPLOYEE INVENTIONS § 7.1 Duty of employee to... of time or services of other Government employees on official duty. ...

  10. 22 CFR 1423.19 - Duties and powers of the Administrative Law Judge.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Duties and powers of the Administrative Law... RELATIONS AUTHORITY UNFAIR LABOR PRACTICE PROCEEDINGS § 1423.19 Duties and powers of the Administrative Law Judge. It shall be the duty of the Administrative Law Judge to inquire fully into the facts as they...

  11. 29 CFR 458.76 - Duties and powers of the Administrative Law Judge.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 2 2010-07-01 2010-07-01 false Duties and powers of the Administrative Law Judge. 458.76... LABOR STANDARDS OF CONDUCT STANDARDS OF CONDUCT Hearing and Related Matters § 458.76 Duties and powers of the Administrative Law Judge. It shall be the duty of the Administrative Law Judge to inquire...

  12. 78 FR 50381 - Certain Frozen Warmwater Shrimp From Malaysia: Final Affirmative Countervailing Duty Determination

    Science.gov (United States)

    2013-08-19

    ... Shrimp From Malaysia: Final Affirmative Countervailing Duty Determination AGENCY: Import Administration... From Malaysia: Preliminary Countervailing Duty Determination, 78 FR 33345 (June 4, 2013) (Preliminary... 10. Tax Exemptions for Exporters in Free Trade Zones 11. Duty Exemptions for Exporters in Free Trade...

  13. 78 FR 58520 - Extruded Rubber Thread From Malaysia; Notice of Amended Final Results of Antidumping Duty...

    Science.gov (United States)

    2013-09-24

    ... Malaysia; Notice of Amended Final Results of Antidumping Duty Administrative Review AGENCY: Import... Extruded Rubber Thread From Malaysia; Final Results of Antidumping Duty Administrative Review, 63 FR 12752... the final results of its administrative review of the antidumping duty order on extruded rubber thread...

  14. 75 FR 38076 - Carbazole Violet Pigment 23 from India: Final Results of Antidumping Duty Administrative Review

    Science.gov (United States)

    2010-07-01

    ... International Trade Administration Carbazole Violet Pigment 23 from India: Final Results of Antidumping Duty... administrative review of the antidumping duty order on carbazole violet pigment 23 (CVP 23) from India. The... Pigment 23 from India: Preliminary Results of Antidumping Duty Administrative Review, 74 FR 68038...

  15. 77 FR 67790 - Honey From Argentina; Antidumping and Countervailing Duty Changed Circumstances Reviews...

    Science.gov (United States)

    2012-11-14

    ... International Trade Administration Honey From Argentina; Antidumping and Countervailing Duty Changed... antidumping and countervailing duty orders on honey from Argentina.\\1\\ In the Initiation Notice, we invited.... \\1\\ See Honey from Argentina: Notice of Initiation of Antidumping and Countervailing Duty Changed...

  16. 76 FR 74044 - Honey From Argentina: Final Results of Antidumping Duty New Shipper Review

    Science.gov (United States)

    2011-11-30

    ... International Trade Administration Honey From Argentina: Final Results of Antidumping Duty New Shipper Review... 2009-2010 new shipper review of the antidumping duty order on honey from Argentina.\\1\\ This review... Honey From Argentina: Preliminary Results of Antidumping Duty New Shipper Review, 76 FR 54202 (August 31...

  17. 77 FR 65670 - Honey From Argentina: Final Rescission of Antidumping Duty New Shipper Review

    Science.gov (United States)

    2012-10-30

    ... International Trade Administration Honey From Argentina: Final Rescission of Antidumping Duty New Shipper Review... (``Danangie''), under the antidumping duty order on honey from Argentina for the period of December 1, 2010... are rescinding this NSR. \\1\\ See Honey from Argentina: Preliminary Rescission of Antidumping Duty New...

  18. 77 FR 45334 - Honey From Argentina: Preliminary Rescission of Antidumping Duty New Shipper Review

    Science.gov (United States)

    2012-07-31

    ... International Trade Administration Honey From Argentina: Preliminary Rescission of Antidumping Duty New Shipper... conducting a new shipper review (``NSR'') of the antidumping duty order on honey from Argentina for the... antidumping duty order on honey from Argentina was published on December 10, 2001.\\1\\ On January 3, 2012, the...

  19. 77 FR 74173 - Honey From the People's Republic of China: Continuation of Antidumping Duty Order

    Science.gov (United States)

    2012-12-13

    ... International Trade Administration Honey From the People's Republic of China: Continuation of Antidumping Duty... International Trade Commission (``ITC'') that revocation of the antidumping duty order on honey from the People... sunset review of the antidumping duty order on honey from the PRC, pursuant to section 751(c) of the...

  20. 75 FR 12734 - Honey from Argentina: Rescission of Countervailing Duty Administrative Review

    Science.gov (United States)

    2010-03-17

    ... International Trade Administration Honey from Argentina: Rescission of Countervailing Duty Administrative Review... the countervailing duty order on honey from Argentina. See Antidumping or Countervailing Duty Order..., 2009). On December 31, 2009, the American Honey Producers Association and the Sioux Honey Association...