WorldWideScience

Sample records for schedule shifts cancer

  1. Flexible Schedules and Shift Work.

    Science.gov (United States)

    Beers, Thomas M.

    2000-01-01

    Flexible work hours have gained prominence, as more than 25 million workers (27.6% of all full-time workers) can now vary their schedules. However, there has been little change since the mid-1980s in the proportion who work a shift other than a regular daytime shift. (JOW)

  2. Does the association of prostate cancer with night-shift work differ according to rotating vs. fixed schedule? A systematic review and meta-analysis.

    Science.gov (United States)

    Mancio, Jennifer; Leal, Cátia; Ferreira, Marta; Norton, Pedro; Lunet, Nuno

    2018-04-27

    Recent studies suggested that the relation between night-shift work and prostate cancer may differ between rotating and fixed schedules. We aimed to quantify the independent association between night-shift work and prostate cancer, for rotating and fixed schedules. We searched MEDLINE for studies assessing the association of night-shift work, by rotating or fixed schedules, with prostate cancer. We computed summary relative risk (RR) estimates with 95% confidence intervals (95% CI) using the inverse variance method and quantified heterogeneity using the I 2 statistic. Meta-regression analysis was used to compare the summary RR estimates for rotating and fixed schedules, while reducing heterogeneity. A total of nine studies assessed the effect of rotating and, in addition, four of them provided the effect of fixed night-shift work, in relation to daytime workers. Rotating night-shift work was associated with a significantly increased risk of prostate cancer (RR = 1.06, 95% CI of 1.01 to 1.12; I 2  = 50%), but not fixed night-shift work (RR of 1.01, 95% CI of 0.81 to 1.26; I 2  = 33%). In meta-regression model including study design, type of population, and control of confounding, the summary RR was 20% higher for rotating vs. fixed schedule, with heterogeneity fully explained by these variables. This is the first meta-analysis suggesting that an increased risk of prostate cancer may be restricted to workers with rotating night shifts. However, the association was weak and additional studies are needed to further clarify this relation before it can be translated into measures for risk reduction in occupational settings.

  3. Cost effective shift schedules enhance utility operations

    International Nuclear Information System (INIS)

    Coleman, R.M.

    1995-01-01

    This article describes how new shift scheduling concepts can save utility operations millions of dollars every year and yet maintain safety and improve employee morale. The key to scheduling is to define and match the work load. This includes discretionary as well as daily, weekly, and yearly core work loads. In most power plants the overall work load (including maintenance, operations, materials handling, etc.) on day shift is greater than on other shifts, hence an unbalanced schedule would be appropriate

  4. Heuristic Approach for Balancing Shift Schedules

    International Nuclear Information System (INIS)

    Kim, Dae Ho; Yun, Young Su; Lee, Yong Hee

    2005-01-01

    In this paper, a heuristic approach for balancing shift schedules is proposed. For the shift schedules, various constraints which have usually been considered in realworld industry are used, and the objective is to minimize the differences of the workloads in each workgroup. The constraints and objective function are implemented in the proposed heuristic approach. Using a simple instance, the efficiency of the proposed heuristic approach is proved

  5. Staffing, overtime, and shift scheduling project

    International Nuclear Information System (INIS)

    Lewis, P.M.

    1989-01-01

    Recent events at the Peach Bottom nuclear power plant have demonstrated the need to establish a quantifiable basis for assessing the safety significance of long work hours on nuclear power plant operators. The incidents at TMI-2, Chernobyl, and Bhopal, which all occurred during the late evening/night shift, further highlight the importance of the relationship between shift scheduling and performance. The objective of this project is to estimate, using statistical analysis on data from the nuclear industry, the effects on safety of staffing levels, overtime, and shift scheduling for operators and maintenance personnel. Regarding staffing levels, the Nuclear Regulatory Commission (NRC) currently has no explicit regulation concerning the minimum acceptable levels of staffing in a plant that has an operating license. The NRC has no systematic method for collecting data on the number of licensed operators on the operating crews. In 1982 the NRC recommended that plants write into their technical specifications a model policy on overtime. Currently, 77 nuclear power plant units have the model policy or a modification of it written into their technical specifications; 33 units have no policy on overtime. The model policy sets limits on overtime for safety related personnel, although these limits can be exceeded with plant manger approval. The US nuclear power industry has three types of shift schedules: (1) forward-rotating 8-hour/day shift schedules, (2) backward-rotating 8-hour/day schedules, and (3) 12-hour/day schedules

  6. Scheduling nurses’ shifts at PGI Cikini Hospital

    Science.gov (United States)

    Nainggolan, J. C. T.; Kusumastuti, R. D.

    2018-03-01

    Hospitals play an essential role in the community by providing medical services to the public. In order to provide high quality medical services, hospitals must manage their resources (including nurses) effectively and efficiently. Scheduling of nurses’ work shifts, in particular, is crucial, and must be conducted carefully to ensure availability and fairness. This research discusses the job scheduling system for nurses in PGI Cikini Hospital, Jakarta with Goal Programming approach. The research objectives are to identify nurse scheduling criteria and find the best schedule that can meet the criteria. The model has hospital regulations (including government regulations) as hard constraints, and nurses’ preferences as soft constraints. We gather primary data (hospital regulations and nurses’ preferences) through interviews with three Head Nurses and distributing questionnaires to fifty nurses. The results show that on the best schedule, all hard constraints can be satisfied. However, only two out of four soft constraints are satisfied. Compared to current scheduling practice, the resulting schedule ensures the availability of nurses as it satisfies all hospital’s regulations and it has a higher level of fairness as it can accommodate some of the nurses’ preferences.

  7. Shifting schedules: the health effects of reorganizing shift work.

    Science.gov (United States)

    Bambra, Clare L; Whitehead, Margaret M; Sowden, Amanda J; Akers, Joanne; Petticrew, Mark P

    2008-05-01

    Approximately one fifth of workers are engaged in some kind of shift work. The harmful effects of shift work on the health and work-life balance of employees are well known. A range of organizational interventions has been suggested to address these negative effects. This study undertook the systematic review (following Quality Of Reporting Of Meta [QUORUM] analyses guidelines) of experimental and quasi-experimental studies, from any country (in any language) that evaluated the effects on health and work-life balance of organizational-level interventions that redesign shift work schedules. Twenty-seven electronic databases (medical, social science, economic) were searched. Data extraction and quality appraisal were carried out by two independent reviewers. Narrative synthesis was performed. The review was conducted between October 2005 and November 2006. Twenty-six studies were found relating to a variety of organizational interventions. No one type of intervention was found to be consistently harmful to workers. However, three types were found to have beneficial effects on health and work-life balance: (1) switching from slow to fast rotation, (2) changing from backward to forward rotation, and (3) self-scheduling of shifts. Improvements were usually at little or no direct organizational cost. However, there were concerns about the generalizability of the evidence, and no studies reported on impacts on health inequalities. This review reinforces the findings of epidemiologic and laboratory-based research by suggesting that certain organizational-level interventions can improve the health of shift workers, their work-life balance, or both. This evidence could be useful when designing interventions to improve the experience of shift work.

  8. Scheduling Aircraft Landings under Constrained Position Shifting

    Science.gov (United States)

    Balakrishnan, Hamsa; Chandran, Bala

    2006-01-01

    Optimal scheduling of airport runway operations can play an important role in improving the safety and efficiency of the National Airspace System (NAS). Methods that compute the optimal landing sequence and landing times of aircraft must accommodate practical issues that affect the implementation of the schedule. One such practical consideration, known as Constrained Position Shifting (CPS), is the restriction that each aircraft must land within a pre-specified number of positions of its place in the First-Come-First-Served (FCFS) sequence. We consider the problem of scheduling landings of aircraft in a CPS environment in order to maximize runway throughput (minimize the completion time of the landing sequence), subject to operational constraints such as FAA-specified minimum inter-arrival spacing restrictions, precedence relationships among aircraft that arise either from airline preferences or air traffic control procedures that prevent overtaking, and time windows (representing possible control actions) during which each aircraft landing can occur. We present a Dynamic Programming-based approach that scales linearly in the number of aircraft, and describe our computational experience with a prototype implementation on realistic data for Denver International Airport.

  9. Modelling a Nurse Shift Schedule with Multiple Preference Ranks for Shifts and Days-Off

    Directory of Open Access Journals (Sweden)

    Chun-Cheng Lin

    2014-01-01

    Full Text Available When it comes to nurse shift schedules, it is found that the nursing staff have diverse preferences about shift rotations and days-off. The previous studies only focused on the most preferred work shift and the number of satisfactory days-off of the schedule at the current schedule period but had few discussions on the previous schedule periods and other preference levels for shifts and days-off, which may affect fairness of shift schedules. As a result, this paper proposes a nurse scheduling model based upon integer programming that takes into account constraints of the schedule, different preference ranks towards each shift, and the historical data of previous schedule periods to maximize the satisfaction of all the nursing staff's preferences about the shift schedule. The main contribution of the proposed model is that we consider that the nursing staff’s satisfaction level is affected by multiple preference ranks and their priority ordering to be scheduled, so that the quality of the generated shift schedule is more reasonable. Numerical results show that the planned shifts and days-off are fair and successfully meet the preferences of all the nursing staff.

  10. How do employees prioritise when they schedule their own shifts?

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Lund, Henrik; Hansen, Åse Marie

    2013-01-01

    to their family life, having consecutive time off, leisure-time activities, rest between shifts, sleep, regularity of their everyday life, health and that the work schedule balanced. Thus, employees consider both their own and the workplace's needs when they have the opportunity to schedule their own shifts. Age......We investigated how employees prioritised when they scheduled their own shifts and whether priorities depended on age, gender, educational level, cohabitation and health status. We used cross-sectional questionnaire data from the follow-up survey of an intervention study investigating the effect...... of self-scheduling (n = 317). Intervention group participants were asked about their priorities when scheduling their own shifts succeeded by 17 items covering family/private life, economy, job content, health and sleep. At least half of the participants reported that they were giving high priority...

  11. How do employees prioritise when they schedule their own shifts?

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Lund, Henrik; Ajslev, Jeppe Z; Hansen, Åse Marie; Albertsen, Karen; Hvid, Helge; Garde, Anne Helene

    2013-01-01

    We investigated how employees prioritised when they scheduled their own shifts and whether priorities depended on age, gender, educational level, cohabitation and health status. We used cross-sectional questionnaire data from the follow-up survey of an intervention study investigating the effect of self-scheduling (n = 317). Intervention group participants were asked about their priorities when scheduling their own shifts succeeded by 17 items covering family/private life, economy, job content, health and sleep. At least half of the participants reported that they were giving high priority to their family life, having consecutive time off, leisure-time activities, rest between shifts, sleep, regularity of their everyday life, health and that the work schedule balanced. Thus, employees consider both their own and the workplace's needs when they have the opportunity to schedule their own shifts. Age, gender, cohabitation and health status were all significantly associated with at least one of these priorities. Intervention studies report limited health effects of self-scheduling. Therefore, we investigated to what extent employees prioritise their health and recuperation when scheduling their own shifts. We found that employees not only consider both their health and family but also the workplace's needs when they schedule their own shifts.

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

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  13. Learned Helplessness as a Schedule-Shift Effect.

    Science.gov (United States)

    McReynolds, William T.

    1980-01-01

    The essentials of learned helplessness theory are described and supporting evidence surveyed. The explanation Seligman and Maier give for these findings is critically analyzed. A schedule-shift discrimination theory of learned helplessness effects is also discussed. (Author)

  14. Parents' Family Time and Work Schedules: The Split-Shift Schedule in Spain

    NARCIS (Netherlands)

    Gracia, P.; Kalmijn, M.

    2016-01-01

    This study used data on couples from the 2003 Spanish Time Use Survey (N = 1,416) to analyze how work schedules are associated with family, couple, parent–child, and non-family leisure activities. Spain is clearly an interesting case for the institutionalized split-shift schedule, a long lunch break

  15. Using the principles of circadian physiology enhances shift schedule design

    International Nuclear Information System (INIS)

    Connolly, J.J.; Moore-Ede, M.C.

    1987-01-01

    Nuclear power plants must operate 24 h, 7 days a week. For the most part, shift schedules currently in use at nuclear power plants have been designed to meet operational needs without considering the biological clocks of the human operators. The development of schedules that also take circadian principles into account is a positive step that can be taken to improve plant safety by optimizing operator alertness. These schedules reduce the probability of human errors especially during backshifts. In addition, training programs that teach round-the-clock workers how to deal with the problems of shiftwork can help to optimize performance and alertness. These programs teach shiftworkers the underlying causes of the sleep problems associated with shiftwork and also provide coping strategies for improving sleep and dealing with the transition between shifts. When these training programs are coupled with an improved schedule, the problems associated with working round-the-clock can be significantly reduced

  16. 12-hour-shift plant schedule improves operator productivity

    International Nuclear Information System (INIS)

    Gould, S.

    1989-01-01

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

  17. A compressed shift schedule: dealing with some of the problems of shift work

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, J B [Victoria University, Victoria, BC (Canada). School of Public Administration

    1989-07-01

    This study examines some of the psychological and behavioural effects of a 12-hour compressed shift schedule on coal miners in two organisations in Western Canada. It suggests that young, married compressed shift workers are more satisfied with their family relationship. They spend less of their leisure time with spouses when working shifts, and do not spend any more time with them on their days off. They have less time available for many leisure activities on their workdays. The extra time on days off is not reallocated to the leisure activities they were unable to do on their workdays. Some extra leisure time on days off may be spent on personal hobbies. There is no suggestion that the compressed shift schedule has any negative effect on the individual's health. 38 refs., 3 tabs.

  18. Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction.

    Science.gov (United States)

    Hanna, Tarek N; Shekhani, Haris; Lamoureux, Christine; Mar, Hanna; Nicola, Refky; Sliker, Clint; Johnson, Jamlik-Omari

    2017-03-01

    To assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. A survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. Response rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P impact on memory (P job enjoyment and number of annual NS (P job" for radiologists who work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with job satisfaction and negative health self-perception. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Shift scheduling model considering workload and worker’s preference for security department

    Science.gov (United States)

    Herawati, A.; Yuniartha, D. R.; Purnama, I. L. I.; Dewi, LT

    2018-04-01

    Security department operates for 24 hours and applies shift scheduling to organize its workers as well as in hotel industry. This research has been conducted to develop shift scheduling model considering the workers physical workload using rating of perceived exertion (RPE) Borg’s Scale and workers’ preference to accommodate schedule flexibility. The mathematic model is developed in integer linear programming and results optimal solution for simple problem. Resulting shift schedule of the developed model has equally distribution shift allocation among workers to balance the physical workload and give flexibility for workers in working hours arrangement.

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

    OpenAIRE

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

    2016-01-01

    Background: 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. Methods: 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 schedule...

  1. Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up

    NARCIS (Netherlands)

    Merkus, S.L.; Holte, K.A.; Huysmans, M.A.; van de Ven, P.M.; van Mechelen, W.; van der Beek, A.J.

    2015-01-01

    Background Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting

  2. Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-)continuous 3-shift systems.

    Science.gov (United States)

    van de Ven, Hardy A; Brouwer, Sandra; Koolhaas, Wendy; Goudswaard, Anneke; de Looze, Michiel P; Kecklund, Göran; Almansa, Josue; Bültmann, Ute; van der Klink, Jac J L

    2016-09-01

    In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are associated with better sleep, need for recovery, health and performance. Questionnaire data were collected from 491 shift workers of 18 companies with 9 regular (semi)-continuous shift schedules. The shift schedule characteristics were analyzed separately and combined using multilevel linear regression models. The hypothesis was largely not confirmed. Relatively few associations were found, of which the majority was in the direction as expected. In particular early starts of morning shifts and many consecutive shifts seem to be avoided. The healthy worker effect, limited variation between included schedules and the cross-sectional design might explain the paucity of significant results. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-) continuous 3-shift systems

    NARCIS (Netherlands)

    van de Ven, Hardy A.; Brouwer, Sandra; Koolhaas, Wendy; Goudswaard, Anneke; de Looze, Michiel P.; Kecklund, Goran; Almansa, Josue; Bultmann, Ute; van der Klink, Jac J. L.

    In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are

  4. Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-)continuous 3-shift systems

    NARCIS (Netherlands)

    van de Ven, Hardy A.; Brouwer, Sandra; Koolhaas, Wendy; Goudswaard, Anneke; de Looze, Michiel P.; Kecklund, Göran; Almansa, Josue; Bültmann, Ute; van der Klink, Jac J L

    2016-01-01

    In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are

  5. Initial examination of the effects of overtime and shift scheduling on nuclear power plant safety performance

    International Nuclear Information System (INIS)

    Baker, K.; Olson, J.; Montgomery, J.

    1990-01-01

    The research reported here uses currently available data to begin to document overtime and shift scheduling practices in the nuclear industry and assess their safety consequences. Overtime and the 12-hour shift schedule have been found to affect employee fatigue and human error in other industries but neither of these practices have been systematically researched within the nuclear industry. Overtime has long been a standard practice in the nuclear industry and, recently, several licensees have adopted a 12-hour shift schedule for control room operations crews. Although 12-hour shifts have certain benefits for the employer and employee alike (e.g., can require fewer total employees and provide longer periods of time-off) there is some concern that the 12-hour shift may produce greater employee fatigue. Moreover, the 12-hour shift may exacerbate the negative effect of overtime. The potential effect of human error in the nuclear industry for the health and safety of both nuclear power plant workers and the general public requires that these practices be assessed. Data on overtime practices was obtained from the International Brotherhood of Electrical Workers (IBEW) for plants covered by the bargaining unit - approximately 63% of the total number of operating plants. Information on operator shift schedule was collected from all operating plants in 1987 by the NRC. The research produced fairly strong evidence that greater amounts of overtime worked by operators is associated with a greater number of operational problems

  6. Cancer: shift of the paradigm.

    Science.gov (United States)

    Lichtenstein, Anatoly V

    2008-12-01

    Cancer is usually considered to be a by-product of design limitations of a multicellular organism and its intrinsic fallibility. However, recent data prompt a revision of some established notions about carcinogenesis and form a new paradigm of carcinogenesis as a highly conserved biological phenomenon - a programmed death of an organism. This altruistic program, which is unleashed when mutagenesis surpasses a certain critical threshold, gives a population the important benefit acting as a guardian of the gene pool against the spread of certain mutant genes. A growing body of evidence supports this point of view: (i) epigenetic changes leading to cancer arise early, simultaneously in many cells and look like deterministic regulation; (ii) concept of cancer stem cell suggests a view of carcinogenesis not as vague transformation but as well known differentiation; (iii) tumor/host relations usually perceived as antagonistic are, in reality, synergistic; (iv) death of an individual from cancer is predetermined and results apparently from a specific activity (killer function) of cancer cell and (v) evolutionary conservation indicates that cancer comes with a general advantage that explains its evolutionary success. A holistic approach to carcinogenesis suggests new avenues of research and new therapeutic strategy.

  7. The impact of exposure to shift-based schedules on medical students.

    Science.gov (United States)

    Williams, David A; Kogan, Jennifer R; Hauer, Karen E; Yamashita, Traci; Aagaard, Eva M

    2015-01-01

    With new resident duty-hour regulations, resident work schedules have progressively transitioned towards shift-based systems, sometimes resulting in increased team fragmentation. We hypothesized that exposure to shift-based schedules and subsequent team fragmentation would negatively affect medical student experiences during their third-year internal medicine clerkship. As part of a larger national study on duty-hour reform, 67 of 150 eligible third-year medical students completed surveys about career choice, teaching and supervision, assessment, patient care, well-being, and attractiveness of a career in internal medicine after completing their internal medicine clerkship. Students who rotated to hospitals with shift-based systems were compared to those who did not. Non-demographic variables used a five-point Likert scale. Chi-squared and Fisher's exact tests were used to assess the relationships between exposure to shift-based schedules and student responses. Questions with univariate p ≤ 0.1 were included in multivariable logistic regression models. Thirty-six students (54%) were exposed to shift-based schedules. Students exposed to shift-based schedules were less likely to perceive that their attendings were committed to teaching (odds ratio [OR] 0.35, 95% confidence interval [CI]: 0.13-0.90, p = 0.01) or perceive that residents had sufficient exposure to assess their performance (OR 0.29, 95% CI: 0.09-0.91, p = 0.03). However, those students were more likely to feel their interns were able to observe them at the bedside (OR 1.89, 95% CI: 1.08-3.13, p = 0.02) and had sufficient exposure to assess their performance (OR 3.00, 95% CI: 1.01-8.86, p = 0.05). These findings suggest that shift-based schedules designed in response to duty-hour reform may have important broader implications for the teaching environment.

  8. Relationship between shift work schedule and self-reported sleep quality in Chinese employees.

    Science.gov (United States)

    Ma, Yifei; Wei, Fu; Nie, Guanghui; Zhang, Li'e; Qin, Jian; Peng, Suwan; Xiong, Feng; Zhang, Zhiyong; Yang, Xiaobo; Peng, Xiaowu; Wang, Mingjun; Zou, Yunfeng

    2018-02-01

    Few studies have reported on the effects of fixed and rotating shift systems on the prevalence of sleep disturbance. Thus, in this study, the relationships between different work schedules and sleep disturbance in Chinese workers were investigated. A total of 2180 workers aged 19-65 years responded to the self-report questionnaire on shift work schedule (fixed day-shift, fixed night-shift, two-shift or three-shift system), working hours a day, and working days a week, physical effort, subjective sleep quality and subjective mental state. It was found that the rotating shift workers, namely, two- and three-shift workers, exhibited higher risks of sleep disturbance than with the fixed day-shift workers did (OR 1.37; 95% CI 1.07to 1.74; and OR 2.19; 95% CI 1.52 to 3.15, respectively). The risk was particularly high among two- or three-shift workers who worked more than 8 hours a day or more than 5 days a week and among three-shift workers who reported both light and heavy physical effort at work. Moreover, the two- and three-shift workers (rotating shift workers) suffered from poorer sleep quality than the fixed night shift workers did (OR 1.84; 95% CI 1.01 to 3.32; and OR 2.94; 95% CI 1.53 to 5.64, respectively). Consequently, rotating shift work (two- and three-shift work) is a risk factor for sleep disturbance, and the fixed work rhythm may contribute to the quality of sleep.

  9. 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.

  10. A unique, fast-forwards rotating schedule with 12-h long shifts prevents chronic sleep debt.

    Science.gov (United States)

    Fischer, Dorothee; Vetter, Céline; Oberlinner, Christoph; Wegener, Sven; Roenneberg, Till

    2016-01-01

    Sleep debt--together with circadian misalignment--is considered a central factor for adverse health outcomes associated with shift work. Here, we describe in detail sleep-wake behavior in a fast-forward rotating 12-h shift schedule, which involves at least 24 hours off after each shift and thus allows examining the role of immediate recovery after shift-specific sleep debt. Thirty-five participants at two chemical plants in Germany were chronotyped using the Munich ChronoType Questionnaire for Shift-Workers (MCTQ(Shift)) and wore actimeters throughout the two-week study period. From these actimetry recordings, we computed sleep and nap duration, social jetlag (a measure of circadian misalignment), and the daily timing of activity and sleep (center of gravity and mid-sleep, respectively). We observed that the long off-work periods between each shift create a fast alternation between shortened (mean ± standard deviation, 5h 17min ± 56min) and extended (8h 25min ± 72min) sleep episodes resulting in immanent reductions of sleep debt. Additionally, extensive napping of early chronotypes (up to 3 hours before the night shift) statistically compensated short sleep durations after the night shift. Partial rank correlations showed chronotype-dependent patterns of sleep and activity that were similar to those previously described in 8-h schedules; however, sleep before the day shift did not differ between chronotypes. Our findings indicate that schedules preventing a build-up of chronic sleep debt may reduce detrimental effects of shift work irrespective of shift duration. Prospective studies are needed to further elucidate the relationship between sleep, the circadian system, and health and safety hazards.

  11. Shift scheduling limits for the nuclear industry NRC policy and recommendations

    International Nuclear Information System (INIS)

    Koontz, J.; Morisseau, D.; Lewis, P.

    1985-01-01

    A study on shift scheduling and use of overtime and their effects on human performance in nuclear and non-nuclear industries was conducted. An analysis of the literature, current practices, and federal policy on shift scheduling resulted in human factors recommendations for limiting hours of work in the nuclear industry for nuclear power plant personnel conducting safety related functions. Recommended limits on total hours of work were developed by a panel of experts for both 8-hour and 12-hour daily shift schedules for weekly, biweekly, monthly, and annual work periods. The study results are particularly applicable to control room operators but should also be considered for other personnel where performance degradation due to fatigue could directly affect safe plant operations

  12. Evaluation of the 12-hour shift schedule at the Fast Flux Test Facility

    International Nuclear Information System (INIS)

    Lewis, P.M.; Swaim, D.J.; Rosa, R.R.; Colligan, M.J.; Booth, R.J.; Swint, M.J.

    1986-09-01

    The objective of this report are to evaluate the effect of the change to the 12-hour/day schedule on operational performance and safety of FFTF; to evaluate the degree to which the change to the 12-hour/day schedule has met its objectives; and to gather information that may be useful to FFTF management and the US Department of Energy (DOE) in evaluating 8- and 12-hour shift schedules at other facilities. The principal conclusion of this report is that the 12-hour/day shift schedule is a reasonable alternative to an 8-hour/day schedule at FFTF. As a result of the scedule change, it seems clear that plant performance improved in two ways. The operator error rate in keeping the Technical Specification Compliance Logs was already very low on the 8-hour shift. On the 12-hour shift, the rate was even lower. Also, the operator interface with craft personnel resulted in an increase in the productivity of the craft personnel

  13. Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults.

    Science.gov (United States)

    Chinoy, Evan D; Harris, Michael P; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F

    2016-12-01

    We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance and sleep in young adults would also be effective in older adults. We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy) and circadian timing (salivary dim-light melatonin onset, DLMO) in 18 older adults (57.2±3.8 years; mean±SD) in a simulated shift work protocol. 4 day shifts were followed by 3 night shifts in the laboratory. Participants slept at home and were randomised to either the treatment group (scheduled evening sleep and enhanced lighting during the latter half of night shifts) or control group (ad-lib sleep and typical lighting during night shifts). Compared with day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the treatment group but remained lower for the control group. Sleep duration in the treatment group remained similar to baseline (6-7 hours) following night shifts, but was shorter (3-5 hours) following night shifts in the control group. Treatment group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (-9.7±9.9 min) in the control group. The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Scheduled Evening Sleep and Enhanced Lighting Improve Adaptation to Night Shift Work in Older Adults

    Science.gov (United States)

    Chinoy, Evan D.; Harris, Michael P.; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F.

    2017-01-01

    Objectives We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance, and sleep in young adults would also be effective in older adults. Methods We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy), and circadian timing (salivary dim-light melatonin onset, DLMO) in eighteen older adults (57.2±3.8 y; mean±SD) in a simulated shift work protocol. Four day shifts were followed by three night shifts in the laboratory. Participants slept at home and were randomized to either the Treatment Group (scheduled evening sleep and enhanced lighting during the latter half of night shifts), or Control Group (ad lib sleep and typical lighting during night shifts). Results Compared to day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the Treatment Group but remained lower for the Control Group. Sleep duration in the Treatment Group remained similar to baseline (6–7 h) following night shifts, but was shorter (3–5 h) following night shifts in the Control Group. Treatment Group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (−9.7±9.9 min) in the Control Group. Conclusions The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance. PMID:27566781

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

    Directory of Open Access Journals (Sweden)

    Akira Bannai

    2016-09-01

    Full Text Available Background: 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. Methods: 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 nonshift 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 selfreported 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. Results: 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 nonshift 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. Conclusions: The risk of diabetes associated with long working hours differed by shift work schedules.

  16. Day and night shift schedules are associated with lower sleep quality in Evening-types.

    Science.gov (United States)

    Martin, Jeanne Sophie; Laberge, Luc; Sasseville, Alexandre; Bérubé, Marilie; Alain, Samuel; Houle, Jérôme; Hébert, Marc

    2015-06-01

    Eveningness has been suggested as a facilitating factor in adaptation to shift work, with several studies reporting evening chronotypes (E-types) as better sleepers when on night shifts. Conversely, eveningness has been associated with more sleep complaints during day shifts. However, sleep during day shifts has received limited attention in previous studies assessing chronotypes in shift workers. Environmental light exposure has also been reported to differ between chronotypes in day workers. Activity is also known to provide temporal input to the circadian clock. Therefore, the aim of this study was to compare objective sleep, light exposure and activity levels between chronotypes, both during the night and day shifts. Thirty-nine patrol police patrol officers working on a fast rotating shift schedule (mean age ± SD: 28.9 ± 3.2 yrs; 28 males) participated in this study. All subjects completed the Morningness-Eveningness Questionnaire (MEQ). Sleep and activity were monitored with actigraphy (Actiwatch-L; Mini-Mitter/Respironics, Bend, OR) for four consecutive night shifts and four consecutive day shifts (night work schedule: 00:00 h-07:00 h; day work schedule: 07:00 h-15:00 h). Sleep and activity parameters were calculated with Actiware software. MEQ scores ranged from 26 to 56; no subject was categorized as Morning-type. E-types (n = 13) showed significantly lower sleep efficiency, longer snooze time and spent more time awake after sleep onset than Intermediate-types (I-types, n = 26) for both the night and day shifts. E-types also exhibited shorter and more numerous sleep bouts. Furthermore, when napping was taken into account, E-types had shorter total sleep duration than I-types during the day shifts. E-types were more active during the first hours of their night shift when compared to I-types. Also, all participants spent more time active and had higher amount of activity per minute during day shifts when compared to night shifts. No

  17. 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.

  18. The impact of exposure to shift-based schedules on medical students

    Directory of Open Access Journals (Sweden)

    David A. Williams

    2015-06-01

    Full Text Available Background: With new resident duty-hour regulations, resident work schedules have progressively transitioned towards shift-based systems, sometimes resulting in increased team fragmentation. We hypothesized that exposure to shift-based schedules and subsequent team fragmentation would negatively affect medical student experiences during their third-year internal medicine clerkship. Design: As part of a larger national study on duty-hour reform, 67 of 150 eligible third-year medical students completed surveys about career choice, teaching and supervision, assessment, patient care, well-being, and attractiveness of a career in internal medicine after completing their internal medicine clerkship. Students who rotated to hospitals with shift-based systems were compared to those who did not. Non-demographic variables used a five-point Likert scale. Chi-squared and Fisher's exact tests were used to assess the relationships between exposure to shift-based schedules and student responses. Questions with univariate p≤0.1 were included in multivariable logistic regression models. Results: Thirty-six students (54% were exposed to shift-based schedules. Students exposed to shift-based schedules were less likely to perceive that their attendings were committed to teaching (odds ratio [OR] 0.35, 95% confidence interval [CI]: 0.13–0.90, p=0.01 or perceive that residents had sufficient exposure to assess their performance (OR 0.29, 95% CI: 0.09–0.91, p=0.03. However, those students were more likely to feel their interns were able to observe them at the bedside (OR 1.89, 95% CI: 1.08–3.13, p=0.02 and had sufficient exposure to assess their performance (OR 3.00, 95% CI: 1.01–8.86, p=0.05. Conclusions: These findings suggest that shift-based schedules designed in response to duty-hour reform may have important broader implications for the teaching environment.

  19. Is health, measured by work ability index, affected by 12-hour rotating shift schedules?

    Science.gov (United States)

    Yong, Mei; Nasterlack, Michael; Pluto, Rolf-Peter; Elmerich, Kathrin; Karl, Dorothee; Knauth, Peter

    2010-07-01

    Two forms of continuously forward rotating 12-h shift schedules exist at BASF's Ludwigshafen site. These shift schedules were compared with a daytime working system to investigate potential differential effects on employee's health status assessed with the Work Ability Index (WAI). In the 3 x 12 system, a 12-h day shift is followed 24 h later by a 12-h night shift, and after a day off the employee returns to the day shift. The 4 x 12 schedule follows the same pattern except that there are 2 days off between the night and next day shift. A total of 924 participants (278 3 x 12 and 321 4 x 12 shiftworkers and 325 day workers) were recruited. A self-administered questionnaire was used to obtain information about shiftwork schedule, demographic characteristics, and lifestyle and social factors, and the WAI was applied. The outcomes of interest were the WAI sum score and its seven dimensions. In examining the relationship with the WAI categories, a Proportional Odds Model (POM) was used to identify the potential determinants. Logistic regression models were used to estimate the impact of age on single dimensions of WAI after adjustment for potential confounding factors. Increasing age and obesity (BMI > or = 30) were the only significant determinants of poorer WAI. Although a positive association was found linking the second WAI dimension (work ability in relation to job demands) with age, an inverse association was demonstrated consistently between age and the third and fourth WAI dimensions, i.e., number of diagnosed diseases and estimated work impairment due to disease, after adjustment for potential confounders. The age-dependency was moderate overall, but seemed to be stronger among shift- than day workers, although this difference did not reach statistical significance. There was no significant differential impact of the working time systems on the WAI sum score or on the individual WAI dimensions. Thus, there is no indication of an excessive adverse health impact

  20. Shift schedules, work factors, and mental health among onshore and offshore workers in the Norwegian petroleum industry

    Science.gov (United States)

    BERTHELSEN, Mona; PALLESEN, Ståle; BJORVATN, Bjørn; KNARDAHL, Stein

    2015-01-01

    The purpose of the present study was to answer the following research questions: (1) Do workers in different shift schedules differ in mental distress? (2) Do workers in different shift schedules differ in neuroticism? (3) Do shift schedules differ in psychosocial work exposures? (4) Do psychosocial work exposures contribute to mental distress among onshore- and offshore workers? (5) Does neuroticism confound the association between work exposures and mental distress? Workers on six shift-schedules answered a questionnaire (1,471 of 2,628 employees). Psychological and social work factors were measured by QPSNordic, mental distress was measured by HADS and neuroticism was measured by EPQ. The results showed 1) No differences in mental distress between workers in different shift schedules, 2) Revolving-shift workers reported higher neuroticism compared to day workers, 3) Swing-shift workers and revolving-shift workers reported lower job control compared to permanent-night and -day workers, 4) Job demands and role conflict were associated with more mental distress. Job control, role clarity, support, and leadership were associated with lower mental distress, 5) Neuroticism influenced the relationship between psychosocial work factors and mental distress. The present study did not find differences in mental distress between shift schedules. Job characteristics may be contributing factors when determining health effects of shift work. PMID:25740007

  1. Predicting Scheduling and Attending for an Oral Cancer Examination

    Science.gov (United States)

    Shepperd, James A.; Emanuel, Amber S.; Howell, Jennifer L.; Logan, Henrietta L.

    2015-01-01

    Background Oral and pharyngeal cancer is highly treatable if diagnosed early, yet late diagnosis is commonplace apparently because of delays in undergoing an oral cancer examination. Purpose We explored predictors of scheduling and attending an oral cancer examination among a sample of Black and White men who were at high risk for oral cancer because they smoked. Methods During an in-person interview, participants (N = 315) from rural Florida learned about oral and pharyngeal cancer, completed survey measures, and were offered a free examination in the next week. Later, participants received a follow-up phone call to explore why they did or did not attend their examination. Results Consistent with the notion that scheduling and attending an oral cancer exam represent distinct decisions, we found that the two outcomes had different predictors. Defensive avoidance and exam efficacy predicted scheduling an examination; exam efficacy and having coping resources, time, and transportation predicted attending the examination. Open-ended responses revealed that the dominant reasons participants offered for missing a scheduled examination was conflicting obligations, forgetting, and confusion or misunderstanding about the examination. Conclusions The results suggest interventions to increase scheduling and attending an oral cancer examination. PMID:26152644

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

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, P.M.

    1985-07-01

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

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

    International Nuclear Information System (INIS)

    Lewis, P.M.

    1985-07-01

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

  4. Constrained consumption shifting management in the distributed energy resources scheduling considering demand response

    International Nuclear Information System (INIS)

    Faria, Pedro; Vale, Zita; Baptista, Jose

    2015-01-01

    Highlights: • Consumption reduction and/or shift to several periods before and after. • Optimization problem for scheduling of demand response and distributed generation. • Minimization of the Virtual Power Player operation (remuneration) costs. • Demand response can be efficient to meet distributed generation shortages. • Consumers benefit with the remuneration of the participation in demand response. - Abstract: Demand response concept has been gaining increasing importance while the success of several recent implementations makes this resource benefits unquestionable. This happens in a power systems operation environment that also considers an intensive use of distributed generation. However, more adequate approaches and models are needed in order to address the small size consumers and producers aggregation, while taking into account these resources goals. The present paper focuses on the demand response programs and distributed generation resources management by a Virtual Power Player that optimally aims to minimize its operation costs taking the consumption shifting constraints into account. The impact of the consumption shifting in the distributed generation resources schedule is also considered. The methodology is applied to three scenarios based on 218 consumers and 4 types of distributed generation, in a time frame of 96 periods

  5. [Cancer and nutrition - a paradigma shift].

    Science.gov (United States)

    Imoberdorf, R; Rühlin, M; Ballmer, P E

    2017-08-01

    Substantial international differences in the prevalence of cancer disease suppose that nutrition may be an important factor in the development of cancer. Many experts believe, that nutritional factors may contribute up to 35 % to the development of malignant tumors. Many patients have lost substantial body weight already at the time of the diagnosis of the disease as consequence of undernutrition and malnutrition, respectively. During the course of the disease the nutritional status often is deteriorating further. Caused by both the cancer disease itself and the treatment, loss of appetite, changes in taste, nausea and vomiting may additionally contribute to undernutrition. Undernutrition is a relevant factor for the outcome of the disease and for the tolerance of the treatment as well. Therefore, supporting the heavily impaired patients in nutritional intake is of paramount importance and an urgent task for physicians and nurses. In view of physiology, pathophysiology, genetics and molecular biology, metabolic processes in cancer are highly complex regulated and there is increasing evidence that a diet rich in fat and protein is favourable. This, however, implies a paradigma shift away from the "healthy" balanced diet rich in fruit, vegetable and complex carbohydrates. So far, the evidence based data of this new concept is, however, a controversial issue. Georg Thieme Verlag KG Stuttgart · New York.

  6. Simultaneous personnel and vehicle shift scheduling in the waste management sector.

    Science.gov (United States)

    Ghiani, Gianpaolo; Guerriero, Emanuela; Manni, Andrea; Manni, Emanuele; Potenza, Agostino

    2013-07-01

    Urban waste management is becoming an increasingly complex task, absorbing a huge amount of resources, and having a major environmental impact. The design of a waste management system consists in various activities, and one of these is related to the definition of shift schedules for both personnel and vehicles. This activity has a great incidence on the tactical and operational cost for companies. In this paper, we propose an integer programming model to find an optimal solution to the integrated problem. The aim is to determine optimal schedules at minimum cost. Moreover, we design a fast and effective heuristic to face large-size problems. Both approaches are tested on data from a real-world case in Southern Italy and compared to the current practice utilized by the company managing the service, showing that simultaneously solving these problems can lead to significant monetary savings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule.

    LENUS (Irish Health Repository)

    Munson, Gregory W

    2011-03-01

    Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue.

  8. Re-scheduling nursing shifts: Scoping the challenge and examining the potential of mathematical model based tools

    OpenAIRE

    Clark, A.; Moule, P.; Topping, A.; Serpell, M.

    2015-01-01

    Aims: To review research in the literature on nursing shift scheduling/rescheduling, and report key issues identified in a listening exercise with managers in four English NHS trusts to inform the development of mathematical tools for rescheduling decision-making.\\ud Background: Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives than scheduling. Poor rescheduling decisions can have quality, cost and morale implications.\\ud Evaluation: A...

  9. SHIFT WORK AND BREAST CANCER AMONG WOMEN TEXTILE WORKERS IN SHANGHAI, CHINA

    Science.gov (United States)

    Li, Wenjin; Ray, Roberta M.; Thomas, David B.; Davis, Scott; Yost, Michael; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E. Dawn; Camp, Janice E.; Wong, Eva; Wernli, Karen J.; Checkoway, Harvey

    2014-01-01

    PURPOSE Although night shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. METHODS The study included 1709 incident breast cancer cases and 4780 non-cases. Data on historical shift-work schedules were collected by categorized jobs from the factories where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. RESULTS We observed no associations with either years of night-shift work, or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. CONCLUSIONS The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggest that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women. PMID:25421377

  10. Shift work and breast cancer among women textile workers in Shanghai, China.

    Science.gov (United States)

    Li, Wenjin; Ray, Roberta M; Thomas, David B; Davis, Scott; Yost, Michael; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E Dawn; Camp, Janice E; Wong, Eva; Wernli, Karen J; Checkoway, Harvey

    2015-01-01

    Although night-shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. The study included 1,709 incident breast cancer cases and 4,780 non-cases. Data on historical shift work schedules were collected by categorized jobs from the factories, where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night-shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95 % confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. We observed no associations with either years of night-shift work or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggests that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women.

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

    Science.gov (United States)

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

    2015-09-01

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

  12. Can varying the number of teams in a shift schedule constitute a preventive strategy?

    Directory of Open Access Journals (Sweden)

    Hans Jeppe Jeppesen

    2004-12-01

    Full Text Available OBJECTIVE: The study examines the implications for shiftworkers of applying different numbers of teams in the organization of shiftwork. METHODS: The participating operators came from five different companies applying continuous shift rotation systems. The companies shared the same product organization and a common corporate culture belonging to the same multinational company. Each company had a shift system consisting of four, five or six teams, with the proportion of shifts outside day work decreasing as the number of teams increased. Questionnaire and documentary data were used as data sources. RESULTS: Operators in systems with additional teams had more daywork but also more irregular working hours due to both overtime and schedule changes. Operators using six teams used fewer social compensation strategies. Operators in four teams were most satisfied with their work hours. Satisfaction with the time available for various social activities outside work varied inconsistently between the groups. CONCLUSIONS: In rotating systems the application of more teams reduces the number of shifts outside day work. This apparent improvement for shiftworkers was counteracted by a concomitant irregularity produced by greater organizational requirements for flexibility. The balance of this interaction was found to have a critical impact on employees.

  13. Shift work schedule and night work load: Effects on body mass index - a four-year longitudinal study.

    Science.gov (United States)

    Buchvold, Hogne Vikanes; Pallesen, Ståle; Waage, Siri; Bjorvatn, Bjørn

    2018-05-01

    Objectives The aim of this study was to investigate changes in body mass index (BMI) between different work schedules and different average number of yearly night shifts over a four-year follow-up period. Methods A prospective study of Norwegian nurses (N=2965) with different work schedules was conducted: day only, two-shift rotation (day and evening shifts), three-shift rotation (day, evening and night shifts), night only, those who changed towards night shifts, and those who changed away from schedules containing night shifts. Paired student's t-tests were used to evaluate within subgroup changes in BMI. Multiple linear regression analysis was used to evaluate between groups effects on BMI when adjusting for BMI at baseline, sex, age, marital status, children living at home, and years since graduation. The same regression model was used to evaluate the effect of average number of yearly night shifts on BMI change. Results We found that night workers [mean difference (MD) 1.30 (95% CI 0.70-1.90)], two shift workers [MD 0.48 (95% CI 0.20-0.75)], three shift workers [MD 0.46 (95% CI 0.30-0.62)], and those who changed work schedule away from [MD 0.57 (95% CI 0.17-0.84)] or towards night work [MD 0.63 (95% CI 0.20-1.05)] all had significant BMI gain (Pnight workers had significantly larger BMI gain compared to day workers [B=0.89 (95% CI 0.06-1.72), Pnight shifts and BMI change using our multiple linear regression model. Conclusions After adjusting for possible confounders, we found that BMI increased significantly more among night workers compared to day workers.

  14. The Impact of a Rigorous Multiple Work Shift Schedule and Day Versus Night Shift Work on Reaction Time and Balance Performance in Female Nurses: A Repeated Measures Study.

    Science.gov (United States)

    Thompson, Brennan J; Stock, Matt S; Banuelas, Victoria K; Akalonu, Chibuzo C

    2016-07-01

    The aim of this study was to determine the impact of a demanding work schedule involving long, cumulative work shifts on response time and balance-related performance outcomes and to evaluate the prevalence of musculoskeletal disorders between day and night shift working nurses. A questionnaire was used to identify the prevalence of past (12-month) and current (7-day) musculoskeletal disorders. Nurses worked three 12-hour work shifts in a 4-day period. Reaction time and balance tests were conducted before and after the work period. The work period induced impairments for reaction time, errors on reaction time tasks, and balance performance, independent of shift type. Musculoskeletal symptom prevalence was high in workers of both work shifts. Compressed work shifts caused performance-based fatigue in nurses. Reaction time and balance tests may be sensitive fatigue identification markers in nurses.

  15. [Working time and sleep in nursing staff employed in "3 x 8" and "2 x 12" fast rotating shift schedules].

    Science.gov (United States)

    Castellini, G; Anelli, M M; Punzi, S; Boari, P; Camerino, D; Costa, G

    2011-01-01

    The study is aimed at assessing, in 200 nurses shift workers, the impact on sleep of two different working areas ("emergency" and "hospitalization") having the same "3 x 8" shift system, and of two different shift schedules at quick rotation ("2 x 12" and "3 x 8") in the same working area ("emergency"). Night and morning shifts prove to interfere to a greater extent with sleep in relation to both "2 x 12" and "3 x 8" shift systems as well as to the two operative areas. Hence the importance to consider in shift work planning, the direction of shift rotation and the length of the duty period according to the type of activity.

  16. The androgen receptor malignancy shift in prostate cancer.

    Science.gov (United States)

    Copeland, Ben T; Pal, Sumanta K; Bolton, Eric C; Jones, Jeremy O

    2018-05-01

    Androgens and the androgen receptor (AR) are necessary for the development, function, and homeostatic growth regulation of the prostate gland. However, once prostate cells are transformed, the AR is necessary for the proliferation and survival of the malignant cells. This change in AR function appears to occur in nearly every prostate cancer. We have termed this the AR malignancy shift. In this review, we summarize the current knowledge of the AR malignancy shift, including the DNA-binding patterns that define the shift, the transcriptome changes associated with the shift, the putative drivers of the shift, and its clinical implications. In benign prostate epithelial cells, the AR primarily binds consensus AR binding sites. In carcinoma cells, the AR cistrome is dramatically altered, as the AR associates with FOXA1 and HOXB13 motifs, among others. This shift leads to the transcription of genes associated with a malignant phenotype. In model systems, some mutations commonly found in localized prostate cancer can alter the AR cistrome, consistent with the AR malignancy shift. Current evidence suggests that the AR malignancy shift is necessary but not sufficient for transformation of prostate epithelial cells. Reinterpretation of prostate cancer genomic classification systems in light of the AR malignancy shift may improve our ability to predict clinical outcomes and treat patients appropriately. Identifying and targeting the molecular factors that contribute to the AR malignancy shift is not trivial but by doing so, we may be able to develop new strategies for the treatment or prevention of prostate cancer. © 2018 Wiley Periodicals, Inc.

  17. Effects of scheduled exercise on cancer-related fatigue in women with early breast cancer

    OpenAIRE

    Husebø, Anne Marie Lunde; Dyrstad, Sindre Mikal; Mjaaland, Ingvil; Søreide, Jon Arne; Bru, Lars Edvin

    2014-01-01

    The article was originally published in The Scientific World Journal; by Hindawi Publishing Corporation under the Creative Commons Attribution License; see http://dx.doi.org/10.1155/2014/27182. While physical activity during cancer treatment is found beneficial for breast cancer patients, evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms. This study investigated effects of a scheduled home-based exercise intervention i...

  18. Shiftworking families: parents' working schedule and sleep patterns of adolescents attending school in two shifts

    Directory of Open Access Journals (Sweden)

    Biserka Radoševic-Vidacek

    2004-12-01

    Full Text Available OBJECTIVE: To explore whether parents' engagement in shift work affects the sleep habits of their adolescent children who attend school in two shifts. METHODS: The data were drawn from an extensive survey of sleep and daytime functioning of adolescents attending school one week in the morning and the other in the afternoon. The participants were 1,386 elementary and high school students (11-18 years old whose parents were both employed. The data were analyzed using MANOVA, with parents' work schedule, adolescents' gender and type of school as between-subject factors. RESULTS: Parents' working schedule significantly affected the sleep patterns of high school adolescents. When attending school in the morning, adolescents whose parents were both day workers woke up somewhat later than adolescents with one shiftworking parent. In addition, they slept longer than adolescents whose parents were both shift workers. On weekends, adolescents whose parents both worked during the day went to bed earlier than adolescents whose parents were both shiftworkers. They also had smaller bedtime delay on weekends with respect to both morning and afternoon shifts than adolescents for whom one or both parents worked shifts. A significant interaction between parents' working schedule, adolescents' gender and type of school was found for sleep extension on weekends after afternoon shift school. CONCLUSIONS: Parental involvement in shift work has negative effects on the sleep of high school adolescents. It contributes to earlier wake-up time and shorter sleep in a week when adolescents attend school in the morning, as well as to greater bedtime irregularity.OBJETIVO: Investigar se a ocupação de pais com o trabalho em turnos interfere nos hábitos de sono dos filhos adolescentes que freqüentam a escola em dois períodos distintos. MÉTODOS: Os dados foram coletados em uma extensa pesquisa sobre sono e atividades diurnas de adolescentes que freqüentavam a escola no

  19. Shift schedule, work–family relationships, marital communication, job satisfaction and health among transport service shift workers

    Directory of Open Access Journals (Sweden)

    Irena Iskra-Golec

    2017-02-01

    Full Text Available Objectives: Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1–3 shifts of the same kind in a row and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work–family and family–work positive and negative spillover, marital communication style, job satisfaction and health. Material and Methods: Employees (N = 168 of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system participated in the study. They completed the Work– Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index. Results: The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165 = 4.175, p = 0.007 and a higher level of constructive style of marital communication (Engagement F(3, 165 = 2.761, p = 0.044 than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. Conclusions: A higher level of work–family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night. This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1:121–131

  20. Application-Oriented Optimal Shift Schedule Extraction for a Dual-Motor Electric Bus with Automated Manual Transmission

    Directory of Open Access Journals (Sweden)

    Mingjie Zhao

    2018-02-01

    Full Text Available The conventional battery electric buses (BEBs have limited potential to optimize the energy consumption and reach a better dynamic performance. A practical dual-motor equipped with 4-speed Automated Manual Transmission (AMT propulsion system is proposed, which can eliminate the traction interruption in conventional AMT. A discrete model of the dual-motor-AMT electric bus (DMAEB is built and used to optimize the gear shift schedule. Dynamic programming (DP algorithm is applied to find the optimal results where the efficiency and shift time of each gear are considered to handle the application problem of global optimization. A rational penalty factor and a proper shift time delay based on bench test results are set to reduce the shift frequency by 82.5% in Chinese-World Transient Vehicle Cycle (C-WTVC. Two perspectives of applicable shift rule extraction methods, i.e., the classification method based on optimal operating points and clustering method based on optimal shifting points, are explored and compared. Eventually, the hardware-in-the-loop (HIL simulation results demonstrate that the proposed structure and extracted shift schedule can realize a significant improvement in reducing energy loss by 20.13% compared to traditional empirical strategies.

  1. Shift schedule, work-family relationships, marital communication, job satisfaction and health among transport service shift workers.

    Science.gov (United States)

    Iskra-Golec, Irena; Smith, Lawrence; Wilczek-Rużyczka, Ewa; Siemiginowska, Patrycja; Wątroba, Joanna

    2017-02-21

    Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health. Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index). The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  2. Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up.

    Science.gov (United States)

    Merkus, Suzanne L; Holte, Kari Anne; Huysmans, Maaike A; van de Ven, Peter M; van Mechelen, Willem; van der Beek, Allard J

    2015-09-01

    Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the 1(st) day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1(st) day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

  3. Phosphatases in Cancer : Shifting the balance

    NARCIS (Netherlands)

    E. Hoekstra (Elmer)

    2015-01-01

    markdownabstractAbstract The role of phosphatases in cancer is an ignored research field, mostly based on the dogma that phosphatases function as tumor suppressor genes. However, in our opinion dephosphorylation events by phosphatases can also enhance signaling in cancer. The current research

  4. Can varying the number of teams in a shift schedule constitute a preventive strategy?

    Directory of Open Access Journals (Sweden)

    Hans Jeppe Jeppesen

    2004-12-01

    Full Text Available OBJECTIVE: The study examines the implications for shiftworkers of applying different numbers of teams in the organization of shiftwork. METHODS: The participating operators came from five different companies applying continuous shift rotation systems. The companies shared the same product organization and a common corporate culture belonging to the same multinational company. Each company had a shift system consisting of four, five or six teams, with the proportion of shifts outside day work decreasing as the number of teams increased. Questionnaire and documentary data were used as data sources. RESULTS: Operators in systems with additional teams had more daywork but also more irregular working hours due to both overtime and schedule changes. Operators using six teams used fewer social compensation strategies. Operators in four teams were most satisfied with their work hours. Satisfaction with the time available for various social activities outside work varied inconsistently between the groups. CONCLUSIONS: In rotating systems the application of more teams reduces the number of shifts outside day work. This apparent improvement for shiftworkers was counteracted by a concomitant irregularity produced by greater organizational requirements for flexibility. The balance of this interaction was found to have a critical impact on employees.OBJETIVOS: Investigar as implicações para trabalhadores em turnos do uso de um número distinto de turmas de trabalho na organização dos turnos. MÉTODOS: Participaram do estudo operadores de cinco empresas que usavam sistemas contínuos de turnos alternantes. As empresas tinham em comum a organização de produtos e cultura empresarial e pertenciam a uma mesma empresa multinacional. Cada uma das empresas tinha um sistema de turnos que compreendia quatro, cinco ou seis turmas de trabalho, sendo que a proporção de turnos fora dos horários diurnos diminuía à medida que aumentava o número de turmas. Foram

  5. No difference in self reported health among coalminers in two different shift schedules at Spitsbergen, Norway, a two years follow-up.

    Science.gov (United States)

    Hanoa, Rolf; Baste, Valborg; Kooij, Arne; Sommervold, Linda; Moen, Bente Elisabeth

    2011-01-01

    This study was performed among coal miners in the remote location Svea, Spitsbergen. The shift schedule used to be 7 d on and 7 d off. The aim of this study was to investigate possible changes in health after a voluntary implementation of a new shift schedule, with periods of 14 d on and 14 d off, for 74 percent of the workers in 2007. A questionnaire was distributed to all employees before and two times after the new shift schedule, comprising questions on type of work, shift schedule, pain, sleep, stress and coping. Ninety nine percent of the employees responded; 274 in 2006, 307 in 2007 and 312 in 2008. Work neither in the 14/14 shift nor 7/7 shift was related to any change in the health after these two years. The coping index for workers in the 14/14 shift improved.

  6. [Night work, shift work: Breast cancer risk factor?].

    Science.gov (United States)

    Benabu, J-C; Stoll, F; Gonzalez, M; Mathelin, C

    2015-12-01

    The aim of this review was to determine the link between night/shift work and breast cancer. The analysed articles were taken from the PUBMED database between 1996 and 2015. The keywords used were "breast cancer risk", "night work" and "shift work". In total, 25 articles were selected. Night/shift workers are more at risk to develop a breast cancer (relative risk (RR) between 1.09; 95% CI: 1.02-1.20 and 1.48; 95% CI: 1.36-1.61 in the meta-analyses). However, this risk is not found by some cohort and case-control studies. The circadian rhythm disruption, responsible of disorderliness of melatonin secretion, could be one of the mechanisms involved in the increase of that risk. Hormonal status of night/shift workers, their geographic origin, their lifestyle and their vitamin D deficiency appear as other mechanisms potentially responsible for increased risk of cancer in this professional population. Moreover, a dose-effect connection may exist, with an increase of the risk with the number of years of night/shift work. Night/shift work is associated with a moderate increased risk of breast cancer, especially among women who worked over 20 years. Recommendations concerning the breast monitoring in this population could be diffused. The benefit of melatonin supplementation remains to be assessed. Copyright © 2015. Published by Elsevier SAS.

  7. Paradigm Shift in the Management Strategy for Epithelial Ovarian Cancer.

    Science.gov (United States)

    Fujiwara, Keiichi; McAlpine, Jessica N; Lheureux, Stephanie; Matsumura, Noriomi; Oza, Amit M

    2016-01-01

    The hypothesis on the pathogenesis of epithelial ovarian cancer continues to evolve. Although epithelial ovarian cancer had been assumed to arise from the coelomic epithelium of the ovarian surface, it is now becoming clearer that the majority of serous carcinomas arise from epithelium of the distal fallopian tube, whereas clear cell and endometrioid cancers arise from endometriosis. Molecular and genomic characteristics of epithelial ovarian cancer have been extensively investigated. Our understanding of pathogenesis of the various histologic types of ovarian cancer have begun to inform changes to the strategies for management of epithelial ovarian cancer, which represent a paradigm shift not only for treatment but also for prevention, which previously had not been considered achievable. In this article, we will discuss novel attempts at the prevention of high-grade serous ovarian cancer and treatment strategies for two distinct entities in epithelial ovarian cancer: low-grade serous and clear cell ovarian carcinomas, which are relatively rare and resistant to conventional chemotherapy.

  8. How shift scheduling practices contribute to fatigue amongst freight rail operating employees: Findings from Canadian accident investigations.

    Science.gov (United States)

    Rudin-Brown, Christina M; Harris, Sarah; Rosberg, Ari

    2018-02-01

    Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  9. Cervical Cancer: Reality and Paradigm Shift

    Directory of Open Access Journals (Sweden)

    Alfredo Quiñones Ceballos

    2014-09-01

    Full Text Available Invasive cervical carcinoma usually reaches its highest frequency between 35-50 years of age. The Cuban prevention program screens the female population aged 25 to 60 years using the Pap smear and reexamines them every three years. Despite this effort, advanced cancer is diagnosed in young women as well as in those 40 to 60 years of age.

  10. Mechanisms of breast cancer risk in shift workers: association of telomere shortening with the duration and intensity of night work.

    Science.gov (United States)

    Samulin Erdem, Johanna; Notø, Heidi Ødegaard; Skare, Øivind; Lie, Jenny-Anne S; Petersen-Øverleir, Marte; Reszka, Edyta; Pepłońska, Beata; Zienolddiny, Shanbeh

    2017-08-01

    Occupational factors such as shiftwork and especially night work that involves disruption of the circadian rhythm may contribute to increased breast cancer risk. Circadian disruption may also affect telomere length (TL). While short TL generally is associated with increased cancer risk, its association with breast cancer risk is inconclusive. We suggest that working schedules might be an important factor in assessment of effects of TL on breast cancer risk. Moreover, telomere shortening might be a potential mechanism for night work-related breast cancer. In this study, effects of shift work on TL and its association with breast cancer risk were investigated in a nested breast cancer case-control study of Norwegian nurses. TL was assessed by qPCR in DNA from 563 breast cancer patients and 619 controls. Here, we demonstrate that TL is affected by intensive night work schedules, as work with six consecutive night for a period of more than 5 years was associated with decreased telomere lengths (-3.18, 95% CI: -6.46 to -0.58, P = 0.016). Furthermore, telomere shortening is associated with increased breast cancer risk in workers with long periods of consecutive night shifts. Thus, nurses with longer telomere lengths had a lower risk for breast cancer if they had worked more than four (OR: 0.37, 95% CI: 0.16-0.79, P = 0.014) or five (OR: 0.31, 95% CI: 0.10-0.83, P = 0.029) consecutive night shifts for a period of 5 years or more. These data suggest that telomere shortening is associated with the duration and intensity of night work and may be a contributing factor for breast cancer risk among female shift workers. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  11. Stokes shift spectroscopy for breast cancer diagnosis

    Science.gov (United States)

    Jeyasingh, Ebenezar; Prakashrao, Aruna; Singaravelu, Ganesan

    2010-02-01

    The objective of this study is to assess the diagnostic potential of stokes shift (SS) spectroscopy (SSS) for normal and different pathological breast tissues such as fibroadenoma and infiltrating ductal carcinoma. The SS spectra is measured by simultaneously scanning both the excitation and emission wavelengths while keeping a fixed wavelength interval Δλ=20 nm between them. Characteristic, highly resolved peaks and significant spectral differences between normal and different pathological breast tissues were observed. The SS spectra of normal and different pathological breast tissues shows the distinct peaks around 300, 350, 450, 500 and 600 nm may be attributed to tryptophan, collagen, NADH, flavin and porphyrin respectively. Using SSS technique one can obtain all the key fluorophores in a single scan and hence they can be targeted as a tumor markers in this study. In order to quantify the altered spectral differences between normal and different pathological breast tissues are verified by different ratio parameters.

  12. Fractionation schedules for cancers of the head and neck

    International Nuclear Information System (INIS)

    Harari, Paul M.

    1995-01-01

    Purpose/Objective: This refresher course reviews current research activity and treatment results in the field of radiation therapy fractionation. The presentation emphasizes worldwide studies of altered fractionation, highlighting head and neck cancer as the primary teaching model. Basic radiobiological principles guiding the development of altered fractionation regimens, and advancing the understanding of fractionation effects on normal and tumor tissue are reviewed. A 'standard' prescription of 2 Gy x 35 fractions = 70 Gy may not provide the optimal balance between primary tumor control and late normal tissue effects for all patients with squamous cell carcinoma of the head and neck. The last decade has witnessed the treatment of thousands of head and neck cancer patients with curative radiotherapy using altered fractination schedules designed to improve overall treatment results. Although the number of different fractionation regimens currently being investigated continues to increase, the common guiding principles behind their design are relatively simple. Common fractionation terminology (i.e., accelerated hyperfractionation) will be reviewed, as well as a brief summary of radiobiological concepts pertaining to tumor potential doubling time, tumor proliferation kinetics, overall treatment time and fraction size-dependence of acute and late tissue effects. Several well known head and neck fractionation schedules from around the world (Manchester Christie Hospital-United Kingdom, Princess Margaret Hospital-Canada, Massachusetts General Hospital-USA, MD Anderson Hospital-USA, University of Florida-USA, Mount Vernon Hospital CHART-United Kingdom, RTOG and EORTC trials-USA and Europe) will be summarized with regard to design-rationale, treatment technique and results. The design of several current cooperative group trials investigating altered head and neck fractionation will be presented, as well as concepts prompting the pilot evaluation of several brand new

  13. Night Shift Work and Risk of Breast Cancer.

    Science.gov (United States)

    Hansen, Johnni

    2017-09-01

    Night work is increasingly common and a necessity in certain sectors of the modern 24-h society. The embedded exposure to light-at-night, which suppresses the nocturnal hormone melatonin with oncostatic properties and circadian disruption, i.e., misalignment between internal and external night and between cells and organs, are suggested as main mechanisms involved in carcinogenesis. In 2007, the International Agency for Research on Cancer (IARC) classified shift work that involves circadian disruption as probably carcinogenic to humans based on limited evidence from eight epidemiologic studies on breast cancer, in addition to sufficient evidence from animal experiments. The aim of this review is a critical update of the IARC evaluation, including subsequent and the most recent epidemiologic evidence on breast cancer risk after night work. After 2007, in total nine new case-control studies, one case-cohort study, and eight cohort studies are published, which triples the number of studies. Further, two previous cohorts have been updated with extended follow-up. The assessment of night shift work is different in all of the 26 existing studies. There is some evidence that high number of consecutive night shifts has impact on the extent of circadian disruption, and thereby increased breast cancer risk, but this information is missing in almost all cohort studies. This in combination with short-term follow-up of aging cohorts may explain why some cohort studies may have null findings. The more recent case-control studies have contributed interesting results concerning breast cancer subtypes in relation to both menopausal status and different hormonal subtypes. The large differences in definitions of both exposure and outcome may contribute to the observed heterogeneity of results from studies of night work and breast cancer, which overall points in the direction of an increased breast cancer risk, in particular after over 20 years of night shifts. Overall, there is a

  14. Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study.

    Science.gov (United States)

    Stimpfel, Amy Witkoski; Brewer, Carol S; Kovner, Christine T

    2015-11-01

    Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics. To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model. This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design. The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration. Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated. The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses

  15. Night shift work, chronotype and prostate cancer risk in the MCC-Spain case-control study.

    Science.gov (United States)

    Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Aragonés, Nuria; Pérez-Gómez, Beatriz; Burgos, Javier; Gómez-Acebo, Inés; Llorca, Javier; Peiró, Rosana; Jimenez-Moleón, Jose Juan; Arredondo, Francisco; Tardón, Adonina; Pollan, Marina; Kogevinas, Manolis

    2015-09-01

    Night shift work has been classified as a probable human carcinogen based on experimental studies and limited human evidence on breast cancer. Evidence on other common cancers, such as prostate cancer, is scarce. Chronotype is an individual characteristic that may relate to night work adaptation. We evaluated night shift work with relation to prostate cancer, taking into account chronotype and disease severity in a population based case-control study in Spain. We included 1,095 prostate cancer cases and 1,388 randomly selected population controls. We collected detailed information on shift schedules (permanent vs. rotating, time schedules, duration, frequency), using lifetime occupational history. Sociodemographic and lifestyle factors were assessed by face-to-face interviews and chronotype through a validated questionnaire. We used unconditional logistic regression analysis adjusting for potential confounders. Subjects who had worked at least for one year in night shift work had a slightly higher prostate cancer risk [Odds Ratio (OR) 1.14; 95%CI 0.94, 1.37] compared with never night workers; this risk increased with longer duration of exposure (≥ 28 years: OR 1.37; 95%CI 1.05, 1.81; p-trend = 0.047). Risks were more pronounced for high risk tumors [D'Amico classification, Relative Risk Ratio (RRR) 1.40; 95%CI 1.05, 1.86], particularly among subjects with longer duration of exposure (≥28 years: RRR 1.63; 95%CI 1.08, 2.45; p-trend = 0.027). Overall risk was higher among subjects with an evening chronotype, but also increased in morning chronotypes after long-term night work. In this large population based study, we found an association between night shift work and prostate cancer particularly for tumors with worse prognosis. © 2014 UICC.

  16. Restless Legs Syndrome/Willis-Ekbom Disease Is Prevalent in Working Nurses, but Seems Not to Be Associated with Shift Work Schedules.

    Science.gov (United States)

    Waage, Siri; Pallesen, Ståle; Moen, Bente Elisabeth; Bjorvatn, Bjørn

    2018-01-01

    Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis-Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25-67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference ( p  shift work also are sensitive to other complaints related to a misalignment of the biological clock.

  17. Conflicts between employee preferences and ergonomic recommendations in shift scheduling: regulation based on consent is not sufficient

    Directory of Open Access Journals (Sweden)

    Johannes Gärtner

    2004-12-01

    Full Text Available OBJECTIVE: Contribution to the discussion of the role of participation/consent of employees in working hours regulation. METHODS: Exploratory analysis of conflicts between preferences of employees and ergonomic recommendations in shift scheduling by analysing a large number of participative shift scheduling projects. RESULTS: The analysis showed that very often the pursuit of higher income played the major role in the decision making process of employees and employees preferred working hours in conflict with health and safety principles. CONCLUSIONS: First, the consent of employees or the works council alone does not ensure ergonomically sound schedules. Besides consent, risk assessment procedures seem to be a promising but difficult approach. Secondly, more research is necessary to check the applicability of recommendations under various settings, to support the risk assessment processes and to improve regulatory approaches to working hours.OBJETIVO: Contribuir para a discussão do papel da participação/consentimento dos empregados na regulamentação das horas de trabalho. MÉTODOS: Realizou-se um estudo exploratório dos conflitos existentes entre as preferências dos empregados e as recomendações ergonômicas no planejamento de esquemas de trabalho em turnos, analisando-se um grande número de projetos participativos de planejamento dos turnos. RESULTADOS: O estudo mostrou que, com freqüência, a busca por um rendimento maior teve um papel importante no processo de tomada de decisão dos empregados, quando estes optaram pelas horas de trabalho em oposição aos princípios de saúde e segurança. CONCLUSÕES: Em primeiro lugar, o consentimento dos empregados ou da comissão de trabalhadores por si só não garante horários salutares do ponto de vista ergonômico. Além do consentimento, processos de avaliação de risco parecem ser uma abordagem promissora embora complicada. Em segundo lugar, fazem-se necessários mais estudos para

  18. Patients' preference for radiotherapy fractionation schedule in the palliation of symptomatic unresectable lung cancer

    International Nuclear Information System (INIS)

    Tang, J. I.; Lu, J. J.; Wong, L. C.

    2008-01-01

    Full text: The palliative radiotherapeutic management of unresectable non-small-cell lung cancer is controversial, with various fractionation (F x) schedules available. We aimed to determine patient's choice of F x schedule after involvement in a decision-making process using a decision board. A decision board outlining the various advantages and disadvantages apparent in the Medical Research Council study of F x schedules (17 Gy in two fractions vs 39 Gy in 13 fractions) was discussed with patients who met Medical Research Council eligibility criteria. Patients were then asked to indicate their preferred F x schedules, reasons and their level of satisfaction with being involved in the decision making process. Radiation oncologists (R O ) could prescribe radiotherapy schedules irrespective of patients' preferences. Of 92 patients enrolled, 55% chose the longer schedule. English-speaking patients were significantly more likely to choose the longer schedule (P 0.02, 95% confidence interval: 1.2-7.6). Longer F x was chosen because of longer survival (90%) and better local control (12%). Shorter F x was chosen for shorter overall treatment duration (80%), cost (61%) and better symptom control (20%). In all, 56% of patients choosing the shorter schedule had their treatment altered by the treating R O , whereas only 4% of patients choosing longer F x had their treatment altered (P O 's own biases.

  19. Noninvasive diagnosis of oral cancer by Stokes shift spectroscopy

    Science.gov (United States)

    Ebenezar, Jeyasingh; Ganesan, Singaravelu; Aruna, Prakasrao; Muralinaidu, Radhakrishnan

    2014-03-01

    The objective of this study is to evaluate the diagnostic potential of stokes shift (SS) spectroscopy (S3) for normal, precancer and cancerous oral lesions in vivo. The SS spectra were recorded in the 250 - 650 nm spectral range by simultaneously scanning both the excitation and emission wavelengths while keeping a fixed wavelength interval Δλ=20 nm between them. Characteristic, highly resolved peaks and significant spectral differences between normal and different pathological oral lesions observed around 300, 355, 395, and 420 nm which are attributed to tryptophan, collagen, and NADH respectively. Using S3 technique one can obtain the key fluorophores in a single scan and hence they can be targeted as a tumor markers in this study. In order to quantify the altered spectral differences between normal and different pathological oral lesions are verified by different ratio parameters.

  20. Mechanisms of Breast Cancer in Shift Workers: DNA Methylation in Five Core Circadian Genes in Nurses Working Night Shifts.

    Science.gov (United States)

    Samulin Erdem, Johanna; Skare, Øivind; Petersen-Øverleir, Marte; Notø, Heidi Ødegaard; Lie, Jenny-Anne S; Reszka, Edyta; Pepłońska, Beata; Zienolddiny, Shanbeh

    2017-01-01

    Shift work has been suggested to be associated with breast cancer risk, and circadian disruption in shift workers is hypothesized as one of the mechanisms of increased cancer risk. There is, however, insufficient molecular evidence supporting this hypothesis. Using the quantitative methodology of pyrosequencing, epigenetic changes in 5-methyl cytosine (5mC) in five circadian genes CLOCK , BMAL1 , CRY1, PER1 and PER2 in female nurses working night shift work (278 breast cancer cases, 280 controls) were analyzed. In breast cancer cases, a medium exposure to night work was associated with increased methylation levels of the CLOCK (p=0.050), BMAL1 (p=0.001) and CRY1 (p=0.040) genes, compared with controls. Within the cases, analysis of the effects of shift work on the methylation patterns showed that methylation of CRY1 was lower in those who had worked night shift and had a high exposure (p=0.006) compared with cases that had worked only days. For cases with a medium exposure to night work, an increase in BMAL1 (p=0.003) and PER1 (p=0.035) methylation was observed compared with day working (unexposed) cases. The methylation levels of the five core circadian genes were also analyzed in relation to the estrogen and progesterone receptors status of the tumors in the cases, and no correlations were observed. Furthermore, nineteen polymorphisms in the five circadian genes were assessed for their effects on the methylation levels of the respective genes, but no associations were found. In summary, our data suggest that epigenetic regulation of CLOCK , BMAL1, CRY1 and PER1 may contribute to breast cancer in shift workers.

  1. Sleep duration as a mediator between an alternating day and night shift work schedule and metabolic syndrome among female hospital employees.

    Science.gov (United States)

    Korsiak, Jill; Tranmer, Joan; Day, Andrew; Aronson, Kristan J

    2018-02-01

    The main objective was to determine whether sleep duration on work shifts mediates the relationship between a current alternating day and night shift work schedule and metabolic syndrome among female hospital employees. The secondary objective was to assess whether cumulative lifetime shift work exposure was associated with metabolic syndrome. In this cross-sectional study of 294 female hospital employees, sleep duration was measured with the ActiGraph GT3X+. Shift work status was determined through self-report. Investigation of the total, direct and indirect effects between shift work, sleep duration on work shifts and metabolic syndrome was conducted using regression path analysis. Logistic regression was used to determine the association between cumulative shift work exposure and metabolic syndrome. Shift work is strongly associated with metabolic syndrome (OR Total =2.72, 95% CI 1.38 to 5.36), and the relationship is attenuated when work shift sleep duration is added to the model (OR Direct =1.18, 95% CI 0.49 to 2.89). Sleep duration is an important intermediate between shift work and metabolic syndrome (OR Indirect =2.25, 95% CI 1.27 to 4.26). Cumulative shift work exposure is not associated with metabolic syndrome in this population. Sleep duration mediates the association between a current alternating day-night shift work pattern and metabolic syndrome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Effects of requested, forced and denied shift schedule change on work ability and health of nurses in Europe -results from the European NEXT-Study.

    Science.gov (United States)

    Galatsch, Michael; Li, Jian; Derycke, Hanne; Müller, Bernd Hans; Hasselhorn, Hans Martin

    2013-12-05

    Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and - to somewhat lesser extent - health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable preventive tool to promote nurses' work ability and - to lesser extent - their perceived health, not least in aging nursing work forces.

  3. Night-shift work and breast cancer risk in a cohort of Chinese women.

    Science.gov (United States)

    Pronk, Anjoeka; Ji, Bu-Tian; Shu, Xiao-Ou; Xue, Shouzheng; Yang, Gong; Li, Hong-Lan; Rothman, Nathaniel; Gao, Yu-Tang; Zheng, Wei; Chow, Wong-Ho

    2010-05-01

    Shift work involving disruption of circadian rhythms has been classified as a probable cause of human cancer by the International Agency for Research on Cancer, based on limited epidemiologic evidence and abundant experimental evidence. The authors investigated this association in a population-based prospective cohort study of Chinese women. At baseline (1996-2000), information on lifetime occupational history was obtained from 73,049 women. Lifetime night-shift exposure indices were created using a job exposure matrix. During 2002-2004, self-reported data on frequency and duration of night-shift work were collected. Hazard ratios and 95% confidence intervals, adjusted for major breast cancer risk factors, were calculated. During follow-up through 2007, 717 incident cases of breast cancer were diagnosed. Breast cancer risk was not associated with ever working the night shift on the basis of the job exposure matrix (adjusted hazard ratio = 1.0, 95% confidence interval: 0.9, 1.2) or self-reported history of night-shift work (adjusted hazard ratio = 0.9, 95% confidence interval: 0.7, 1.1). Risk was also not associated with frequency, duration, or cumulative amount of night-shift work. There were no indications of effect modification. The lack of an association between night-shift work and breast cancer adds to the inconsistent epidemiologic evidence. It may be premature to consider shift work a cause of cancer.

  4. A shorter fractionation schedule for postlumpectomy breast cancer patients

    International Nuclear Information System (INIS)

    Shelley, Wendy; Brundage, Michael; Hayter, Charles; Paszat, Lawrence; Zhou, Sam; Mackillop, William

    2000-01-01

    Purpose: The purpose of this retrospective review was to determine the effectiveness of 40 Gy in 16 daily fractions in preventing local recurrence in postlumpectomy invasive breast cancer patients whose margins of resection were clear of tumor by at least 2 mm. Methods: Between September 1989 and December 1993, 294 breasts were treated with this regimen. The entire breast was treated, using a tangential parallel pair, with wedges as necessary, to a dose of 40 Gy in 16 daily fractions. No additional boost was given. The median duration of follow-up of surviving patients is 5.5 years. Recently, the patients' assessment of the cosmetic outcome of their treatment was obtained, using a mailed questionnaire. Results: The 5-year actuarial breast-relapse rate was 3.5%, with an overall 5-year survival and disease-specific survival of 87.8% and 92.1%, respectively. In response to the cosmesis questionnaire, 77% of patients stated they were either extremely or very satisfied with the overall appearance of the breast, 19.5% moderately satisfied, and 3.5% either slightly or not at all satisfied. The corresponding responses for overall level of comfort of the breast were 79%, 16.5%, and 4.5% respectively. Conclusion: This regimen is very effective at preventing recurrent breast cancer in this group of patients, and it provides a high level of patient satisfaction with cosmetic outcome. Its short duration offers the added advantage of a more efficient use of resources and greater patient convenience

  5. Chronological shifts and changing causes of death after radiotherapy for early-stage oral cancer.

    Science.gov (United States)

    Fujisawa, Rina; Shibuya, Hitoshi; Harata, Naoki; Yuasa-Nakagawa, Keiko; Toda, Kazuma; Hayashi, Keiji

    2014-02-01

    Following recent improvements in the curability of oral cancer, chronological shifts and changes in the causes of death after treatment have been observed. We conducted a review of the post-treatment causes of death following radiotherapy for oral cancers. The medical records of 966 patients with early-stage (stage I and II) oral cancer treated at our institute between 1980 and 2001 were reviewed, and the chronological shifts and changes in the causes of death after radiotherapy were assessed. Of the 966 patients enrolled in this study, 365 have died to date. Two hundred and eleven patients died of their primary malignancy; 193 of these deaths occurred within 5 years of treatment for the primary oral cancer. The second most frequent cause of death was second primary cancer (n = 90). Twenty-three patients with head and neck cancers and 18 patients with esophageal cancers died within 10 years of radiotherapy, and six patients with lung cancers died after more than 10 years. Within the first 5 years following treatment, the major cause of death was the primary oral cancer. After 5-10 years, a second primary cancer, such as head and neck cancer or esophageal cancer, became the leading cause of death. Over a 10-year period, the proportion of deaths from a second primary cancer in the lung was significant. We have demonstrated that there are chronological shifts and changes in the causes of death following treatment for early-stage oral cancer.

  6. Factors associated with shift work disorder in nurses working with rapid-rotation schedules in Japan: the nurses' sleep health project.

    Science.gov (United States)

    Asaoka, Shoichi; Aritake, Sayaka; Komada, Yoko; Ozaki, Akiko; Odagiri, Yuko; Inoue, Shigeru; Shimomitsu, Teruichi; Inoue, Yuichi

    2013-05-01

    Workers who meet the criteria for shift work disorder (SWD) have elevated levels of risk for various health and behavioral problems. However, the impact of having SWD on shiftworkers engaged in rapid-rotation schedules is unknown. Moreover, the risk factors for the occurrence of SWD remain unclear. To clarify these issues, we conducted a questionnaire-based, cross-sectional survey on a sample of shiftworking nurses. Responses were obtained from 1202 nurses working at university hospitals in Tokyo, Japan, including 727 two-shift workers and 315 three-shift workers. The questionnaire included items relevant to age, gender, family structure, work environment, health-related quality of life (QOL), diurnal type, depressive symptoms, and SWD. Participants who reported insomnia and/or excessive sleepiness for at least 1 mo that was subjectively relevant to their shiftwork schedules were categorized as having SWD. The prevalence of SWD in the sampled shiftworking nurses was 24.4%; shiftworking nurses with SWD showed lower health-related QOL and more severe depressive symptoms, with greater rates of both actual accidents/errors and near misses, than those without SWD. The results of logistic regression analyses showed that more time spent working at night, frequent missing of nap opportunities during night work, and having an eveningness-oriented chronotype were significantly associated with SWD. The present study indicated that SWD might be associated with reduced health-related QOL and decreased work performance in shiftworking nurses on rapid-rotation schedules. The results also suggested that missing napping opportunities during night work, long nighttime working hours, and the delay of circadian rhythms are associated with the occurrence of SWD among shiftworking nurses on rapid-rotation schedules.

  7. Radical radiotherapy for invasive bladder cancer: What dose and fractionation schedule to choose?

    International Nuclear Information System (INIS)

    Pos, Floris J.; Hart, Guus; Schneider, Christoph; Sminia, Peter

    2006-01-01

    Purpose: To establish the α/β ratio of bladder cancer from different radiotherapy schedules reported in the literature and provide guidelines for the design of new treatment schemes. Methods and Materials: Ten external beam radiotherapy (EBRT) and five brachytherapy schedules were selected. The biologically effective dose (BED) of each schedule was calculated. Logistic modeling was used to describe the relationship between 3-year local control (LC3y) and BED. Results: The estimated α/β ratio was 13 Gy (95% confidence interval [CI], 2.5-69 Gy) for EBRT and 24 Gy (95% CI, 1.3-460 Gy) for EBRT and brachytherapy combined. There is evidence for an overall dose-response relationship. After an increase in total dose of 10 Gy, the odds of LC3y increase by a factor of 1.44 (95% CI, 1.23-1.70) for EBRT and 1.47 (95% CI, 1.25-1.72) for the data sets of EBRT and brachytherapy combined. Conclusion: With the clinical data currently available, a reliable estimation of the α/β ratio for bladder cancer is not feasible. It seems reasonable to use a conventional α/β ratio of 10-15 Gy. Dose escalation could significantly increase local control. There is no evidence to support short overall treatment times or large fraction sizes in radiotherapy for bladder cancer

  8. Kidney cancer progression linked to shifts in tumor metabolism

    Science.gov (United States)

    Investigators in The Cancer Genome Atlas Research Network have uncovered a connection between how tumor cells use energy from metabolic processes and the aggressiveness of the most common form of kidney cancer, clear cell renal cell carcinoma.

  9. Cancer research in need of a scientific revolution: Using 'paradigm shift' as a method of investigation.

    Science.gov (United States)

    Wion, Didier; Appaix, Florence; Burruss, Meriwether; Berger, Francois; van der Sanden, Boudewijn

    2015-09-01

    Despite important human and financial resources and considerable accumulation of scientific publications, patents, and clinical trials, cancer research has been slow in achieving a therapeutic revolution similar to the one that occurred in the last century for infectious diseases. It has been proposed that science proceeds not only by accumulating data but also through paradigm shifts. Here, we propose to use the concept of 'paradigm shift' as a method of investigation when dominant paradigms fail to achieve their promises. The first step in using the 'paradigm shift' method in cancer research requires identifying its founding paradigms. In this review, two of these founding paradigms will be discussed: (i) the reification of cancer as a tumour mass and (ii) the translation of the concepts issued from infectious disease in cancer research. We show how these founding paradigms can generate biases that lead to over-diagnosis and over-treatment and also hamper the development of curative cancer therapies. We apply the 'paradigm shift' method to produce perspective reversals consistent with current experimental evidence. The 'paradigm shift' method enlightens the existence of a tumour physiologic-prophylactic-pathologic continuum. It integrates the target/antitarget concept and that cancer is also an extracellular disease. The 'paradigm shift' method has immediate implications for cancer prevention and therapy. It could be a general method of investigation for other diseases awaiting therapy.

  10. Association between shift work and the risk of death from biliary tract cancer in Japanese men.

    Science.gov (United States)

    Lin, Yingsong; Nishiyama, Takeshi; Kurosawa, Michiko; Tamakoshi, Akiko; Kubo, Tatsuhiko; Fujino, Yoshihisa; Kikuchi, Shogo

    2015-10-21

    There is increasing evidence suggesting that shift work involving night work may increase cancer risk. We examined the association between working rotating shifts and the risk of death from biliary tract cancer among Japanese men who participated in the Japan Collaborative Cohort Study. Of the 46,395 men recruited, 22,224 men aged 40-65 at baseline (1988-1990) who reported working full-time or were self-employed were included in the present analysis. The study subjects were followed through December 31, 2009. Information regarding occupation and lifestyle factors was collected using a self-administered questionnaire. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95 % confidence interval (CI) for the risk of death from biliary tract cancer in relation to shift work. During a mean 17-year follow-up, we observed 94 biliary tract cancer deaths, including 23 deaths from gallbladder cancer and 71 deaths from extrahepatic bile duct cancer. Overall, shift work was associated with a statistically non-significant increase in the risk of biliary tract cancer, with an HR of 1.50 (95 % CI: 0.81-2.77), among rotating shift workers. When the analysis was limited to extrahepatic bile duct cancer, a significant association appeared, with a multivariable-adjusted HR of 1.93 (95 % CI: 1.00-3.72) for rotating shift workers. Our data indicate that shift work may be associated with increased risk of death from extrahepatic bile duct cancer in this cohort of Japanese men. The association with gallbladder cancer remains unclear because of the small number of deaths.

  11. Night shift work and stomach cancer risk in the MCC-Spain study.

    Science.gov (United States)

    Gyarmati, Georgina; Turner, Michelle C; Castaño-Vinyals, Gemma; Espinosa, Ana; Papantoniou, Kyriaki; Alguacil, Juan; Costas, Laura; Pérez-Gómez, Beatriz; Martin Sanchez, Vicente; Ardanaz, Eva; Moreno, Victor; Gómez-Acebo, Inés; Fernández-Tardon, Guillermo; Villanueva Ballester, Vicent; Capelo, Rocio; Chirlaque, Maria-Dolores; Santibáñez, Miguel; Pollán, Marina; Aragonés, Nuria; Kogevinas, Manolis

    2016-08-01

    Night shift work has been classified as a probable human carcinogen by the International Agency for Research on Cancer, based on experimental studies and limited evidence on human breast cancer risk. Evidence at other cancer sites is scarce. We evaluated the association between night shift work and stomach cancer risk in a population-based case-control study. A total of 374 incident stomach adenocarcinoma cases and 2481 population controls were included from the MCC-Spain study. Detailed data on lifetime night shift work were collected including permanent and rotating shifts, and their cumulative duration (years). Adjusted unconditional logistic regression models were used in analysis. A total of 25.7% of cases and 22.5% of controls reported ever being a night shift worker. There was a weak positive, non-significant association between ever having had worked for at least 1 year in permanent night shifts and stomach cancer risk compared to never having worked night shifts (OR=1.2, 95% CI 0.9 to 1.8). However, there was an inverse 'U' shaped relationship with cumulative duration of permanent night shifts, with the highest risk observed in the intermediate duration category (OR 10-20 years=2.0, 95% CI 1.1 to 3.6) (p for trend=0.19). There was no association with ever having had worked in rotating night shifts (OR=0.9, 95% CI 0.6 to 1.2) and no trend according to cumulative duration (p for trend=0.68). We found no clear evidence concerning an association between night shift work and stomach cancer risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Night-Shift Work and Breast Cancer Risk in a Cohort of Chinese Women

    OpenAIRE

    Pronk, Anjoeka; Ji, Bu-Tian; Shu, Xiao-Ou; Xue, Shouzheng; Yang, Gong; Li, Hong-Lan; Rothman, Nathaniel; Gao, Yu-Tang; Zheng, Wei; Chow, Wong-Ho

    2010-01-01

    Shift work involving disruption of circadian rhythms has been classified as a probable cause of human cancer by the International Agency for Research on Cancer, based on limited epidemiologic evidence and abundant experimental evidence. The authors investigated this association in a population-based prospective cohort study of Chinese women. At baseline (1996–2000), information on lifetime occupational history was obtained from 73,049 women. Lifetime night-shift exposure indices were created ...

  13. Shift work, light at night, and the risk of breast cancer.

    Science.gov (United States)

    Reed, Virginia A

    2011-01-01

    Studies of the effect of shift work have identified several negative health outcomes, most notably breast cancer. Disruption of circadian rhythm by exposure to light at night has been identified as the mechanism likely responsible for this outcome. This article recommends that health care institutions work with occupational health nurses to develop and implement hazard communication and policies concerning shift work, exposure to light at night, and increased risk for negative health outcomes, particularly breast cancer. 2011, SLACK Incorporated.

  14. Short-term effects of night shift work on breast cancer risk

    DEFF Research Database (Denmark)

    Vistisen, H. T.; Garde, A. H.; Frydenberg, M.

    2017-01-01

    .80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography......Objectives: The objective was to examine if night shift work is a short-term risk factor for breast cancer, including combined estrogen receptor (ER) and human epidermal growth factor 2 (HER2) breast cancer subtypes. Methods: The cohort comprised 155 540 public sector female workers in Denmark who...... were followed from 2007-2012. Day-to-day work-hour information was available from payroll registers and 1245 incident cases of breast cancer were identified in national cancer registries together with receptor subtype information. Results: A rate ratio (RR) of 0.90 [95% confidence interval (95% CI) 0...

  15. Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up

    Directory of Open Access Journals (Sweden)

    Suzanne L. Merkus

    2015-09-01

    Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1st day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

  16. Discontinuous Schedule of Bevacizumab in Colorectal Cancer Induces Accelerated Tumor Growth and Phenotypic Changes

    Directory of Open Access Journals (Sweden)

    Selma Becherirat

    2018-04-01

    Full Text Available Antiangiogenics administration in colorectal cancer patients seemed promising therapeutic approach. Inspite of early encouraging results, it however gave only modest clinical benefits. When AAG was administered with discontinuous schedule, the disease showed acceleration in certain cases. Though resistance to AAG has been extensively studied, it is not documented for discontinuous schedules. To simulate clinical situations, we subjected a patient-derived CRC subcutaneous xenograft in mice to three different protocols: 1 AAG (bevacizumab treatment for 30 days (group A (group B was the control, 2 bevacizumab treatment for 50 days (group C and bevacizumab for 30 days and 20 without treatment (group D, and 3 bevacizumab treatment for 70 days (group E and 70 days treatment with a drug-break period between day 30 and 50 (group F. The tumor growth was monitored, and at sacrifice, the vascularity of tumors was measured and the proangiogenic factors quantified. Tumor phenotype was studied by quantifying cancer stem cells. Interrupting bevacizumab during treatment accelerated tumor growth and revascularization. A significant increase of proangiogenic factors was observed when therapy was stopped. On withdrawal of bevacizumab, as also after the drug-break period, the plasmatic VEGF increased significantly. Similarly, a notable increase of CSCs after the withdrawal and drug-break period of bevacizumab was observed (P<.01. The present study indicates that bevacizumab treatment needs to be maintained because discontinuous schedules tend to trigger tumor regrowth, and increase tumor resistance and CSC heterogeneity.

  17. Night-shift work and breast cancer risk in a cohort of Chinese women

    NARCIS (Netherlands)

    Pronk, A.; Ji, B.T.; Shu, X.O.; Xue, S.; Yang, G.; Li, H.L.; Rothman, N.; Gao, Y.T.; Zheng, W.; Chow, W.H.

    2010-01-01

    Shift work involving disruption of circadian rhythms has been classified as a probable cause of human cancer by the International Agency for Research on Cancer, based on limited epidemiologic evidence and abundant experimental evidence. The authors investigated this association in a population-based

  18. Drug scheduling of cancer chemotherapy based on natural actor-critic approach.

    Science.gov (United States)

    Ahn, Inkyung; Park, Jooyoung

    2011-11-01

    Recently, reinforcement learning methods have drawn significant interests in the area of artificial intelligence, and have been successfully applied to various decision-making problems. In this paper, we study the applicability of the NAC (natural actor-critic) approach, a state-of-the-art reinforcement learning method, to the drug scheduling of cancer chemotherapy for an ODE (ordinary differential equation)-based tumor growth model. ODE-based cancer dynamics modeling is an active research area, and many different mathematical models have been proposed. Among these, we use the model proposed by de Pillis and Radunskaya (2003), which considers the growth of tumor cells and their interaction with normal cells and immune cells. The NAC approach is applied to this ODE model with the goal of minimizing the tumor cell population and the drug amount while maintaining the adequate population levels of normal cells and immune cells. In the framework of the NAC approach, the drug dose is regarded as the control input, and the reward signal is defined as a function of the control input and the cell populations of tumor cells, normal cells, and immune cells. According to the control policy found by the NAC approach, effective drug scheduling in cancer chemotherapy for the considered scenarios has turned out to be close to the strategy of continuing drug injection from the beginning until an appropriate time. Also, simulation results showed that the NAC approach can yield better performance than conventional pulsed chemotherapy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules

    International Nuclear Information System (INIS)

    Park, Shin Hyung; Kim, Jae Chul

    2016-01-01

    The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45–50 Gy in 25–28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer

  20. Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules

    Energy Technology Data Exchange (ETDEWEB)

    Park, Shin Hyung; Kim, Jae Chul [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45–50 Gy in 25–28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.

  1. Associations Among Rotating Night Shift Work, Sleep, and Skin Cancer in Nurses’ Health Study II Participants

    Science.gov (United States)

    Heckman, Carolyn J.; Kloss, Jacqueline D.; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S.

    2016-01-01

    Background Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (e.g., sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. Methods The current study used data from 74,323 Nurses’ Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for skin cancers across categories of shift work and sleep duration. Results Over 10 years of follow-up, 4308 BCC, 334 SCC and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI: 0.90-0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI: 0.86-1.21) or SCC (HR=0.92, 95% CI: 0.80-1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI: 0.46-0.98) and BCC (HR=0.93, 95% CI: 0.86-1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI: 0.83-1.06). Conclusions Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. PMID:27663986

  2. Immunotherapy for head and neck cancer patients: shifting the balance

    NARCIS (Netherlands)

    Turksma, A.W.; Braakhuis, B.J.M.; Bloemena, E.; Meijer, C.J.L.M.; Leemans, C.R.; Hooijberg, E.

    2013-01-01

    Head and neck squamous cell carcinoma is the sixth most common cancer in the western world. Over the last few decades little improvement has been made to increase the relatively low 5-year survival rate. This calls for novel and improved therapies. Here, we describe opportunities in immunotherapy

  3. Work schedule and self-reported hypertension - the potential beneficial role of on-shift naps for night workers.

    Science.gov (United States)

    Rotenberg, Lúcia; Silva-Costa, Aline; Vasconcellos-Silva, Paulo Roberto; Griep, Rosane Härter

    2016-01-01

    Data on the association between shift work and hypertension are controversial. Sleep restriction is hypothesized to be involved in this relationship. Since on-shift nap can partly compensate for sleep deprivation among night workers, this investigation is aimed at (i) comparing the prevalence of hypertension among workers considering both current and former night work, (ii) testing the association between on-shift naps and hypertension among night workers, and (iii) analyzing the influence of sleep complaints in the association between on-shift nap and hypertension. Nap was defined as a sleep episode with duration shorter than the average nighttime sleep. A cross-sectional study was performed at the 18 largest public hospitals in Rio de Janeiro, Brazil, in 2010-2011 (N = 2588 female registered nurses). Nurses were informally allowed to nap for up to three consecutive hours during working nights. Workers completed a multidimensional questionnaire including self-reported information on physician diagnosis of hypertension, napping, and sleep complaints (insomnia, diurnal sleepiness, and non-satisfactory sleep). Epidemiological and statistical treatment of data included binomial logistic regression and interaction tests. Higher chances of hypertension were observed for both current and former night workers compared with workers with no previous experience in night work, i.e. exclusive day workers (OR = 1.68; CI95% 1.22-2.33 and OR = 1.40; CI95% 1.01-1.96, respectively) after adjustment for age, race/ethnicity, physical activity, smoking, alcohol consumption, insomnia, weekly work hours, and BMI. Compared with exclusive day workers, both non-nappers and nappers were at a higher likelihood of reporting hypertension (OR = 1.93 CI95% 1.35-2.79 and OR = 1.41 CI95% 1.08-2.20, respectively). An interaction was observed between napping behavior and insomnia (p = 0.037). In the whole sample of night workers, the lower OR for nappers was confirmed when they were directly

  4. Exosomes and Metabolic Function in Mice Exposed to Alternating Dark-Light Cycles Mimicking Night Shift Work Schedules

    Directory of Open Access Journals (Sweden)

    Abdelnaby Khalyfa

    2017-11-01

    Full Text Available Sleep is an important modulator of metabolic function. Disruptions of sleep in circadian rhythm are common in modern societies and are associated with increased risk of developing cardiometabolic disorders. Exosomes are ubiquitous extracellular vesicles that may play a mechanistic role in metabolic derangements. We hypothesized that alternating dark-light cycles mimicking shift work in mice would alter fecal microbiota and colonic epithelium permeability and alter plasma exosome cargo and metabolic function. C57BL/6 mice were randomly assigned to (i control day light (CL, or (ii inverted dark-light every 2 weeks for 8 weeks (IN. Body weight, fat mass and HOMA-IR were measured, along with Tregs, metabolic, and resident macrophages in visceral white adipose tissue (vWAT. Fecal water samples were incubated with confluent colonic epithelium cell cultures in electric cell-substrate impedance sensing (ECIS arrays, and plasma exosomes were added to differentiated adipocytes and insulin-induced pAKT/AKT expression changes were assessed by western blots. Mice exposed to IN showed elevated HOMA-IR, and their fecal samples showed altered microbiota which promote increased permeability of the colonic epithelial cell barrier. Plasma exosomes decreased pAKT/AKT responses to exogenous insulin compared to CL, and altered expression of circadian clock genes. Inflammatory macrophages (Ly-6chigh were increased in IN-exposed vWAT, while Tregs were decreased. Thus, gut microbiota and the cargo of plasma exosomes are altered by periodic shifts in environmental lighting, and effectively alter metabolic function, possibly via induction of systemic inflammation and altered clock expression in target tissues. Further exploration of exosomal miRNA signatures in shift workers and their putative metabolic organ cell targets appears warranted.

  5. Shift work and colorectal cancer risk in the MCC-Spain case-control study.

    Science.gov (United States)

    Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Turner, Michelle C; Alonso-Aguado, Maria Henar; Martin, Vicente; Aragonés, Nuria; Pérez-Gómez, Beatriz; Pozo, Benito Mirón; Gómez-Acebo, Inés; Ardanaz, Eva; Altzibar, Jone M; Peiro, Rosana; Tardon, Adonina; Lorca, José Andrés; Chirlaque, Maria Dolores; García-Palomo, Andrés; Jimenez-Moleon, Jose Juan; Ierssen, Trinidad; Ederra, Maria; Amiano, Pilar; Pollan, Marina; Moreno, Victor; Kogevinas, Manolis

    2017-05-01

    Objectives Shift work that involves circadian disruption has been associated with a higher cancer risk. Most epidemiological studies to date have focused on breast cancer risk and evidence for other common tumors is limited. We evaluated the risk for colorectal cancer (CRC) in relation to shift work history in a population-based case-control study in Spain. Methods This analysis included 1626 incident CRC cases and 3378 randomly selected population controls of both sexes, enrolled in 11 regions of Spain. Sociodemographic and lifestyle information was assessed in face-to-face interviews. Shift work was assessed in detail throughout lifetime occupational history. We estimated the risk of colon and rectal cancer associated with rotating and permanent shift work (ever, cumulative duration, age of first exposure) using unconditional logistic regression analysis adjusting for potential confounders. Results Having ever performed rotating shift work (morning, evening and/or night) was associated with an increased risk for CRC [odds ratio (OR) 1.22, 95% confidence interval (95% CI) 1.04-1.43], as compared to day workers. Having ever worked permanent night shifts (≥3 nights/month) was not associated with CRC risk (OR 0.79, 95% CI 0.62-1.00). OR increased with increasing lifetime cumulative duration of rotating shift work (P-value for trend 0.005) and were highest among subjects in the top quartiles of exposure (3 rd quartile, 20-34 years, OR 1.38, 95%CI 1.06-1.81; 4 th quartile, ≥35 years, OR 1.36, 95% CI 1.02-1.79). Conclusions These data suggest that rotating shift work may increase the risk of CRC especially after long-term exposures.

  6. Rotating Night-Shift Work and the Risk of Breast Cancer in the Nurses' Health Studies.

    Science.gov (United States)

    Wegrzyn, Lani R; Tamimi, Rulla M; Rosner, Bernard A; Brown, Susan B; Stevens, Richard G; Eliassen, A Heather; Laden, Francine; Willett, Walter C; Hankinson, Susan E; Schernhammer, Eva S

    2017-09-01

    In 2007, the International Agency for Research on Cancer declared shift work that involved circadian disruption to be a "probable" carcinogen (group 2A), noting that human evidence was limited. Using data from 2 prospective cohort studies, the Nurses' Health Study (1988-2012; n = 78,516) and Nurses' Health Study II (1989-2013; n = 114,559), we examined associations between rotating night-shift work and breast cancer risk. In the 2 cohorts, there were a total of 9,541 incident invasive breast malignancies and 24 years of follow-up. In the Nurses' Health Study, women with 30 years or more of shift work did not have a higher risk of breast cancer (hazard ratio (HR) = 0.95, 95% confidence interval (95% CI): 0.77, 1.17; P for trend = 0.63) compared with those who never did shift work, although follow-up occurred primarily after retirement from shift work. Among participants in the Nurses' Health Study II, who were younger than participants in the other cohort, the risk of breast cancer was significantly higher in women with 20 years or more of shift work at baseline, reflecting young-adult exposure (HR = 2.15, 95% CI: 1.23, 3.73; P for trend = 0.23), and was marginally significantly higher for women with 20 years or more of cumulative shift work when we used updated exposure information (HR = 1.40, 95% CI: 1.00, 1.97; P for trend = 0.74). In conclusion, long-term rotating night-shift work was associated with a higher risk of breast cancer, particularly among women who performed shift work during young adulthood. Further studies should explore the role of shift work timing on breast cancer risk. © The Author(s) 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. The shifting landscape of metastatic breast cancer to the CNS.

    Science.gov (United States)

    Quigley, Matthew R; Fukui, Olivia; Chew, Brandon; Bhatia, Sanjay; Karlovits, Steven

    2013-07-01

    The improved survival following the diagnosis of breast cancer has potentially altered the characteristics and course of patients presenting with CNS involvement. We therefore sought to define our current cohort of breast cancer patients with metastatic disease to the CNS in regard to modern biomarkers and clinical outcome. Review of clinical and radiographic records of women presenting to a tertiary medical center with the new diagnosis of CNS metastatic disease from breast cancer. This was a retrospective review from patients identities obtained from two prospective databases. There were 88 women analyzed who were treated over the period of January 2003 to February 2010, average age 56.9 years. At the time of initial presentation of CNS disease, 68 % of patients had multiple brain metastases, 17 % had a solitary metastasis, and 15 % had only leptomeningeal disease (LMD). The median survival for all patients from the time of diagnosis of breast disease was 50.0 months, and 9.7 months from diagnosis of CNS involvement. The only factor related to overall survival was estrogen receptor-positive pathology (57.6 v. 38.2 months, p = .02 log-rank); those related to survival post CNS diagnosis were presentation with LMD (p = .004, HR = 3.1, Cox regression) and triple-negative hormonal/HER2 status (p = .02, HR = 2.3, Cox regression). Patients with either had a median survival of 3.1 months (no patients in common). Of the 75 patients who initially presented with metastatic brain lesions, 20 (26 %) subsequently developed LMD in the course of their disease (median 10.4 months), following which survival was grim (1.8 months median). Symptoms of LMD were most commonly lower extremity weakness (14/33), followed by cranial nerve deficits (11/33). The recently described Graded Prognostic Assessment (GPA) tumor index stratified median survival at 2.5, 5.9, 13.1, and 21.7 months, respectively, for indices of 1-4 (p = .004, log-rank), which

  8. Night-shift work, sleep duration, daytime napping, and breast cancer risk.

    Science.gov (United States)

    Wang, Pan; Ren, Fang-Mei; Lin, Ying; Su, Feng-Xi; Jia, Wei-Hua; Su, Xue-Fen; Tang, Lu-Ying; Ren, Ze-Fang

    2015-04-01

    Sleep habits vary among different countries, and sleep problems may cause various health problems. The aim of our study was to evaluate the separate and combined associations of night-shift work, sleep duration, and daytime napping with breast cancer risk among the Chinese population. This study conducted face-to-face interviews with 712 women diagnosed with incident invasive breast cancer before treatment and 742 age-matched controls. Information on sleep habits, demographic characteristics, and suspected or established risk factors of breast cancer were collected from the two groups. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Night-shift work was associated with an increased risk of breast cancer [OR (95% CI): 1.34 (1.05-1.72)]. Compared to women with a sleep duration of 6.1-8.9 h/day, women who had shorter [(≤6.0 h/day) (OR (95% CI): 1.53 (1.10-2.12)] and longer (≥9.0 h/day) sleep duration [(OR (95% CI): 1.59 (1.17-2.17)] had an increased risk of breast cancer. In addition, daytime napping was associated with a reduced risk of breast cancer among night-shift workers [OR (95% CI): 0.57 (0.36-0.90)], but no association was found among women who never had night-shift work [OR (95% CI): 1.01 (0.75-1.35)] (P for interaction = 0.054). Night-shift work and longer sleep duration also synergistically increased breast cancer risk [OR (95% CI): 3.69 (1.94-7.02)] (P for interaction = 0.009). Sleep problems, including night-shift work, and shorter and longer sleep duration, are associated with an increased breast cancer risk. In particular, the combined effects of night-shift work with no daytime napping or longer sleep duration are greater than the independent effects. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Night shift work and prolactin as a breast cancer risk factor

    Directory of Open Access Journals (Sweden)

    Agnieszka Bukowska

    2013-04-01

    Full Text Available Prolactin - a hormone secreted in a circadian rhythm acts as a regulator of growth and development of the mammary glands. It has been observed that working at night increases breast cancer risk in women. Night shift work, probably carcinogenic to humans (Group 2A IARC, can disrupt a circadian rhythm, and thus potentially alter the rhythm of prolactin secretion. The aim of our work was to review epidemiological evidence on the association between prolactin and the risk of breast cancer and the influence of work at night on prolactin secretion. Search was done in the Medline database by keywords (shift work, work at night, risk of breast cancer and prolactin. The increased proliferation of breast cells activated by prolactin can promote the development of cancer. The results of the largest epidemiological prospective studies suggest the association between prolactin levels and the risk of breast cancer in women. So far, only seven studies have investigated the association between work at night and prolactin secretion. In three studies lower concentrations of prolactin have been observed in night shift workers. No relationship between the night shift work duration and prolactin level in women have been reported. Night shift work can modify the profile of prolactin secretion in night workers, probably decreasing the secretion of this hormone at night. It is therefore unlikely that prolactin plays an important role in the development of breast cancer in women working at night. This conclusion is based on the results of a few epidemiological studies. Med Pr 2013;64(2:245–257

  10. Fractionation and delivery schedules in combined radiotherapy-cisplatin for head and neck cancer

    International Nuclear Information System (INIS)

    Marcu, L.; Van Doorn, T.; Royal Adelaide Hospital,; Olver, I.

    2000-01-01

    Full text: Since Rosenberg's initial discovery, cisplatin has become one of the most effective anticancer drugs, with particular significance in head and neck cancer. For advanced disease, where the tumour is unresectable, radiotherapy and chemotherapy, either singularly or combined, remain the possible therapeutic modalities. The majority of the trials using a combination of cisplatin and radiation obtained much better results than the single-agent trials. But the best schedule, dosage and timing between radiation and drug administration are still unknown. Many positive steps were however made to eliminate the cisplatin-produced side effects, as much as possible. The tendency in current trials is to fractionate the drug dose by daily administration and also to hyperfractionate the radiation. In this way the long-term benefits are improved and the toxicity is better tolerated

  11. Considerations of circadian impact for defining 'shift work' in cancer studies: IARC Working Group Report

    NARCIS (Netherlands)

    Stevens, R.G.; Hansen, J.; Costa, G.; Haus, E.; Kauppinen, T.; Aronson, K.J.; Castaño-Vinyals, G.; Davis, S.; Frings-Dresen, M.H.W.; Fritschi, L.; Kogevinas, M.; Kogi, K.; Lie, J.A.; Lowden, A.; Peplonska, B.; Pesch, B.; Pukkala, E.; Schernhammer, E.; Travis, R.C.; Vermeulen, R.; Zheng, T.; Cogliano, V.; Straif, K.

    2011-01-01

    Based on the idea that electric light at night might account for a portion of the high and rising risk of breast cancer worldwide, it was predicted long ago that women working a non-day shift would be at higher risk compared with day-working women. This hypothesis has been extended more recently to

  12. Night shift work and lung cancer risk among female textile workers in Shanghai, China.

    Science.gov (United States)

    Kwon, Paul; Lundin, Jessica; Li, Wenjin; Ray, Roberta; Littell, Christopher; Gao, Daoli; Thomas, David B; Checkoway, Harvey

    2015-01-01

    In 2007, the International Agency for Research on Cancer classified shift work that involves circadian disruption as a probable human carcinogen. Suppression of the anti-neoplastic hormone, melatonin, is a presumed mechanism of action. We conducted a case-cohort study nested within a cohort of 267,400 female textile workers in Shanghai, China. Newly diagnosed lung cancer cases (n = 1451) identified during the study period (1989-2006) were compared with an age-stratified subcohort (n = 3040). Adjusting for age, smoking, parity, and endotoxin exposure, relative risks [hazard ratios (HRs)] were estimated by Cox regression modeling to assess associations with cumulative years and nights of rotating shift work. Results did not consistently reveal any increased risk of lung cancer among rotating shift work or statistically significant trends for both cumulative years (HR 0.82, 95% CI 0.66 to 1.02; P(trend) = 0.294) and nights (HR 0.81, 95% CI 0.65 to 1.00; P(trend) = 0.415). Further analyses imposing 10- and 20-year lag times for disease latency also revealed similar results. Contrary to the initial hypothesis, rotating nighttime shift work appears to be associated with a relatively reduced lung cancer risk although the magnitude of the effect was modest and not statistically significant.

  13. Breast cancer screening among shift workers: a nationwide population-based survey in Korea.

    Science.gov (United States)

    Son, Heesook; Kang, Youngmi

    2017-04-01

    We aimed to examine the association between shift work types and participation in breast cancer screening (BCS) programs by comparing rates of participation for BCS among regular daytime workers and alternative shift workers using data from a nationally representative, population-based survey conducted in Korea. In addition, the results were analyzed according to sociodemographic factors, including occupation, education, income, private health insurance, age, and number of working hours a week. This secondary cross-sectional analysis used data from the 2012 Korean National Health and Nutritional Examination Survey. The target population included women aged ≥ 40 years who responded as to whether they had undergone BCS in the previous year. Accordingly, we analyzed survey data for a total of 1,193 women and used a multivariate logistic regression analysis to evaluate the differences in factors affecting BCS between regular daytime and alternative shift workers. A logistic regression analysis was performed considering private health insurance as a significant sociodemographic factor for BCS among regular daytime shift workers. In contrast, none of the tested variables could significantly predict adherence to BCS among alternative shift workers. The results of this study suggest the need for the development of comprehensive workplace breast cancer prevention programs by considering shift work types. More attention should be given to female workers with low education levels, those who are uninsured, and young workers to improve the participation rate for BCS at the workplace.

  14. Night shift work and breast cancer risk: what do the meta-analyses tell us?

    Science.gov (United States)

    Pahwa, Manisha; Labrèche, France; Demers, Paul A

    2018-05-22

    Objectives This paper aims to compare results, assess the quality, and discuss the implications of recently published meta-analyses of night shift work and breast cancer risk. Methods A comprehensive search was conducted for meta-analyses published from 2007-2017 that included at least one pooled effect size (ES) for breast cancer associated with any night shift work exposure metric and were accompanied by a systematic literature review. Pooled ES from each meta-analysis were ascertained with a focus on ever/never exposure associations. Assessments of heterogeneity and publication bias were also extracted. The AMSTAR 2 checklist was used to evaluate quality. Results Seven meta-analyses, published from 2013-2016, collectively included 30 cohort and case-control studies spanning 1996-2016. Five meta-analyses reported pooled ES for ever/never night shift work exposure; these ranged from 0.99 [95% confidence interval (CI) 0.95-1.03, N=10 cohort studies) to 1.40 (95% CI 1.13-1.73, N=9 high quality studies). Estimates for duration, frequency, and cumulative night shift work exposure were scant and mostly not statistically significant. Meta-analyses of cohort, Asian, and more fully-adjusted studies generally resulted in lower pooled ES than case-control, European, American, or minimally-adjusted studies. Most reported statistically significant between-study heterogeneity. Publication bias was not evident in any of the meta-analyses. Only one meta-analysis was strong in critical quality domains. Conclusions Fairly consistent elevated pooled ES were found for ever/never night shift work and breast cancer risk, but results for other shift work exposure metrics were inconclusive. Future evaluations of shift work should incorporate high quality meta-analyses that better appraise individual study quality.

  15. Night-shift work and breast cancer--a systematic review and meta-analysis.

    Science.gov (United States)

    Ijaz, Sharea; Verbeek, Jos; Seidler, Andreas; Lindbohm, Marja-Liisa; Ojajärvi, Anneli; Orsini, Nicola; Costa, Giovanni; Neuvonen, Kaisa

    2013-09-01

    The aim of this review was to synthesize the evidence on the potential relationship between nightshift work and breast cancer. We searched multiple databases for studies comparing women in shift work to those with no-shift work reporting incidence of breast cancer. We calculated incremental risk ratios (RR) per five years of night-shift work and per 300 night shift increases in exposure and combined these in a random effects dose-response meta-analysis. We assessed study quality in ten domains of bias. We identified 16 studies: 12 case-control and 4 cohort studies. There was a 9% risk increase per five years of night-shift work exposure in case-control studies [RR 1.09, 95% confidence interval (95% CI) 1.02-1.20; I (2) = 37%, 9 studies], but not in cohort studies (RR 1.01, 95% CI 0.97-1.05; I (2) = 53%, 3 studies). Heterogeneity was significant overall (I (2) = 55%, 12 studies). Results for 300 night shifts were similar (RR 1.04, 95% CI 1.00-1.10; I (2) = 58%, 8 studies). Sensitivity analysis using exposure transformations such as cubic splines, a fixed-effect model, or including only better quality studies did not change the results. None of the 16 studies had a low risk of bias, and 6 studies had a moderate risk. Based on the low quality of exposure data and the difference in effect by study design, our findings indicate insufficient evidence for a link between night-shift work and breast cancer. Objective prospective exposure measurement is needed in future studies.

  16. Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants.

    Science.gov (United States)

    Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S

    2017-03-01

    Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. The current study used data from 74 323 Nurses' Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration. Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06). Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  17. Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies

    OpenAIRE

    Travis, Ruth C.; Balkwill, Angela; Fensom, Georgina K.; Appleby, Paul N.; Reeves, Gillian K.; Wang, Xiao-Si; Roddam, Andrew W.; Gathani, Toral; Peto, Richard; Green, Jane; Key, Timothy J.; Beral, Valerie

    2016-01-01

    Background: It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence. Methods: Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions ...

  18. A New Model for Predicting Acute Mucosal Toxicity in Head-and-Neck Cancer Patients Undergoing Radiotherapy With Altered Schedules

    International Nuclear Information System (INIS)

    Strigari, Lidia; Pedicini, Piernicola; D’Andrea, Marco; Pinnarò, Paola; Marucci, Laura; Giordano, Carolina; Benassi, Marcello

    2012-01-01

    Purpose: One of the worst radiation-induced acute effects in treating head-and-neck (HN) cancer is grade 3 or higher acute (oral and pharyngeal) mucosal toxicity (AMT), caused by the killing/depletion of mucosa cells. Here we aim to testing a predictive model of the AMT in HN cancer patients receiving different radiotherapy schedules. Methods and Materials: Various radiotherapeutic schedules have been reviewed and classified as tolerable or intolerable based on AMT severity. A modified normal tissue complication probability (NTCP) model has been investigated to describe AMT data in radiotherapy regimens, both conventional and altered in dose and overall treatment time (OTT). We tested the hypothesis that such a model could also be applied to identify intolerable treatment and to predict AMT. This AMT NTCP model has been compared with other published predictive models to identify schedules that are either tolerable or intolerable. The area under the curve (AUC) was calculated for all models, assuming treatment tolerance as the gold standard. The correlation between AMT and the predicted toxicity rate was assessed by a Pearson correlation test. Results: The AMT NTCP model was able to distinguish between acceptable and intolerable schedules among the data available for the study (AUC = 0.84, 95% confidence interval = 0.75-0.92). In the equivalent dose at 2 Gy/fraction (EQD2) vs OTT space, the proposed model shows a trend similar to that of models proposed by other authors, but was superior in detecting some intolerable schedules. Moreover, it was able to predict the incidence of ≥G3 AMT. Conclusion: The proposed model is able to predict ≥G3 AMT after HN cancer radiotherapy, and could be useful for designing altered/hypofractionated schedules to reduce the incidence of AMT.

  19. Nested case-control study of night shift work and breast cancer risk among women in the Danish military.

    Science.gov (United States)

    Hansen, Johnni; Lassen, Christina F

    2012-08-01

    Growing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case-control study nested within a cohort of 18,551 female military employees born in 1929-1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference. The authors documented 218 cases of breast cancer (1990-2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression. Overall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02),with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers. The results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.

  20. Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins.

    Science.gov (United States)

    Dickerman, Barbra A; Markt, Sarah C; Koskenvuo, Markku; Hublin, Christer; Pukkala, Eero; Mucci, Lorelei A; Kaprio, Jaakko

    2016-11-01

    Sleep disruption and shift work have been associated with cancer risk, but epidemiologic evidence for prostate cancer remains limited. We aimed to prospectively investigate the association between midlife sleep- and circadian-related parameters and later prostate cancer risk and mortality in a population-based cohort of Finnish twins. Data were drawn from the Older Finnish Twin Cohort and included 11,370 twins followed from 1981 to 2012. Over the study period, 602 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between midlife sleep duration, sleep quality, chronotype, and shift work with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were employed to account for potential familial confounding. Compared to "definite morning" types, "somewhat evening" types had a significantly increased risk of prostate cancer (HR 1.3; 95 % CI 1.1, 1.6). Chronotype significantly modified the relationship between shift work and prostate cancer risk (p-interaction shift work and prostate cancer risk in the overall analyses and no significant association between any sleep- or circadian-related parameter and risk in co-twin analyses. Neither sleep- nor circadian-related parameters were significantly associated with prostate cancer-specific mortality. The association between sleep disruption, chronotype, and shift work with prostate cancer risk and mortality has never before been studied in a prospective study of male twins. Our findings suggest that chronotype may be associated with prostate cancer risk and modify the association between shift work and prostate cancer risk. Future studies of circadian disruption and prostate cancer should account for this individual-level characteristic.

  1. Transcriptomic alterations during ageing reflect the shift from cancer to degenerative diseases in the elderly.

    Science.gov (United States)

    Aramillo Irizar, Peer; Schäuble, Sascha; Esser, Daniela; Groth, Marco; Frahm, Christiane; Priebe, Steffen; Baumgart, Mario; Hartmann, Nils; Marthandan, Shiva; Menzel, Uwe; Müller, Julia; Schmidt, Silvio; Ast, Volker; Caliebe, Amke; König, Rainer; Krawczak, Michael; Ristow, Michael; Schuster, Stefan; Cellerino, Alessandro; Diekmann, Stephan; Englert, Christoph; Hemmerich, Peter; Sühnel, Jürgen; Guthke, Reinhard; Witte, Otto W; Platzer, Matthias; Ruppin, Eytan; Kaleta, Christoph

    2018-01-30

    Disease epidemiology during ageing shows a transition from cancer to degenerative chronic disorders as dominant contributors to mortality in the old. Nevertheless, it has remained unclear to what extent molecular signatures of ageing reflect this phenomenon. Here we report on the identification of a conserved transcriptomic signature of ageing based on gene expression data from four vertebrate species across four tissues. We find that ageing-associated transcriptomic changes follow trajectories similar to the transcriptional alterations observed in degenerative ageing diseases but are in opposite direction to the transcriptomic alterations observed in cancer. We confirm the existence of a similar antagonism on the genomic level, where a majority of shared risk alleles which increase the risk of cancer decrease the risk of chronic degenerative disorders and vice versa. These results reveal a fundamental trade-off between cancer and degenerative ageing diseases that sheds light on the pronounced shift in their epidemiology during ageing.

  2. Breast cancer risk and night shift work in a case-control study in a Spanish population.

    Science.gov (United States)

    Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Aragonés, Nuria; Pérez-Gómez, Beatriz; Ardanaz, Eva; Altzibar, Jone Miren; Sanchez, Vicente Martin; Gómez-Acebo, Inés; Llorca, Javier; Muñoz, David; Tardón, Adonina; Peiró, Rosana; Marcos-Gragera, Rafael; Pollan, Marina; Kogevinas, Manolis

    2016-09-01

    Epidemiologic and animal data indicate that night shift work might increase the risk for breast cancer. We evaluated the association of night work with different clinical types of breast cancer in a population based case-control study (MCC-Spain study) taking into account chronotype, an individual characteristic that may relate to night shift work adaptation. Lifetime occupational history was assessed by face-to-face interviews and shift work information was available for 1708 breast cancer cases and 1778 population controls from 10 Spanish regions, enrolled from 2008 to 2013. We evaluated three shift work domains, including shift work type (permanent vs rotating), lifetime cumulative duration and frequency. We estimated odds ratios (OR) for night work compared to day work using unconditional logistic regression models adjusting for confounders. Having ever worked permanent or rotating night shift was associated with an increased risk for breast cancer compared to day workers [odds ratio (OR) 1.18; 95 % CI 0.97, 1.43]. Chronotype was differentially associated with breast cancer depending on the duration of night shift work. Risk was higher in women with invasive tumors (OR 1.23; 95 % CI 1.00, 1.51) and for estrogen and progestagen positive tumors among premenopausal women (OR 1.44; 95 % CI 1.05, 1.99). Having ever performed night shift was associated with a small increased risk for breast cancer and especially in subgroups of women with particular hormone related characteristics.

  3. A Bile Duct Cancer Patient Whose Stent Shifted Significantly Over the Course of External Beam Radiotherapy

    International Nuclear Information System (INIS)

    Yun, Hyong Geun

    2011-01-01

    The author reports a bile duct cancer patient whose stent shifted significantly from right to left over the course of radiotherapy. The 80-year-old female patient had a short stature with thoracic kyphosis and mutiple spinal compression fractures. She was also emaciated and very lean. By comparing the weekly scanned computed tomography images, the author found her stent to have shifted by more than 4 cm from right to left over the course of external beam radiotherapy. The results of this case study suggest that for a very lean and emaciated kyphotic bile duct cancer patient, the possibility of large interfractional movement of the bile duct or stent during radiotherapy should be considered.

  4. The Air Traffic Controller Work-Shift Scheduling Problem in Spain from a Multiobjective Perspective: A Metaheuristic and Regular Expression-Based Approach

    Directory of Open Access Journals (Sweden)

    Faustino Tello

    2018-01-01

    Full Text Available We address an air traffic control operator (ATCo work-shift scheduling problem. We consider a multiple objective perspective where the number of ATCos is fixed in advance and a set of ATCo labor conditions have to be satisfied. The objectives deal with the ATCo work and rest periods and positions, the structure of the solution, the number of control center changes, or the distribution of the ATCo workloads. We propose a three-phase problem-solving methodology. In the first phase, a heuristic is used to derive infeasible initial solutions on the basis of templates. Then, a multiple independent run of the simulated annealing metaheuristic is conducted aimed at reaching feasible solutions in the second phase. Finally, a multiple independent simulated annealing run is again conducted from the initial feasible solutions to optimize the objective functions. To do this, we transform the multiple to single optimization problem by using the rank-order centroid function. In the search processes in phases 2 and 3, we use regular expressions to check the ATCo labor conditions in the visited solutions. This provides high testing speed. The proposed approach is illustrated using a real example, and the optimal solution which is reached outperforms an existing template-based reference solution.

  5. Gemcitabine and cisplatin in locally advanced and metastatic bladder cancer; 3- or 4-week schedule?

    DEFF Research Database (Denmark)

    Als, Anne Birgitte; Sengeløv, Lisa; Von Der Maase, Hans

    2008-01-01

    BACKGROUND: Chemotherapy with gemcitabine and cisplatin (GC) is an active regimen in advanced transitional cell carcinoma (TCC). Traditionally, GC has been administered as a 4-week schedule. However, an alternative 3-week schedule may be more feasible. Long-term survival data for the alternative 3......-week schedule and comparisons of the feasibility and toxicity between the two schedules have not previously been published. MATERIAL AND METHODS: We performed a retrospective analysis of patients with stage IV TCC, treated with GC by a standard 4-week or by an alternative 3-week schedule. RESULTS...

  6. Theoretical and Experimental Estimations of Volumetric Inductive Phase Shift in Breast Cancer Tissue

    Science.gov (United States)

    González, C. A.; Lozano, L. M.; Uscanga, M. C.; Silva, J. G.; Polo, S. M.

    2013-04-01

    Impedance measurements based on magnetic induction for breast cancer detection has been proposed in some studies. This study evaluates theoretical and experimentally the use of a non-invasive technique based on magnetic induction for detection of patho-physiological conditions in breast cancer tissue associated to its volumetric electrical conductivity changes through inductive phase shift measurements. An induction coils-breast 3D pixel model was designed and tested. The model involves two circular coils coaxially centered and a human breast volume centrally placed with respect to the coils. A time-harmonic numerical simulation study addressed the effects of frequency-dependent electrical properties of tumoral tissue on the volumetric inductive phase shift of the breast model measured with the circular coils as inductor and sensor elements. Experimentally; five female volunteer patients with infiltrating ductal carcinoma previously diagnosed by the radiology and oncology departments of the Specialty Clinic for Women of the Mexican Army were measured by an experimental inductive spectrometer and the use of an ergonomic inductor-sensor coil designed to estimate the volumetric inductive phase shift in human breast tissue. Theoretical and experimental inductive phase shift estimations were developed at four frequencies: 0.01, 0.1, 1 and 10 MHz. The theoretical estimations were qualitatively in agreement with the experimental findings. Important increments in volumetric inductive phase shift measurements were evident at 0.01MHz in theoretical and experimental observations. The results suggest that the tested technique has the potential to detect pathological conditions in breast tissue associated to cancer by non-invasive monitoring. Further complementary studies are warranted to confirm the observations.

  7. Contemporary management of locally advanced rectal cancer: Resolving issues, controversies and shifting paradigms.

    Science.gov (United States)

    Nacion, Aeris Jane D; Park, Youn Young; Kim, Nam Kyu

    2018-02-01

    Advancements in rectal cancer treatment have resulted in improvement only in locoregional control and have failed to address distant relapse, which is the predominant mode of treatment failure in rectal cancer. As the efficacy of conventional chemoradiotherapy (CRT) followed by total mesorectal excision (TME) reaches a plateau, the need for alternative strategies in locally advanced rectal cancer (LARC) has grown in relevance. Several novel strategies have been conceptualized to address this issue, including: 1) neoadjuvant induction and consolidation chemotherapy before CRT; 2) neoadjuvant chemotherapy alone to avoid the sequelae of radiation; and 3) nonoperative management for patients who achieved pathological or clinical complete response after CRT. This article explores the issues, recent advances and paradigm shifts in the management of LARC and emphasizes the need for a personalized treatment plan for each patient based on tumor stage, location, gene expression and quality of life.

  8. Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies.

    Science.gov (United States)

    Travis, Ruth C; Balkwill, Angela; Fensom, Georgina K; Appleby, Paul N; Reeves, Gillian K; Wang, Xiao-Si; Roddam, Andrew W; Gathani, Toral; Peto, Richard; Green, Jane; Key, Timothy J; Beral, Valerie

    2016-12-01

    It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence. Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions on shift work and were followed for incident cancer. Cox regression yielded multivariable-adjusted breast cancer incidence rate ratios (RRs) and 95% confidence intervals (CIs) for night shift work vs no night shift work, and likelihood ratio tests for interaction were used to assess heterogeneity. Our meta-analyses combined these and relative risks from the seven previously published prospective studies (1.4 million women in total), using inverse-variance weighted averages of the study-specific log RRs. In the Million Women Study, EPIC-Oxford, and UK Biobank, respectively, 673, 28, and 67 women who reported night shift work developed breast cancer, and the RRs for any vs no night shift work were 1.00 (95% CI = 0.92 to 1.08), 1.07 (95% CI = 0.71 to 1.62), and 0.78 (95% CI = 0.61 to 1.00). In the Million Women Study, the RR for 20 or more years of night shift work was 1.00 (95% CI = 0.81 to 1.23), with no statistically significant heterogeneity by sleep patterns or breast cancer risk factors. Our meta-analysis of all 10 prospective studies included 4660 breast cancers in women reporting night shift work; compared with other women, the combined relative risks were 0.99 (95% CI = 0.95 to 1.03) for any night shift work, 1.01 (95% CI = 0.93 to 1.10) for 20 or more years of night shift work, and 1.00 (95% CI = 0.87 to 1.14) for 30 or more years. The totality of the prospective evidence shows that night shift work, including long-term shift work, has little or no effect on

  9. Short-term effects of night shift work on breast cancer risk; a cohort study of payroll data

    DEFF Research Database (Denmark)

    Vistisen, Helene Tilma; Garde, Anne Helene; Frydenberg, Morten

    2017-01-01

    were followed from 2007-2012. Day-to-day work-hour information was available from payroll registers and 1245 incident cases of breast cancer were identified in national cancer registries together with receptor subtype information. Results: A rate ratio (RR) of 0.90 [95% confidence interval (95% CI) 0......Objectives: The objective was to examine if night shift work is a short-term risk factor for breast cancer, including combined estrogen receptor (ER) and human epidermal growth factor 2 (HER2) breast cancer subtypes. Methods: The cohort comprised 155 540 public sector female workers in Denmark who.......80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography...

  10. Shiftwork Scheduling for the 1990s.

    Science.gov (United States)

    Coleman, Richard M.

    1989-01-01

    The author discusses the problems of scheduling shift work, touching on such topics as employee desires, health requirements, and business needs. He presents a method for developing shift schedules that addresses these three areas. Implementation hints are also provided. (CH)

  11. Alternative Work Schedules: Definitions

    Science.gov (United States)

    Journal of the College and University Personnel Association, 1977

    1977-01-01

    The term "alternative work schedules" encompasses any variation of the requirement that all permanent employees in an organization or one shift of employees adhere to the same five-day, seven-to-eight-hour schedule. This article defines staggered hours, flexible working hours (flexitour and gliding time), compressed work week, the task system, and…

  12. Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data.

    Science.gov (United States)

    Vistisen, Helene Tilma; Garde, Anne Helene; Frydenberg, Morten; Christiansen, Peer; Hansen, Åse Marie; Andersen, Johnni; Bonde, Jens Peter E; Kolstad, Henrik A

    2017-01-01

    Objectives The objective was to examine if night shift work is a short-term risk factor for breast cancer, including combined estrogen receptor (ER) and human epidermal growth factor 2 (HER2) breast cancer subtypes. Methods The cohort comprised 155 540 public sector female workers in Denmark who were followed from 2007-2012. Day-to-day work-hour information was available from payroll registers and 1245 incident cases of breast cancer were identified in national cancer registries together with receptor subtype information. Results A rate ratio (RR) of 0.90 [95% confidence interval (95% CI) 0.80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography screening, and other potential confounders. Comparable results were seen for the inception population of employees with first recorded employment after 2007. Modestly increased RR were suggested for breast cancer subtypes characterized by a positive HER2 status irrespective of ER status. Conclusions These findings do not support an overall short-term effect of night shift work on breast cancer risk. Future studies should explore further the impact of HER2 status.

  13. A meta-analysis including dose-response relationship between night shift work and the risk of colorectal cancer.

    Science.gov (United States)

    Wang, Xiao; Ji, Alin; Zhu, Yi; Liang, Zhen; Wu, Jian; Li, Shiqi; Meng, Shuai; Zheng, Xiangyi; Xie, Liping

    2015-09-22

    A meta-analysis was conducted to quantitatively evaluate the correlation between night shift work and the risk of colorectal cancer. We searched for publications up to March 2015 using PubMed, Web of Science, Cochrane Library, EMBASE and the Chinese National Knowledge Infrastructure databases, and the references of the retrieved articles and relevant reviews were also checked. OR and 95% CI were used to assess the degree of the correlation between night shift work and risk of colorectal cancer via fixed- or random-effect models. A dose-response meta-analysis was performed as well. The pooled OR estimates of the included studies illustrated that night shift work was correlated with an increased risk of colorectal cancer (OR = 1.318, 95% CI 1.121-1.551). No evidence of publication bias was detected. In the dose-response analysis, the rate of colorectal cancer increased by 11% for every 5 years increased in night shift work (OR = 1.11, 95% CI 1.03-1.20). In conclusion, this meta-analysis indicated that night shift work was associated with an increased risk of colorectal cancer. Further researches should be conducted to confirm our findings and clarify the potential biological mechanisms.

  14. Shifting brachytherapy monotherapy case mix toward intermediate-risk prostate cancer.

    Science.gov (United States)

    Muralidhar, Vinayak; Mahal, Brandon A; Ziehr, David R; Chen, Yu-Wei; Nezolosky, Michelle D; Viswanathan, Vidya B; Beard, Clair J; Devlin, Phillip M; Martin, Neil E; Orio, Peter F; Nguyen, Paul L

    2015-01-01

    The relative use of brachytherapy (BT) for prostate cancer has declined in recent years. In this setting, we sought to determine whether the case mix of BT monotherapy-treated men has changed over time in terms of risk group composition. The Surveillance, Epidemiology, and End Results database was used to identify 30,939 patients diagnosed with prostate adenocarcinoma between 2004 and 2011 who received BT monotherapy. The case mix of BT monotherapy patients was calculated by patient risk group and year of diagnosis. Between 2004 and 2011, the use of BT monotherapy declined overall. The relative percentage of men undergoing BT with low-risk disease declined by 4.5%, whereas the relative percentage of patients with intermediate-risk disease increased by 4.7%. Non-white patients and those from poorer counties did not show shifts in the risk group makeup of BT monotherapy patients, whereas white patients and those from wealthier counties did. Although fewer patients with prostate cancer are undergoing BT monotherapy, men with intermediate-risk disease comprised a significantly larger portion of the BT case mix in 2011 compared with 2004. Future research efforts by brachytherapists should be directed toward improving BT technique, optimizing radiation doses, and obtaining long-term followup data for patients with intermediate-risk prostate cancer. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  15. Wives' Shift Work Schedules and Husbands' and Wives' Well-Being in Dual-Earner Couples with Children: A within-Couple Analysis

    Science.gov (United States)

    Chait Barnett, Rosalind; Gareis, Karen C.; Brennan, Robert T.

    2008-01-01

    In a sample of 55 dual-earner families with children aged 8 to 14 in which the mothers are registered nurses regularly working either day shifts (typically 7:00 a.m. to 3:00 p.m.) or evening shifts (typically 3:00 p.m. to 11:00 p.m.), we estimated the within-couple relationship between the wife's work variables (i.e., work shift, work hours, and…

  16. Prognostic relevance of sunitinib toxicities and comparison of continuous vs. intermittent sunitinib dosing schedule in metastatic renal cell cancer patients

    Directory of Open Access Journals (Sweden)

    Çetin Ordu

    2016-06-01

    Full Text Available Aim of the study : Sunitinib-related side effects may develop as a result of the pharmacokinetic pathway affects the of the drug. Material and methods : Data on mRCC patients were obtained from the hospital archives. Outcomes of patients were evaluated in terms of related prognostic factors, sunitinib adverse events during the treatment, and two different sunitinib dosing schedules. Results : Seventy patients diagnosed with mRCC and treated with sunitinib were analyzed for prognostic factors and survival rates. During the mean follow-up of 33.5 months, 38 (54% patients were alive and 32 (46% patients died. The median time of overall survival (OS and progression-free survival (PFS was 27 months (12–61 and 19 months (5–45, respectively. In univariate analysis, good prognostic risk group according to the Memorial Sloan-Kettering Cancer Center (MSKCC, hypothyroidism as sunitinib toxicity and patients on sunitinib treatment more than 1 year were favorable prognostic factors for OS. Leukopenia and fatigue as sunitinib toxicity were poor prognostic factors for OS. PFS and OS of the patients were not significantly different when we compared intermittent (4/2 vs. continuous treatment dosing schedules. Conclusions : As a result of this trial, having hypothyroidism as an adverse effect of sunitinib was a favorable prognostic factor for OS and PFS in mRCC patients. It was also found that 4/2 and continuous dosing schedules of sunitinib did not give rise to different outcomes in mRCC patients.

  17. A meta-analysis including dose-response relationship between night shift work and the risk of colorectal cancer

    OpenAIRE

    Wang, Xiao; Ji, Alin; Zhu, Yi; Liang, Zhen; Wu, Jian; Li, Shiqi; Meng, Shuai; Zheng, Xiangyi; Xie, Liping

    2015-01-01

    A meta-analysis was conducted to quantitatively evaluate the correlation between night shift work and the risk of colorectal cancer. We searched for publications up to March 2015 using PubMed, Web of Science, Cochrane Library, EMBASE and the Chinese National Knowledge Infrastructure databases, and the references of the retrieved articles and relevant reviews were also checked. OR and 95% CI were used to assess the degree of the correlation between night shift work and risk of colorectal cance...

  18. A meta-analysis on dose-response relationship between night shift work and the risk of breast cancer.

    Science.gov (United States)

    Wang, F; Yeung, K L; Chan, W C; Kwok, C C H; Leung, S L; Wu, C; Chan, E Y Y; Yu, I T S; Yang, X R; Tse, L A

    2013-11-01

    This study aimed to conduct a systematic review to sum up evidence of the associations between different aspects of night shift work and female breast cancer using a dose-response meta-analysis approach. We systematicly searched all cohort and case-control studies published in English on MEDLINE, Embase, PSYCInfo, APC Journal Club and Global Health, from January 1971 to May 2013. We extracted effect measures (relative risk, RR; odd ratio, OR; or hazard ratio, HR) from individual studies to generate pooled results using meta-analysis approaches. A log-linear dose-response regression model was used to evaluate the relationship between various indicators of exposure to night shift work and breast cancer risk. Downs and Black scale was applied to assess the methodological quality of included studies. Ten studies were included in the meta-analysis. A pooled adjusted relative risk for the association between 'ever exposed to night shift work' and breast cancer was 1.19 [95% confidence interval (CI) 1.05-1.35]. Further meta-analyses on dose-response relationship showed that every 5-year increase of exposure to night shift work would correspondingly enhance the risk of breast cancer of the female by 3% (pooled RR = 1.03, 95% CI 1.01-1.05; Pheterogeneity night shifts would result in a 13% (RR = 1.13, 95% CI 1.07-1.21; Pheterogeneity = 0.06) increase in breast cancer risk. This systematic review updated the evidence that a positive dose-response relationship is likely to present for breast cancer with increasing years of employment and cumulative shifts involved in the work.

  19. Scheduling delay in suspected cases of oral cancer Atraso de agendamento em casos suspeitos de câncer bucal

    Directory of Open Access Journals (Sweden)

    Luciana Meneses Souza

    2011-12-01

    Full Text Available The objective of the study was to evaluate scheduling delay of dental exams in the city of São Paulo of patients suspected of having oral cancer. A cross-sectional study was performed in which telephone conversations simulated clinical situations that represented two types of patients: one presenting symptoms suggestive of oral cancer (CA, and another one suggesting the need for prostheses (PR. The scheduling delay was evaluated by the days until an appointment for care; and among public offices, by type of schedule (emergency or routine. Negative binomial regression was used (95% statistical significance. Five hundred and seventy-five public and private dental offices participated in the study. The mean scheduling delay for the CA group was 2.88 days, and for the PR group, 4.34 days (p = 0.01. The mean scheduling delay was shorter in private dental offices (2.59 days than in offices that accepted health insurance (2.74 days (p = 0.01; the delay was shorter when performed by the dentist rather than by the dental assistant, 2.45 versus 4.21 days (p = 0.01. In public services, 69% of patients in the cancer group were sent to the emergency service. Dental services were accessible for scheduling clinical examinations among patients suspected of having oral cancer.O objetivo do estudo foi avaliar o atraso de agendamento de pacientes com suspeita de câncer bucal aos exames odontológicos na cidade de São Paulo. Realizou-se estudo transversal, em que conversações telefônicas simularam situações clínicas, representando dois tipos de pacientes-padrão: um com sintomas sugestivos de câncer bucal e outro com necessidade de prótese. O atraso do agendamento foi avaliado pelo tempo de agendamento para a consulta e, no caso de estabelecimentos públicos, pelo tipo de agendamento (rotina ou urgência. Utilizou-se regressão binomial negativa (95% de nível de significância. Participaram do estudo 575 estabelecimentos públicos e privados. O tempo m

  20. A retrospective cohort study of shift work and risk of cancer-specific mortality in German male chemical workers.

    Science.gov (United States)

    Yong, Mei; Nasterlack, Michael; Messerer, Peter; Oberlinner, Christoph; Lang, Stefan

    2014-02-01

    Human evidence of carcinogenicity concerning shift work is inconsistent. In a previous study, we observed no elevated risk of total mortality in shift workers followed up until the end of 2006. The present study aimed to investigate cancer-specific mortality, relative to shift work. The cohort consisted of male production workers (14,038 shift work and 17,105 day work), employed at BASF Ludwigshafen for at least 1 year between 1995 and 2005. Vital status was followed from 2000 to 2009. Cause-specific mortality was obtained from death certificates. Exposure to shift work was measured both as a dichotomous and continuous variable. While lifetime job history was not available, job duration in the company was derived from personal data, which was then categorized at the quartiles. Cox proportional hazard model was used to adjust for potential confounders, in which job duration was treated as a time-dependent covariate. Between 2000 and 2009, there were 513 and 549 deaths among rotating shift and day work employees, respectively. Risks of total and cancer-specific mortalities were marginally lower among shift workers when taking age at entry and job level into consideration and were statistically significantly lower when cigarette smoking, alcohol intake, job duration, and chronic disease prevalence at entry to follow-up were included as explanatory factors. With respect to mortality risks in relation to exposure duration, no increased risks were found in any of the exposure groups after full adjustment and there was no apparent trend suggesting an exposure-response relation with duration of shift work. The present analysis extends and confirms our previous finding of no excess risk of mortality associated with work in the shift system employed at BASF Ludwigshafen. More specifically, there is also no indication of an increased risk of mortality due to cancer.

  1. Response shift in the assessment of anxiety, depression and perceived health in urologic cancer patients: an individual perspective.

    Science.gov (United States)

    Hinz, A; Finck Barboza, C; Zenger, M; Singer, S; Schwalenberg, T; Stolzenburg, J-U

    2011-09-01

    The assessment of quality of life in cancer patients is hampered because patients may change their frames of reference during the course of the disease. The aim of this study was to test individual differences in these response shift effects. Urologic cancer patients (n= 275) were examined during the stay in the hospital (T1), 2 weeks later (T2) and 3 months later (T3). Furthermore, at T3 they were asked to retrospectively assess their situation at T1 (then-test). The difference between this retrospective assessment and the original assessment at T1 was used to determine the response shift effect (recalibration). Anxiety (Generalized Anxiety Disorder Questionnaire-2), depression (Patient Health Questionnaire-2) and health dissatisfaction (Questionnaire on Life Satisfaction) were obtained at all points in time. The effect sizes of the mean response shift effects (recalibration) ranged between 0.26 and 0.48. Nevertheless, a large proportion of the sample showed no response shift (22-38%) or even negative response shift effects (20-30%). There were significant correlations among the response shift measures of the domains (anxiety, depression and health dissatisfaction) with coefficients between 0.29 and 0.51. The results indicate that response shift should not only be assessed on the mean score level, since it is also a dimension of individual difference. © 2011 Blackwell Publishing Ltd.

  2. Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate Cancer

    Science.gov (United States)

    Dignam, James J.; Amin, Mahul B.; Bruner, Deborah W.; Low, Daniel; Swanson, Gregory P.; Shah, Amit B.; D’Souza, David P.; Michalski, Jeff M.; Dayes, Ian S.; Seaward, Samantha A.; Hall, William A.; Nguyen, Paul L.; Pisansky, Thomas M.; Faria, Sergio L.; Chen, Yuhchyau; Koontz, Bridget F.; Paulus, Rebecca; Sandler, Howard M.

    2016-01-01

    Purpose Conventional radiotherapy (C-RT) treatment schedules for patients with prostate cancer typically require 40 to 45 treatments that take place from > 8 to 9 weeks. Preclinical and clinical research suggest that hypofractionation—fewer treatments but at a higher dose per treatment—may produce similar outcomes. This trial was designed to assess whether the efficacy of a hypofractionated radiotherapy (H-RT) treatment schedule is no worse than a C-RT schedule in men with low-risk prostate cancer. Patients and Methods A total of 1,115 men with low-risk prostate cancer were randomly assigned 1:1 to C-RT (73.8 Gy in 41 fractions over 8.2 weeks) or to H-RT (70 Gy in 28 fractions over 5.6 weeks). This trial was designed to establish (with 90% power and an α of .05) that treatment with H-RT results in 5-year disease-free survival (DFS) that is not worse than C-RT by more than 7.65% (H-RT/C-RT hazard ratio [HR] < 1.52). Results A total of 1,092 men were protocol eligible and had follow-up information; 542 patients were assigned to C-RT and 550 to H-RT. Median follow-up was 5.8 years. Baseline characteristics were not different according to treatment assignment. The estimated 5-year DFS was 85.3% (95% CI, 81.9 to 88.1) in the C-RT arm and 86.3% (95% CI, 83.1 to 89.0) in the H-RT arm. The DFS HR was 0.85 (95% CI, 0.64 to 1.14), and the predefined noninferiority criterion that required that DFS outcomes be consistent with HR < 1.52 was met (P < .001). Late grade 2 and 3 GI and genitourinary adverse events were increased (HR, 1.31 to 1.59) in patients who were treated with H-RT. Conclusion In men with low-risk prostate cancer, the efficacy of 70 Gy in 28 fractions over 5.6 weeks is not inferior to 73.8 Gy in 41 fractions over 8.2 weeks, although an increase in late GI/genitourinary adverse events was observed in patients treated with H-RT. PMID:27044935

  3. Collagen Matrix Density Drives the Metabolic Shift in Breast Cancer Cells

    Directory of Open Access Journals (Sweden)

    Brett A. Morris

    2016-11-01

    Full Text Available Increased breast density attributed to collagen I deposition is associated with a 4–6 fold increased risk of developing breast cancer. Here, we assessed cellular metabolic reprogramming of mammary carcinoma cells in response to increased collagen matrix density using an in vitro 3D model. Our initial observations demonstrated changes in functional metabolism in both normal mammary epithelial cells and mammary carcinoma cells in response to changes in matrix density. Further, mammary carcinoma cells grown in high density collagen matrices displayed decreased oxygen consumption and glucose metabolism via the tricarboxylic acid (TCA cycle compared to cells cultured in low density matrices. Despite decreased glucose entry into the TCA cycle, levels of glucose uptake, cell viability, and ROS were not different between high and low density matrices. Interestingly, under high density conditions the contribution of glutamine as a fuel source to drive the TCA cycle was significantly enhanced. These alterations in functional metabolism mirrored significant changes in the expression of metabolic genes involved in glycolysis, oxidative phosphorylation, and the serine synthesis pathway. This study highlights the broad importance of the collagen microenvironment to cellular expression profiles, and shows that changes in density of the collagen microenvironment can modulate metabolic shifts of cancer cells.

  4. Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Koolen, B.B.; Aukema, T.S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Vrancken Peeters, M.J.T.F.D.; Rutgers, E.J.T. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Wesseling, J.; Lips, E.H. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Pathology and Experimental Therapy, Amsterdam (Netherlands); Vogel, W.V.; Valdes Olmos, R.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Werkhoven, E. van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Gilhuijs, K.G.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Rodenhuis, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)

    2012-12-15

    The aim of this study was to evaluate the association of primary tumour {sup 18}F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake. PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUV{sub max}). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses. In 203 tumours (95 %) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUV{sub max} was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUV{sub max}. Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. (orig.)

  5. Self-reported shift work, recall bias, and belief about disease causation in a case-control study of breast cancer.

    Science.gov (United States)

    Lizama, Natalia; Heyworth, Jane; Thomson, Allyson; Slevin, Terry; Fritschi, Lin

    2017-10-01

    Recall bias is a potential source of misclassification in case-control studies. Studies have shown that the association between exposure and disease can differ according to participants' beliefs or knowledge about the effect of that exposure on disease. We investigated the association between belief about breast cancer causation and self-reported shift work exposure in a case-control study. Women completed a questionnaire asking whether they believed that shift work caused cancer either before or after reporting their history of shift work. We measured: whether belief modified the association between reported shift work and disease; whether belief was associated with reported shift work exposure; and whether being prompted to recall shift work exposure was associated with an increased likelihood of believing that shift work increased breast cancer risk. There was a significant association between believing shift work increased breast cancer risk and reporting exposure to shift work. Being prompted to recall shift work was not associated with a belief that shift work increased risk. The association between pre-existing belief about breast cancer risk and reported shift work is likely to be due to exposed individuals believing that exposure increases risk, rather than resulting from recall bias. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Clinical implications in the shift of syndecan-1 expression from the cell membrane to the cytoplasm in bladder cancer

    International Nuclear Information System (INIS)

    Miyake, Makito; Lawton, Adrienne; Dai, Yunfeng; Chang, Myron; Mengual, Lourdes; Alcaraz, Antonio; Goodison, Steve; Rosser, Charles J

    2014-01-01

    To determine the diagnostic and prognostic capability of urinary and tumoral syndecan-1 (SDC-1) levels in patients with cancer of the urinary bladder. SDC-1 levels were quantitated by enzyme-linked immunosorbent assay (ELISA) in 308 subjects (102 cancer subjects and 206 non-cancer subjects) to assess its diagnostic capabilities in voided urine. The performance of SDC-1 was evaluated using the area under the curve of a receiver operating characteristic curve. In addition, immunohistochemical (IHC) staining assessed SDC-1 protein expression in 193 bladder specimens (185 cancer subjects and 8 non-cancer subjects). Outcomes were correlated to SDC-1 levels. Mean urinary levels of SDC-1 did not differ between the cancer subjects and the non-cancer subjects, however, the mean urinary levels of SDC-1 were reduced in high-grade compared to low-grade disease (p < 0.0001), and in muscle invasive bladder cancer (MIBC) compared to non-muscle invasive bladder cancer (NMIBC) (p = 0.005). Correspondingly, preliminary data note a shift from a membranous cellular localization of SDC-1 in normal tissue, low-grade tumors and NMIBC, to a distinctly cytoplasmic localization in high-grade tumors and MIBC was observed in tissue specimens. Alone urinary SDC-1 may not be a diagnostic biomarker for bladder cancer, but its urinary levels and cellular localization were associated with the differentiation status of patients with bladder tumors. Further studies are warranted to define the potential role for SDC-1 in bladder cancer progression

  7. Exploring the Response Shift Phenomenon in Childhood Patients With Cancer and Its Effect on Health-Related Quality of Life

    NARCIS (Netherlands)

    Brinksma, Aeltsje; Tissing, Wim J. E.; Sulkers, Esther; Kamps, Willem A.; Roodbol, Petrie F.; Sanderman, Robbert

    Purpose/Objectives: To explore the response shift phenomenon in pediatric patients with cancer and to determine its effects on ratings of health-related quality of life (HRQOL). Design: Retrospective pre- and post-test design. Setting: Pediatric oncology department in the northern part of the

  8. Schedule-dependent cytotoxic synergism of pemetrexed and erlotinib in BXPC-3 and PANC-1 human pancreatic cancer cells.

    Science.gov (United States)

    Wang, Lin; Zhu, Zhi-Xia; Zhang, Wen-Ying; Zhang, Wei-Min

    2011-09-01

    Previous studies have shown that both pemetrexed, a cytotoxic drug, and erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), inhibit the cell growth of pancreatic cancer cells. However, whether they exert a synergistic antitumor effect on pancreatic cancer cells remains unknown. The present study aimed to assess the synergistic effect of erlotinib in combination with pemetrexed using different sequential administration schedules on the proliferation of human pancreatic cancer BXPC-3 and PANC-1 cells and to probe its cellular mechanism. The EGFR and K-ras gene mutation status was examined by quantitative PCR high-resolution melting (qPCR-HRM) analysis. BXPC-3 and PANC-1 cells were incubated with pemetrexed and erlotinib using different administration schedules. MTT assay was used to determine cytotoxicity, and cell cycle distribution was determined by flow cytometry. The expression and phosphorylation of EGFR, HER3, AKT and MET were determined using Western blotting. Both pemetrexed and erlotinib inhibited the proliferation of BXPC-3 and PANC-1 cells in a dose- and time-dependent manner in vitro. Synergistic effects on cell proliferation were observed when pemetrexed was used in combination with erlotinib. The degree of the synergistic effects depended on the administration sequence, which was most obvious when erlotinib was sequentially administered at 24-h interval following pemetrexed. Cell cycle studies revealed that pemetrexed induced S arrest and erlotinib induced G(0)/G(1) arrest. The sequential administration of erlotinib following pemetrexed induced S arrest. Western blot analyses showed that pemetrexed increased and erlotinib decreased the phosphorylation of EGFR, HER3 and AKT, respectively. However, both pemetrexed and erlotinib exerted no significant effects on the phosphorylation of c-MET. The phosphorylation of EGFR, HER3 and AKT was significantly suppressed by scheduled incubation with pemetrexed followed by erlotinib

  9. Radiochemotherapy in Anal Cancer: cCR, clinical outcomes and quality of life using two different treatment schedules.

    Science.gov (United States)

    Di Santo, Sara; Trignani, Marianna; Neri, Matteo; Milano, Angelo; Innocenti, Paolo; Taraborrelli, Maria; Augurio, Antonietta; Vinciguerra, Annamaria; Di Tommaso, Monica; Ursini, Lucia Anna; Di Pilla, Angelo; Di Nicola, Marta; Genovesi, Domenico

    2015-01-01

    Main endpoint was a response rate to therapy; secondary endpoints were disease-free survival, overall survival, acute and late toxicities, specially in terms of anorectal and urinary continence. Radiochemotherapy for anal cancer achieves a good clinical response, locoregional control, anal function preservation. However, oncologic outcomes can differ using radiotherapy plus fluorouracil and mytomicin vs. cisplatin and fluorouracil. Between 2000 and 2012, 27 anal cancer patients receiving radiotherapy combined with two different radiochemotherapy schedules, fluorouracil and mytomicin (group A) and cisplatin plus fluorouracil (group B). The Kaplan-Meier method was also used to estimate local control, overall survival and disease free survival. Statistical significance between curves was evaluated using the Log-rank test. Complete pathological response was found in 85.2% of patients, with higher rates of response in the group A (100% vs. 63.6%, p = 0.039). No significantly difference was found between the two groups for the other endpoints. Low rates of both acute and late toxicities were recorded. Radiotherapy plus fluorouracil and mytomicin provide a better complete pathological response than radiotherapy plus cisplatin and fluorouracil and a greater rate of anal sphincter function preservation. Globally, radiochemotherapy of the anal cancer provides excellent clinical outcomes with a good profile of acute and late toxicity, without difference between the two groups studied.

  10. Association of shift-work, daytime napping, and nighttime sleep with cancer incidence and cancer-caused mortality in Dongfeng-tongji cohort study.

    Science.gov (United States)

    Bai, Yansen; Li, Xiaoliang; Wang, Ke; Chen, Shi; Wang, Suhan; Chen, Zhuowang; Wu, Xiulong; Fu, Wenshan; Wei, Sheng; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Zhang, Xiaomin; He, Meian; Yang, Handong; Wu, Tangchun; Guo, Huan

    2016-12-01

    Few studies investigated the combined effects of night-shift work, daytime napping, and nighttime sleep on cancer incidence and mortality. A total of 25,377 participants were included in this study. Information on sleep habits, cancer incidences, and mortalities were collected. Cox proportional hazards models were used to calculate the adjusted hazard ratios and 95% confidence intervals (HRs, 95%CIs). Male subjects experienced ≥20 years of night-shift work, or without daytime napping had an increased risk of cancer, when compared with males who did not have night-shift work or napped for 1-30 min [HR (95%CI) = 1.27 (1.01-1.59) and 2.03 (1.01-4.13), respectively]. Nighttime sleep for ≥10 h was associated with a separate 40% and 59% increased risk of cancer [HR (95%CI) = 1.40 (1.04-1.88)] and cancer-caused mortality [HR (95%CI) = 1.59 (1.01-2.49)] than sleep for 7-8 h/night. Combined effects of three sleep habits were further identified. Male participants with at least two above risk sleep habits had a 43% increased risk of cancer [HR (95%CI) = 1.43 (1.07-2.01)] and a 2.07-fold increased cancer-caused mortality [HR (95%CI) = 2.07 (1.25-3.29)] than those who did not have any above risk sleep habits. However, no significant associations were observed among women. Long night-shift work history, without daytime napping, and long nighttime sleep duration were independently and jointly associated with higher cancer incidence among males. KEY MESSAGES Night-shift work of ≥20 years, without napping, and nighttime sleep of ≥10 h were associated with increased cancer incidence. Nighttime sleep ≥10 h was associated with a 2.07-fold increased cancer-caused mortality among males. Combined effects of night-shift work ≥20 years, without napping, and nighttime sleep ≥10 h on increasing cancer incidence were existed among males.

  11. Night-shift work and hematological cancers: a population based case-control study in three Nordic countries.

    Science.gov (United States)

    Talibov, Madar; Pukkala, Eero; Martinsen, Jan Ivar; Tryggvadottir, Laufey; Weiderpass, Elisabete; Hansen, Johnni

    2018-05-01

    Objective The aim of this case-control study was to assess the effect of night-shift work on the risk of hematological cancers. Methods The study included 39 371 leukemia, 56 713 non-Hodgkin lymphoma, 9322 Hodgkin lymphoma, and 26 188 multiple myeloma cases diagnosed between 1961 and 2005 in Finland, Sweden, and Iceland. Five controls for each case were selected from the Nordic Occupational Cancer Study (NOCCA) cohort, matched by year of birth, sex and country. Night-shift exposure was assessed by using the NOCCA job-exposure matrix (JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated from conditional logistic regression models. Results Overall, night work was not associated with a risk of hematological cancers. We observed a small but non-significantly increased risk for leukemia (OR 1.07, 95% CI 0.99-1.16), especially for acute myeloid leukemia (OR 1.15, 95% CI 0.97-1.36) among workers exposed to a high level of cumulative night work exposure. Night work exposure was not associated with lymphatic cancers and multiple myeloma. Conclusion This study did not support associations between night-shift work and hematological cancers.

  12. A Timely shift from shotgun to targeted proteomics and how it can be groundbreaking for cancer research

    DEFF Research Database (Denmark)

    Faria, Sara S.; Morris, Carlos F.M.; Silva, Adriano R.

    2017-01-01

    shifting potential of modern targeted proteomics applied to cancer research can be demonstrated by the large number of advancements and increasing examples of new and more useful biomarkers found during the course of this review in different aspects of cancer research. Out of the many studies dedicated...... to cancer biomarker discovery, we were able to devise some clear trends, such as the fact that breast cancer is the most common type of tumor studied and that most of the research for any given type of cancer is focused on the discovery diagnostic biomarkers, with the exception of those that rely on samples...... applicable results have called for the implementation of more direct, hypothesis-based studies such as those made available through targeted approaches, that might be able to streamline biomarker discovery and validation as a means to increase survivability of affected patients. In fact, the paradigm...

  13. Vehicle and driver scheduling for public transit.

    Science.gov (United States)

    2009-08-01

    The problem of driver scheduling involves the construction of a legal set of shifts, including allowance : of overtime, which cover the blocks in a particular vehicle schedule. A shift is the work scheduled to be performed by : a driver in one day, w...

  14. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation.

    Science.gov (United States)

    Haus, Erhard L; Smolensky, Michael H

    2013-08-01

    Shift work that includes a nighttime rotation has become an unavoidable attribute of today's 24-h society. The related disruption of the human circadian time organization leads in the short-term to an array of jet-lag-like symptoms, and in the long-run it may contribute to weight gain/obesity, metabolic syndrome/type II diabetes, and cardiovascular disease. Epidemiologic studies also suggest increased cancer risk, especially for breast cancer, in night and rotating female shift workers. If confirmed in more controlled and detailed studies, the carcinogenic effect of night and shift work will constitute additional serious medical, economic, and social problems for a substantial proportion of the working population. Here, we examine the possible multiple and interconnected cancer-promoting mechanisms as a consequence of shift work, i.e., repeated disruption of the circadian system, pineal hormone melatonin suppression by exposure to light at night, sleep-deprivation-caused impairment of the immune system, plus metabolic changes favoring obesity and generation of proinflammatory reactive oxygen species. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Effect of 3D radiotherapy planning compared to 2D planning within a conventional treatment schedule of advanced lung cancer

    International Nuclear Information System (INIS)

    Schraube, P.; Spahn, U.; Oetzel, D.; Wannenmacher, M.

    2000-01-01

    Background: The effect of 3D radiotherapy planning (3D RTP) in comparison to 2D radiotherapy planning (2D RTP) was evaluated in a usually practiced treatment schedule (starting by v./d. opposing portals, continued with computer-planned portals) for non-small-cell lung cancer. Patients and Methods: In 20 patients with locally advanced non-small-cell lung cancer the computer-planned part of the treatment schedule was calculated 2- and 3-dimensionally. Target volume were the primary tumor, the involved and the electively irradiated mediastinal lymph nodes. The results of the 2D RTP were recalculated 3-dimensionally and the mean doses to target volume and organs at risk were defined. Further, the normal tissue complications were calculated. Results: Under the prerequisite of 44 Gy maximally allowed to the spinal cord and a dose to the reference point of 50 Gy a small, but significant advantage with 2.1 Gy to the target (p=0.004) and a reduction of 3.6 Gy to the heart (p=0.05) was achievable for 3D RTP. The dose to the lungs did not differ significantly (19.7 Gy for 2D RTP, 20.3 Gy for 3D RTP). The dose to the heart was not estimated critical by NTCP (normal tissue complication probability). The NTCP for the ipsilateral lung was 16.1 and 18.7% for 2D RTP and 3D RTP, respectively. Regarding the simulator-planned ap/pa fields at the start of the radiotherapy the advantage of 3D RTP was further reduced but remained significant. Favorable with respect to the mean lung dose and the NTCP (18.7% NTCP ipsilateral lung for early onset of 3D planned radiotherapy vs 31.7% for late onset of 3D planned radiotherapy) but not significantly measurable is the early start of the treatment by computerized RTP. Conclusion: The main advantage of 3D RTP in treatment of advanced lung cancer is the better coverage of the target volume. A reduction of the mean lung dose cannot be expected. A dose escalation by 3D RTP to target volumes as described here seems not to be possible because of

  16. Does Current Scientific Evidence Support a Link Between Light at Night and Breast Cancer Among Female Night-Shift Nurses?

    Science.gov (United States)

    Dickerman, Barbra; Liu, Jianghong

    2014-01-01

    Breast cancer is increasingly prevalent in industrialized regions of the world, and exposure to light at night (LAN) has been proposed as a potential risk factor. Epidemiological observations have documented an increased breast cancer risk among female night-shift workers, and strong experimental evidence for this relationship has also been found in rodent models. Indirect support for the LAN hypothesis comes from studies involving blind women, sleep duration, bedroom light levels, and community nighttime light levels. This article reviews the literature, discusses possible mechanisms of action, and provides recommendations for occupational health nursing research, practice, and education. Research is needed to further explore the relationship between exposure to LAN and breast cancer risk and elucidate the mechanisms underlying this relationship before interventions can be designed for prevention and mitigation of breast cancer. PMID:22658734

  17. Harmonious personnel scheduling

    NARCIS (Netherlands)

    Fijn van Draat, Laurens; Post, Gerhard F.; Veltman, Bart; Winkelhuijzen, Wessel

    2006-01-01

    The area of personnel scheduling is very broad. Here we focus on the ‘shift assignment problem’. Our aim is to discuss how ORTEC HARMONY handles this planning problem. In particular we go into the structure of the optimization engine in ORTEC HARMONY, which uses techniques from genetic algorithms,

  18. Hybrid job shop scheduling

    NARCIS (Netherlands)

    Schutten, Johannes M.J.

    1995-01-01

    We consider the problem of scheduling jobs in a hybrid job shop. We use the term 'hybrid' to indicate that we consider a lot of extensions of the classic job shop, such as transportation times, multiple resources, and setup times. The Shifting Bottleneck procedure can be generalized to deal with

  19. Practical job shop scheduling

    NARCIS (Netherlands)

    Schutten, Johannes M.J.

    1998-01-01

    The Shifting Bottleneck procedure is an intuitive and reasonably good approximation algorithm for the notoriously difficult classical job shop scheduling problem. The principle of decomposing a classical job shop problem into a series of single-machine problems can also easily be applied to job shop

  20. Refinery scheduling

    Energy Technology Data Exchange (ETDEWEB)

    Magalhaes, Marcus V.; Fraga, Eder T. [PETROBRAS, Rio de Janeiro, RJ (Brazil); Shah, Nilay [Imperial College, London (United Kingdom)

    2004-07-01

    This work addresses the refinery scheduling problem using mathematical programming techniques. The solution adopted was to decompose the entire refinery model into a crude oil scheduling and a product scheduling problem. The envelope for the crude oil scheduling problem is composed of a terminal, a pipeline and the crude area of a refinery, including the crude distillation units. The solution method adopted includes a decomposition technique based on the topology of the system. The envelope for the product scheduling comprises all tanks, process units and products found in a refinery. Once crude scheduling decisions are Also available the product scheduling is solved using a rolling horizon algorithm. All models were tested with real data from PETROBRAS' REFAP refinery, located in Canoas, Southern Brazil. (author)

  1. Cancer treatment scheduling and dynamic heterogeneity in social dilemmas of tumour acidity and vasculature.

    Science.gov (United States)

    Kaznatcheev, Artem; Vander Velde, Robert; Scott, Jacob G; Basanta, David

    2017-03-14

    Tumours are diverse ecosystems with persistent heterogeneity in various cancer hallmarks like self-sufficiency of growth factor production for angiogenesis and reprogramming of energy metabolism for aerobic glycolysis. This heterogeneity has consequences for diagnosis, treatment and disease progression. We introduce the double goods game to study the dynamics of these traits using evolutionary game theory. We model glycolytic acid production as a public good for all tumour cells and oxygen from vascularisation via vascular endothelial growth factor production as a club good benefiting non-glycolytic tumour cells. This results in three viable phenotypic strategies: glycolytic, angiogenic and aerobic non-angiogenic. We classify the dynamics into three qualitatively distinct regimes: (1) fully glycolytic; (2) fully angiogenic; or (3) polyclonal in all three cell types. The third regime allows for dynamic heterogeneity even with linear goods, something that was not possible in prior public good models that considered glycolysis or growth factor production in isolation. The cyclic dynamics of the polyclonal regime stress the importance of timing for anti-glycolysis treatments like lonidamine. The existence of qualitatively different dynamic regimes highlights the order effects of treatments. In particular, we consider the potential of vascular normalisation as a neoadjuvant therapy before follow-up with interventions like buffer therapy.

  2. Paradigm shift in cancer treatment: Cancer treatment as a metabolic disease – fusion of Eastern and Western medicine

    Directory of Open Access Journals (Sweden)

    Reo Hamaguchi

    2017-10-01

    Full Text Available Current standard therapies for cancer, including surgery, anti-cancer drugs, and radiotherapy, are thought to contribute to the improvement in the survival rates of cancer patients. However, such standard therapies have 3 major problems: in advanced cancers, it is unlikely that standard cancer treatments will cure the disease; adverse side effects that accompany standard cancer treatments put many patients in distress; and a large amount of medical expenditure is required for new and expensive anti-cancer drugs. These problems may be viewed as a result of establishing treatments without any consideration regarding the root cause of the cancer. Otto Warburg suggested that particular changes in the energy metabolism of cells, which are associated with a shortage of oxygen, are the root cause of cancer. Cancer cells have unique metabolic characteristics, and thus we believe that it is important to treat cancer as a metabolic disease. More specifically, not only is it important to suppress cancer cell metabolism, but it is also important to improve the chronic inflammation that is associated with the development and progression of cancer, and to support the functions of immune cells. This type of view of cancer treatment coincides with the principles of Chinese medicine, which has a history of 4000 years, such as “fuzheng quxie” and “zhibing qiuben”, which can assist in the establishment of cancer treatments for patients. In this article, we discuss cancer treatments from the view of cancer as a metabolic disease and their association with Chinese medicine, and introduce some clinical cases along with a review of the literature.

  3. Medium-dose-rate brachytherapy of cancer of the cervix: preliminary results of a prospectively designed schedule based on the linear-quadratic model

    International Nuclear Information System (INIS)

    Leborgne, Felix; Fowler, Jack F.; Leborgne, Jose H.; Zubizarreta, Eduardo; Curochquin, Rene

    1999-01-01

    Purpose: To compare results and complications of our previous low-dose-rate (LDR) brachytherapy schedule for early-stage cancer of the cervix, with a prospectively designed medium-dose-rate (MDR) schedule, based on the linear-quadratic model (LQ). Methods and Materials: A combination of brachytherapy, external beam pelvic and parametrial irradiation was used in 102 consecutive Stage Ib-IIb LDR treated patients (1986-1990) and 42 equally staged MDR treated patients (1994-1996). The planned MDR schedule consisted of three insertions on three treatment days with six 8-Gy brachytherapy fractions to Point A, two on each treatment day with an interfraction interval of 6 hours, plus 18 Gy external whole pelvic dose, and followed by additional parametrial irradiation. The calculated biologically effective dose (BED) for tumor was 90 Gy 10 and for rectum below 125 Gy 3 . Results: In practice the MDR brachytherapy schedule achieved a tumor BED of 86 Gy 10 and a rectal BED of 101 Gy 3 . The latter was better than originally planned due to a reduction from 85% to 77% in the percentage of the mean dose to the rectum in relation to Point A. The mean overall treatment time was 10 days shorter for MDR in comparison with LDR. The 3-year actuarial central control for LDR and MDR was 97% and 98% (p = NS), respectively. The Grades 2 and 3 late complications (scale 0 to 3) were 1% and 2.4%, respectively for LDR (3-year) and MDR (2-year). Conclusions: LQ is a reliable tool for designing new schedules with altered fractionation and dose rates. The MDR schedule has proven to be an equivalent treatment schedule compared with LDR, with an additional advantage of having a shorter overall treatment time. The mean rectal BED Gy 3 was lower than expected

  4. Shift work and the incidence of prostate cancer: a 10-year follow-up of a German population-based cohort study.

    Science.gov (United States)

    Behrens, Thomas; Rabstein, Sylvia; Wichert, Katharina; Erbel, Raimund; Eisele, Lewin; Arendt, Marina; Dragano, Nico; Brüning, Thomas; Jöckel, Karl-Heinz

    2017-11-01

    Objectives We investigated the association of shift and night work with the incidence of prostate cancer using data of the population-based prospective Heinz Nixdorf Recall Study from the highly industrialized Ruhr area in Germany. Methods Participants of the baseline survey were recruited between 2000-2003. A follow-up survey including, a detailed interview on shift and night work, was conducted from 2011-2014. We included 1757 men who did not report a history of prostate cancer at baseline. We assessed shift- and night-work exposure up to time of the baseline interview. Incident prostate cancers were recorded from baseline through September 2014. We calculated hazard ratios (HR) of shift- and night-work exposure using Cox proportional hazards regression with age at event as timescale, adjusting for smoking status, family history of prostate cancer, education (≤13, 14-17, ≥18 years), and equivalent income (low, medium, high). Results We observed a twofold increased HR for prostate cancer among shift and night workers. Ever employment in shift work was associated with HR 2.29, 95% confidence interval (CI) 1.43-3.67 and night work with HR 2.27, 95% CI 1.42-3.64. HR increased steadily with duration of employment in shift or night work. Stratifying analyses by preferred midpoint of sleep, yielded strongly elevated HR among subjects with early sleep preference, although these analyses were limited by small number of cases. Conclusions We identified increased risks for prostate cancer among men with employment in shift or night work. HR were strongly elevated among long-term employed shift workers and men with early preferred midpoint of sleep.

  5. Night Shift Work Increases the Risks of Multiple Primary Cancers in Women: A Systematic Review and Meta-analysis of 61 Articles.

    Science.gov (United States)

    Yuan, Xia; Zhu, Chenjing; Wang, Manni; Mo, Fei; Du, Wei; Ma, Xuelei

    2018-01-01

    A growing number of studies have examined associations between night shift work and the risks of common cancers among women, with varying conclusions. We did a meta-analysis to identify whether long-term night shift work increased the risks of common cancers in women. We enrolled 61 articles involving 114,628 cases and 3,909,152 participants from Europe, North America, Asia, and Australia. Risk estimates were performed with a random-effect model or a fixed-effect model. Subgroup analyses and meta-regression analyses about breast cancer were conducted to explore possible sources of heterogeneity. In addition, we carried out a dose-response analysis to quantitatively estimate the accumulative effect of night shift work on the risk of breast cancer. A positive relationship was revealed between long-term night shift work and the risks of breast [OR = 1.316; 95% confidence interval (CI), 1.196-1.448], digestive system (OR = 1.177; 95% CI, 1.065-1.301), and skin cancer (OR = 1.408; 95% CI, 1.024-1.934). For every 5 years of night shift work, the risk of breast cancer in women was increased by 3.3% (OR = 1.033; 95% CI, 1.012-1.056). Concerning the group of nurses, long-term night shift work presented potential carcinogenic effect in breast cancer (OR = 1.577; 95% CI, 1.235-2.014), digestive system cancer (OR = 1.350; 95% CI, 1.030-1.770), and lung cancer (OR = 1.280; 95% CI, 1.070-1.531). This systematic review confirmed the positive association between night shift work and the risks of several common cancers in women. We identified that cancer risk of women increased with accumulating years of night shift work, which might help establish and implement effective measures to protect female night shifters. Cancer Epidemiol Biomarkers Prev; 27(1); 25-40. ©2018 AACR . ©2018 American Association for Cancer Research.

  6. Importance of dose-schedule of 5-aza-2'-deoxycytidine for epigenetic therapy of cancer

    International Nuclear Information System (INIS)

    Lemaire, Maryse; Chabot, Guy G; Raynal, Noël JM; Momparler, Louise F; Hurtubise, Annie; Bernstein, Mark L; Momparler, Richard L

    2008-01-01

    The inactivation of tumor suppressor genes (TSGs) by aberrant DNA methylation plays an important role in the development of malignancy. Since this epigenetic change is reversible, it is a potential target for chemotherapeutic intervention using an inhibitor of DNA methylation, such as 5-aza-2'-deoxycytidine (DAC). Although clinical studies show that DAC has activity against hematological malignancies, the optimal dose-schedule of this epigenetic agent still needs to be established. Clonogenic assays were performed on leukemic and tumor cell lines to evaluate the in vitro antineoplastic activity of DAC. The reactivation of TSGs and inhibition of DNA methylation by DAC were investigated by reverse transcriptase-PCR and Line-1 assays. The in vivo antineoplastic activity of DAC administered as an i.v. infusion was evaluated in mice with murine L1210 leukemia by measurement of survival time, and in mice bearing murine EMT6 mammary tumor by excision of tumor after chemotherapy for an in vitro clonogenic assay. Increasing the DAC concentration and duration of exposure produced a greater loss of clonogenicity for both human leukemic and tumor cell lines. The reactivation of the TSGs (p57KIP2 in HL-60 leukemic cells and p16CDKN2A in Calu-6 lung carcinoma cells) and the inhibition of global DNA methylation in HL-60 leukemic cells increased with DAC concentration. In mice with L1210 leukemia and in mice bearing EMT6 tumors, the antineoplastic action of DAC also increased with the dose. The plasma level of DAC that produced a very potent antineoplastic effect in mice with leukemia or solid tumors was > 200 ng/ml (> 1 μM). We have shown that intensification of the DAC dose markedly increased its antineoplastic activity in mouse models of cancer. Our data also show that there is a good correlation between the concentrations of DAC that reduce in vitro clonogenicity, reactivate TSGs and inhibit DNA methylation. These results suggest that the antineoplastic action of DAC is

  7. Schedule Analytics

    Science.gov (United States)

    2016-04-30

    Warfare, Naval Sea Systems Command Acquisition Cycle Time : Defining the Problem David Tate, Institute for Defense Analyses Schedule Analytics Jennifer...research was comprised of the following high- level steps :  Identify and review primary data sources 1...research. However, detailed reviews of the OMB IT Dashboard data revealed that schedule data is highly aggregated. Program start date and program end date

  8. Response to Dr Stevens' letter ref. Visitisen et al: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data"

    DEFF Research Database (Denmark)

    Kolstad, Henrik A; Garde, Anne Helene; Hansen, Åse Marie

    2017-01-01

    We thank Dr Richard Stevens for his comments (1) on our recent article that showed no increased risk of breast cancer following recent night shift work when compared with recent day shift work (2). This finding was based on linkage of day-by-day information on working hours and breast cancer...... incidence data. Results are thus less likely to have been biased by differential misclassification than findings from earlier studies relying on self-report (3). We defined a night shift as ≥3 hours of work between 24:00-05:00 hours and a day shift as ≥3 hours work between 6:00-20:00 hours. This day shift...... definitions of shifts affect the risk of breast cancer, which will be possible using this type of data. We only had information on working hours from 2007 and onwards, and night shift work prior to 2007 could have confounded our analyses towards no effect but only if inversely associated with night shift work...

  9. Unravelling biology and shifting paradigms in cancer with single-cell sequencing.

    Science.gov (United States)

    Baslan, Timour; Hicks, James

    2017-08-24

    The fundamental operative unit of a cancer is the genetically and epigenetically innovative single cell. Whether proliferating or quiescent, in the primary tumour mass or disseminated elsewhere, single cells govern the parameters that dictate all facets of the biology of cancer. Thus, single-cell analyses provide the ultimate level of resolution in our quest for a fundamental understanding of this disease. Historically, this quest has been hampered by technological shortcomings. In this Opinion article, we argue that the rapidly evolving field of single-cell sequencing has unshackled the cancer research community of these shortcomings. From furthering an elemental understanding of intra-tumoural genetic heterogeneity and cancer genome evolution to illuminating the governing principles of disease relapse and metastasis, we posit that single-cell sequencing promises to unravel the biology of all facets of this disease.

  10. Gold-Based Medicine: A Paradigm Shift in Anti-Cancer Therapy?

    Science.gov (United States)

    Yeo, Chien Ing; Ooi, Kah Kooi; Tiekink, Edward R T

    2018-06-11

    A new era of metal-based drugs started in the 1960s, heralded by the discovery of potent platinum-based complexes, commencing with cisplatin [(H₃N)₂PtCl₂], which are effective anti-cancer chemotherapeutic drugs. While clinical applications of gold-based drugs largely relate to the treatment of rheumatoid arthritis, attention has turned to the investigation of the efficacy of gold(I) and gold(III) compounds for anti-cancer applications. This review article provides an account of the latest research conducted during the last decade or so on the development of gold compounds and their potential activities against several cancers as well as a summary of possible mechanisms of action/biological targets. The promising activities and increasing knowledge of gold-based drug metabolism ensures that continued efforts will be made to develop gold-based anti-cancer agents.

  11. Outcomes Associated With 3 Treatment Schedules of High-Dose-Rate Brachytherapy Monotherapy for Favorable-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jawad, Maha Saada; Dilworth, Joshua T.; Gustafson, Gary S.; Ye, Hong; Wallace, Michelle [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro [Michigan HealthCare Professionals/21" s" t Century Oncology, Farmington Hills, Michigan (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Krauss, Daniel J., E-mail: DKrauss@beaumont.edu [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)

    2016-03-15

     years. Conclusions: The acute and chronic toxicity profiles associated with these 3 HDR brachytherapy schedules were similar and were well tolerated. Acceptable grade 2, minimal grade 3, and no grade 4 or 5 toxicities were seen. This, combined with the fact that the clinical outcomes were similar, leads to the conclusion that all 3 regimens may be acceptable options for the management of low-risk to intermediate-risk prostate cancer.

  12. Faktor Dan Penjadualan Shift Kerja

    OpenAIRE

    Maurits, Lientje Setyawati; Widodo, Imam Djati

    2008-01-01

    Work shift has negative effect in physical and mental health, work performance and job accident. Disturbance of circadian rhythms is indicated as source of the problems. This article explores some researches related to the impacts of work shift and establishes basic principles of work shift scheduling that considers human need and limitation.

  13. Phase II study of a 3-day schedule with topotecan and cisplatin in patients with previously untreated small cell lung cancer and extensive disease

    DEFF Research Database (Denmark)

    Sorensen, M.; Lassen, Ulrik Niels; Jensen, Peter Buhl

    2008-01-01

    INTRODUCTION: Treatment with a topoisomerase I inhibitor in combination with a platinum results in superior or equal survival compared with etoposide-based treatment in extensive disease small cell lung cancer (SCLC). Five-day topotecan is inconvenient and therefore shorter schedules of topotecan...... and cisplatin are needed. The aim of this phase II study was to establish the response rate and response duration in chemo-naive patients with SCLC receiving a 3-day topotecan and cisplatin schedule. METHODS: Simons optimal two-stage design was used. Patients with previously untreated extensive disease SCLC...... age was 59 (range 44-74), 79% had performance status 0 or 1. Thirty-one patients completed all six cycles. Grade 3/4 anemia, neutrocytopenia, and thrombocytopenia were recorded in 9.5%, 66.7%, and 21.4% of patients, respectively. Fourteen percent of patients experienced neutropenic fever. No episodes...

  14. Improvement of VMAT plan quality for head and neck cancer with high resolution fluences generated by couch shift between arcs.

    Science.gov (United States)

    Park, Jong Min; Park, So-Yeon; Wu, Hong-Gyun; Kim, Jung-In

    2018-02-01

    To investigate the changes in quality of the volumetric modulated arc therapy (VMAT) plans with couch-shift between arcs by half of a multi-leaf collimator (MLC) leaf width. A total of 22 patients with head-and-neck cancer were retrospectively selected. Since the smallest MLC leaf width was 5 mm in this study, the couch was shifted by 2.5 mm in the longitudinal-direction between arcs to increase the resolution of fluence map. A total of three types of VMAT plans were generated for each patient; the three types of plans were a two-full-arc plan without couch-shift (NS plan), a two-half-arc-pair plan with couch-shift (HAS plan), and a two-full-arc pair plan with couch-shift (FAS plan). Changes in the dose-volumetric parameters were investigated. The FAS plan showed the best plan quality for the target volumes and organs at risk compared to the NS and HAS plans. However, the magnitudes of differences among the three types of plans were minimal, and every plan was clinically acceptable. The average integral doses of the NS, HAS, and FAS plans were 160,549 ± 37,600 Gy-cc, 147,828 ± 33,343 Gy-cc, and 156,030 ± 36,263 Gy-cc, respectively. The average monitor unit of the NS, HAS, and FAS plans were 717 ± 120 MU, 648 ± 100 MU, and 763 ± 158 MU, respectively. The HAS plan was better than the others in terms of normal tissue sparing and plan efficiency. By shifting the couch by half of the MLC leaf width in the longitudinal direction between arcs, the VMAT plan quality could be improved. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. Ancestry-shift refinement mapping of the C6orf97-ESR1 breast cancer susceptibility locus.

    Directory of Open Access Journals (Sweden)

    Simon N Stacey

    2010-07-01

    Full Text Available We used an approach that we term ancestry-shift refinement mapping to investigate an association, originally discovered in a GWAS of a Chinese population, between rs2046210[T] and breast cancer susceptibility. The locus is on 6q25.1 in proximity to the C6orf97 and estrogen receptor alpha (ESR1 genes. We identified a panel of SNPs that are correlated with rs2046210 in Chinese, but not necessarily so in other ancestral populations, and genotyped them in breast cancer case:control samples of Asian, European, and African origin, a total of 10,176 cases and 13,286 controls. We found that rs2046210[T] does not confer substantial risk of breast cancer in Europeans and Africans (OR = 1.04, P = 0.099, and OR = 0.98, P = 0.77, respectively. Rather, in those ancestries, an association signal arises from a group of less common SNPs typified by rs9397435. The rs9397435[G] allele was found to confer risk of breast cancer in European (OR = 1.15, P = 1.2 x 10(-3, African (OR = 1.35, P = 0.014, and Asian (OR = 1.23, P = 2.9 x 10(-4 population samples. Combined over all ancestries, the OR was 1.19 (P = 3.9 x 10(-7, was without significant heterogeneity between ancestries (P(het = 0.36 and the SNP fully accounted for the association signal in each ancestry. Haplotypes bearing rs9397435[G] are well tagged by rs2046210[T] only in Asians. The rs9397435[G] allele showed associations with both estrogen receptor positive and estrogen receptor negative breast cancer. Using early-draft data from the 1,000 Genomes project, we found that the risk allele of a novel SNP (rs77275268, which is closely correlated with rs9397435, disrupts a partially methylated CpG sequence within a known CTCF binding site. These studies demonstrate that shifting the analysis among ancestral populations can provide valuable resolution in association mapping.

  16. Nontraditional work schedules for pharmacists.

    Science.gov (United States)

    Mahaney, Lynnae; Sanborn, Michael; Alexander, Emily

    2008-11-15

    Nontraditional work schedules for pharmacists at three institutions are described. The demand for pharmacists and health care in general continues to increase, yet significant material changes are occurring in the pharmacy work force. These changing demographics, coupled with historical vacancy rates and turnover trends for pharmacy staff, require an increased emphasis on workplace changes that can improve staff recruitment and retention. At William S. Middleton Memorial Veterans Affairs Hospital in Madison, Wisconsin, creative pharmacist work schedules and roles are now mainstays to the recruitment and retention of staff. The major challenge that such scheduling presents is the 8 hours needed to prepare a six-week schedule. Baylor Medical Center at Grapevine in Dallas, Texas, has a total of 45 pharmacy employees, and slightly less than half of the 24.5 full-time-equivalent staff work full-time, with most preferring to work one, two, or three days per week. As long as the coverage needs of the facility are met, Envision Telepharmacy in Alpine, Texas, allows almost any scheduling arrangement preferred by individual pharmacists or the pharmacist group covering the facility. Staffing involves a great variety of shift lengths and intervals, with shifts ranging from 2 to 10 hours. Pharmacy leaders must be increasingly aware of opportunities to provide staff with unique scheduling and operational enhancements that can provide for a better work-life balance. Compressed workweeks, job-sharing, and team scheduling were the most common types of alternative work schedules implemented at three different institutions.

  17. Immunotherapy: Shifting the Balance of Cell-Mediated Immunity and Suppression in Human Prostate Cancer

    International Nuclear Information System (INIS)

    Tucker, Jo A.; Jochems, Caroline; Gulley, James L.; Schlom, Jeffrey; Tsang, Kwong Y.

    2012-01-01

    Active immunotherapy is dependent on the ability of the immune system to recognize and respond to tumors. Despite overwhelming evidence to support a cell-mediated immune response to prostate cancer, it is insufficient to eradicate the disease. This is likely due to a high level of suppression at the tumor site from a variety of sources, including immunosuppressive cells. Immune cells entering the tumor microenvironment may be inhibited directly by the tumor, stromal cells or other immune cells that have been induced to adopt a suppressive phenotype. The resurgence of interest in immunotherapy following the approval of sipuleucel-T and ipilimumab by the Food and Drug Administration has brought about new strategies for overcoming tumor-mediated suppression and bolstering anti-tumor responses. Improved understanding of the immune response to prostate cancer can lead to new combination therapies, such as the use of vaccine with small molecule and checkpoint inhibitors or other immunotherapies

  18. Immunotherapy: Shifting the Balance of Cell-Mediated Immunity and Suppression in Human Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tucker, Jo A.; Jochems, Caroline [Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (United States); Gulley, James L. [Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (United States); Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (United States); Schlom, Jeffrey, E-mail: js141c@nih.gov; Tsang, Kwong Y. [Laboratory of Tumor Immunology and Biology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (United States)

    2012-12-11

    Active immunotherapy is dependent on the ability of the immune system to recognize and respond to tumors. Despite overwhelming evidence to support a cell-mediated immune response to prostate cancer, it is insufficient to eradicate the disease. This is likely due to a high level of suppression at the tumor site from a variety of sources, including immunosuppressive cells. Immune cells entering the tumor microenvironment may be inhibited directly by the tumor, stromal cells or other immune cells that have been induced to adopt a suppressive phenotype. The resurgence of interest in immunotherapy following the approval of sipuleucel-T and ipilimumab by the Food and Drug Administration has brought about new strategies for overcoming tumor-mediated suppression and bolstering anti-tumor responses. Improved understanding of the immune response to prostate cancer can lead to new combination therapies, such as the use of vaccine with small molecule and checkpoint inhibitors or other immunotherapies.

  19. Muscle invasive bladder cancer in Upper Egypt: the shift in risk factors and tumor characteristics

    International Nuclear Information System (INIS)

    Zarzour, Ali H; Selim, Mohie; Abd-Elsayed, Alaa A; Hameed, Diaa A; AbdelAziz, Mohammad A

    2008-01-01

    In Egypt, where bilharziasis is endemic, bladder cancer is the commonest cancer in males and the 2 nd in females; squamous cell carcinoma (SCC) is the commonest type found, with a peculiar mode of presentation. The aim of this study is to identify and rank the risk factors of muscle invasive bladder cancer (MIBC) in Upper Egypt and describe its specific criteria of presentation and histopathology. This is an analytical, hospital based, case controlled study conducted in south Egypt cancer institute through comparing MIBC cases (n = 130) with age, sex and residence matched controls (n = 260) for the presence of risk factors of MIBC. Data was collected by personal interview using a well designed questionnaire. Patients' records were reviewed for histopathology and Radiologic findings. The risk factors of MIBC were positive family history [Adjusted odds ratio (AOR) = 7.7], exposure to pesticides [AOR = 6.2], bladder stones [AOR = 5], consanguinity [AOR = 3.9], recurrent cystitis [AOR = 3.1], bilharziasis [odds ratio (OR) = 5.8] and smoking [OR = 5.3]. SCC represented 67.6% of cases with burning micturition being the presenting symptom in 73.8%. MIBC in Upper Egypt is usually of the SCC type (although its percentage is decreasing), occurs at a younger age and presents with burning micturition rather than hematuria. Unlike the common belief, positive family history, parents' consanguinity, exposure to pesticides and chronic cystitis seem to play now more important roles than bilharziasis and smoking in the development of this disease in this area

  20. Insomnia in shift work.

    Science.gov (United States)

    Vallières, Annie; Azaiez, Aïda; Moreau, Vincent; LeBlanc, Mélanie; Morin, Charles M

    2014-12-01

    Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers. Work productivity and absenteeism were more strongly related to insomnia. The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Ceasing intrathecal therapy in chronic non-cancer pain: an invitation to shift from biomedical focus to active management.

    Directory of Open Access Journals (Sweden)

    Chris Hayes

    Full Text Available OBJECTIVE: To report long term experience (1997-2009 of intrathecal (IT therapy for chronic non-cancer pain in the context of our team's increasing emphasis on active management. DESIGN: Descriptive case series. SETTING: Australian tertiary multidisciplinary pain center, Hunter Integrated Pain Service (HIPS. INTERVENTION: This case series reports the changing use of IT implanted drug delivery systems (IDDSs for chronic non-cancer pain over 13 years. Initially IT therapy was used selectively following multidisciplinary assessment and double blind IT trial. Typical therapy combined opioid with clonidine. Multidimensional management was offered. Treatment strategy changed in 2003 due to HIPS experience of limited therapeutic gains and equivocal support for IT therapy in the literature. Subsequently IT therapy was no longer initiated for non-cancer pain and those on established regimes were encouraged to shift to oral/transdermal opioids with greater emphasis on active management. Patient education and consultation were key elements. Where IT cessation was elective gradual dose reduction commenced as an outpatient. In elective and urgent cases ketamine infusion and oral clonidine were used during hospital admissions to cover the switch to oral/transdermal opioids. Over the study period transition occurred to a broader management framework in which IT therapy for chronic non-cancer pain was no longer supported by HIPS. RESULTS: 25 patients were managed using IDDSs; 8 implanted by HIPS and 17 by other teams. Dose escalation and adverse effects were common. 24 of 25 patients ceased IT therapy; 7 (29% with urgent IDDS related complications, 16 (67% electively and 1 due to an unrelated death. The remaining patient returned to her original team to continue IT therapy. One post-explantation patient transferred to another team to recommence IT therapy. The remainder were successfully maintained on oral/transdermal opioids combined with active management.

  2. Response to Dr Stevens' letter ref. Visitisen et al: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data".

    Science.gov (United States)

    Kolstad, Henrik A; Garde, Anne Helene; Hansen, Åse Marie; Frydenberg, Morten; Christiansen, Peer; Vistisen, Helene Tilma; Bonde, Jens Peter E

    2017-01-01

    We thank Dr Richard Stevens for his comments (1) on our recent article that showed no increased risk of breast cancer following recent night shift work when compared with recent day shift work (2). This finding was based on linkage of day-by-day information on working hours and breast cancer incidence data. Results are thus less likely to have been biased by differential misclassification than findings from earlier studies relying on self-report (3). We defined a night shift as ≥3 hours of work between 24:00-05:00 hours and a day shift as ≥3 hours work between 6:00-20:00 hours. This day shift definition did not exclude shifts starting before 05:00 or ending after 24:00 hours. However, this affected only 0.02% and 0.3% of all day shifts, respectively. This diminutive misclassification, that is expected to be non-differential, can hardly explain our negative findings. It is suggested that shifts that begin after 07:00 and end before 18:00 would constitute a more sensible baseline comparison group. Since the biological mechanism is not certain, it is not obvious to us if this will be a more appropriate reference than the present. However, we agree that future studies should test how different definitions of shifts affect the risk of breast cancer, which will be possible using this type of data. We only had information on working hours from 2007 and onwards, and night shift work prior to 2007 could have confounded our analyses towards no effect but only if inversely associated with night shift work in 2007 or later. We find this unlikely. Left truncation could also have biased findings towards the null. We therefore supplemented analyses of the total study population with analyses of the one-third of the population with first recorded employment in 2008 or later (the inception population). Even if the mean age was 35.5 years - and many undoubtedly had been working (with and without night shifts) prior to 2008 - this population should be less affected by such

  3. Surgical Treatment of Recurrent Endometrial Cancer: Time for a Paradigm Shift.

    Science.gov (United States)

    Papadia, Andrea; Bellati, Filippo; Ditto, Antonino; Bogani, Giorgio; Gasparri, Maria Luisa; Di Donato, Violante; Martinelli, Fabio; Lorusso, Domenica; Benedetti-Panici, Pierluigi; Raspagliesi, Francesco

    2015-12-01

    Although surgery represents the cornerstone treatment of endometrial cancer at initial diagnosis, scarce data are available in recurrent setting. The purpose of this study was to review the outcome of surgery in these patients. Medical records of all patients undergoing surgery for recurrent endometrial cancer at NCI Milano between January 2003 and January 2014 were reviewed. Survival was determined from the time of surgery for recurrence to last follow-up. Survival was estimated using Kaplan-Meier methods. Differences in survival were analyzed using the log-rank test. The Fisher's exact test was used to compare optimal versus suboptimal cytoreduction against possible predictive factors. Sixty-four patients were identified. Median age was 66 years. Recurrences were multiple in 38 % of the cases. Optimal cytoreduction was achieved in 65.6 %. Median OR time was 165 min, median postoperative hemoglobin drop was 2.4 g/dl, and median length hospital stay was 5.5 days. Eleven patients developed postoperative complications, but only four required surgical management. Estimated 5-year progression-free survival (PFS) was 42 and 19 % in optimally and suboptimally cytoreduced patients, respectively. At multivariate analysis, only residual disease was associated with PFS. Estimated 5-year overall survival (OS) was 60 and 30 % in optimally and suboptimally cytoreduced patients, respectively. At multivariate analysis, residual disease and histotype were associated with OS. At multivariate analysis, only performance status was associated with optimal cytoreduction. Secondary cytoreduction in endometrial cancer is associated with long PFS and OS. The only factors associated with improved long-term outcome are the absence of residual disease at the end of surgical resection and histotype.

  4. Optimum radiotherapy schedule for uterine cervical cancer based-on the detailed information of dose fractionation and radiotherapy technique

    International Nuclear Information System (INIS)

    Cho, Jae Ho; Kim, Hyun Chang; Suh, Chang Ok

    2005-01-01

    The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of 23.4 ∼ 59.4 Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-ICBT) was also performed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of 14.4∼ 43.2 Gy (Median 36.0) of EBRT in 495 patients, while in the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder and rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor (α / β = 10) and late-responding tissues (α /β = 3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED Gy 3 and the risk of complication was assessed using serial multiple logistic regressions models. The associations between R-BED Gy 3 and rectal complications

  5. Phase I trial of strictly time-scheduled gemcitabine and cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Brunner, Thomas B.; Grabenbauer, Gerhard G.; Klein, Peter; Baum, Ulrich; Papadopoulos, Thomas; Bautz, Werner; Hohenberger, Werner; Sauer, Rolf

    2003-01-01

    Purpose: Maximal therapeutic gain in xenograft sarcoma and toxicity for jejunal mucosa is time dependent for concurrent gemcitabine and radiotherapy (RT). We used a time-dependent schedule to determine the maximal-tolerated dose and dose-limiting toxicities (DLTs; Grade 4 hematologic or Grade 3 other toxicity). Methods and Materials: Patients with pancreatic cancer (n=33), periampullary carcinoma (n=1), or bile duct cancer (n=2) were treated with 3-day conformal RT with 50.4 Gy (tumor, lymphatics) plus a 5.4-Gy boost. Concurrent cisplatin (20 mg/m 2 /d on Days 1-5 and 29-33) and gemcitabine (initially 600 mg/m 2 , weekly on Fridays 68 h before RT) were administered. Because of DLT, the doses were reduced to 500 mg/m 2 weekly and then 500, 400, or 300 mg/m 2 on Days 2, 5, 26, 33. Results: DLT occurred at all dose levels of gemcitabine >300 mg/m 2 . Fourteen patients were treated at the recommended Phase II dose of gemcitabine (300 mg/m 2 ) without DLT. The response to chemoradiation allowed 10 of 30 initially unresectable patients with primary pancreatic carcinoma to undergo radical surgery, including a complete response in 2 cases. Conclusions: At the recommended Phase II dose, chemoradiation with gemcitabine and cisplatin can be administered safely in pancreatic carcinoma. However, at higher dose levels, toxicity is severe and frequent. Patients with a chance for conversion to resection could benefit from this schedule

  6. Shift work, night work, and the risk of prostate cancer: A meta-analysis based on 9 cohort studies.

    Science.gov (United States)

    Du, Hong-Bing; Bin, Kai-Yun; Liu, Wen-Hong; Yang, Feng-Sheng

    2017-11-01

    Epidemiology studies suggested that shift work or night work may be linked to prostate cancer (PCa); the relationship, however, remains controversy. PubMed, ScienceDirect, and Embase (Ovid) databases were searched before (started from the building of the databases) February 4, 2017 for eligible cohort studies. We pooled the evidence included by a random- or fixed-effect model, according to the heterogeneity. A predefined subgroup analysis was conducted to see the potential discrepancy between groups. Sensitivity analysis was used to test whether our results were stale. Nine cohort studies were eligible for meta-analysis with 2,570,790 male subjects. Our meta-analysis showed that, under the fixed-effect model, the pooled relevant risk (RR) of PCa was 1.05 (95% confidence interval [CI]: 1.00, 1.11; P = .06; I = 24.00%) for men who had ever engaged in night shift work; and under the random-effect model, the pooled RR was 1.08 (0.99, 1.17; P = .08; I = 24.00%). Subgroup analysis showed the RR of PCa among males in western countries was 1.05 (95% CI: 0.99, 1.11; P = .09; I = 0.00%), while among Asian countries it was 2.45 (95% CI: 1.19, 5.04; P = .02; I = 0.00%); and the RR was 1.04 (95% CI: 0.95, 1.14; P = .40; I = 29.20%) for the high-quality group compared with 1.21 (95% CI: 1.03, 1.41; P = .02; I = 0.00%) for the moderate/low-quality group. Sensitivity analysis showed robust results. Based on the current evidence of cohort studies, we found no obvious association between night shift work and PCa. However, our subgroup analysis suggests that night shift work may increase the risk of PCa in Asian men. Some evidence of a small study effect was observed in this meta-analysis.

  7. Estimating exponential scheduling preferences

    DEFF Research Database (Denmark)

    Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid

    Extended abstract Choice of departure time is a travel choice dimension that transportation planners often need to forecast in appraisal. A traveller may shift departure time in response to changes in expected travel time or travel time variability (TTV) or in response to time-differentiated cong......Extended abstract Choice of departure time is a travel choice dimension that transportation planners often need to forecast in appraisal. A traveller may shift departure time in response to changes in expected travel time or travel time variability (TTV) or in response to time...... from the underlying scheduling preferences (Noland and Small, 1995, Bates et al., 2001, Fosgerau and Karlström, 2010). The scheduling preferences can be formally represented as time-dependent rates of utility derived at different locations. Assuming that the travellers are rational and choose departure......’ departure time choice. The assumption underlying the scheduling approach is that the traveller rationally maximises her total utility obtained during a period of time. The total utility depends on time of departure from the origin and time of arrival to the destination. The total utility is usually assumed...

  8. Location-based Scheduling

    DEFF Research Database (Denmark)

    Andersson, Niclas; Christensen, Knud

    on the market. However, CPM is primarily an activity based method that takes the activity as the unit of focus and there is criticism raised, specifically in the case of construction projects, on the method for deficient management of construction work and continuous flow of resources. To seek solutions...... to the identified limitations of the CPM method, an alternative planning and scheduling methodology that includes locations is tested. Location-based Scheduling (LBS) implies a shift in focus, from primarily the activities to the flow of work through the various locations of the project, i.e. the building. LBS uses...... the graphical presentation technique of Line-of-balance, which is adapted for planning and management of work-flows that facilitates resources to perform their work without interruptions caused by other resources working with other activities in the same location. As such, LBS and Lean Construction share...

  9. An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting

    International Nuclear Information System (INIS)

    Allal, A.S.

    2000-01-01

    Background: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. Patients and Methods: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.9 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2x1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). Results: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. Conclusions: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials. (orig.) [de

  10. Shift Colors

    Science.gov (United States)

    Publications & News Shift Colors Pages default Sign In NPC Logo Banner : Shift Colors Search Navy Personnel Command > Reference Library > Publications & News > Shift Colors Top Link Bar Navy Personnel Library Expand Reference Library Quick Launch Shift Colors Shift Colors Archives Mailing Address How to

  11. Scheduling the scheduling task : a time management perspective on scheduling

    NARCIS (Netherlands)

    Larco Martinelli, J.A.; Wiers, V.C.S.; Fransoo, J.C.

    2013-01-01

    Time is the most critical resource at the disposal of schedulers. Hence, an adequate management of time from the schedulers may impact positively on the scheduler’s productivity and responsiveness to uncertain scheduling environments. This paper presents a field study of how schedulers make use of

  12. N-3 poly-unsaturated fatty acids shift estrogen signaling to inhibit human breast cancer cell growth.

    Directory of Open Access Journals (Sweden)

    Wenqing Cao

    Full Text Available Although evidence has shown the regulating effect of n-3 poly-unsaturated fatty acid (n-3 PUFA on cell signaling transduction, it remains unknown whether n-3 PUFA treatment modulates estrogen signaling. The current study showed that docosahexaenoic acid (DHA, C22:6, eicosapentaenoic acid (EPA, C20:5 shifted the pro-survival and proliferative effect of estrogen to a pro-apoptotic effect in human breast cancer (BCa MCF-7 and T47D cells. 17 β-estradiol (E2 enhanced the inhibitory effect of n-3 PUFAs on BCa cell growth. The IC50 of DHA or EPA in MCF-7 cells decreased when combined with E2 (10 nM treatment (from 173 µM for DHA only to 113 µM for DHA+E2, and from 187 µm for EPA only to 130 µm for EPA+E2. E2 also augmented apoptosis in n-3 PUFA-treated BCa cells. In contrast, in cells treated with stearic acid (SA, C18:0 as well as cells not treated with fatty acid, E2 promoted breast cancer cell growth. Classical (nuclear estrogen receptors may not be involved in the pro-apoptotic effects of E2 on the n-3 PUFA-treated BCa cells because ERα agonist failed to elicit, and ERα knockdown failed to block E2 pro-apoptotic effects. Subsequent studies reveal that G protein coupled estrogen receptor 1 (GPER1 may mediate the pro-apoptotic effect of estrogen. N-3 PUFA treatment initiated the pro-apoptotic signaling of estrogen by increasing GPER1-cAMP-PKA signaling response, and blunting EGFR, Erk 1/2, and AKT activity. These findings may not only provide the evidence to link n-3 PUFAs biologic effects and the pro-apoptotic signaling of estrogen in breast cancer cells, but also shed new insight into the potential application of n-3 PUFAs in BCa treatment.

  13. Hyperfractionated chemoradiation with carbogen breathing, with or without erythropoietin: A stepwise developed treatment schedule for advanced head-and-neck cancer

    International Nuclear Information System (INIS)

    Martinez, Jose Carlos; Villar, Alfonso; Cabezon, Maria Auxiliadora; Serdio, Jose Luis de; Fuentes, Claudio; Espineira, Manuel; Perez, Maria Dolores; Gil, Jose; Artazkoz, Juan Jose; Borque, Carlos; Suner, Marcos; Saavedra, Juan Antonio

    2001-01-01

    Purpose: To investigate the influence of carbogen breathing on chemoradiation and the effects of erythropoietin on transfusions. Methods and Materials: From March 1996 to April 2000, 42 (4 Stage III and 38 Stage IV) patients with head and neck cancer were treated with a twice-a-day hyperfractionated schedule. Each fraction consisted of 5 mg/m 2 of carboplatin plus 115 cGy with carbogen breathing. Treatment was given 5 days per week up to total doses of 350 mg/m 2 of carboplatin plus 8050 cGy in 7 weeks. Anemia was treated either by transfusion or by erythropoietin. Results: Forty-one patients tolerated the treatment as scheduled. All patients tolerated the planned radiation dose. Five transfusions were given in the first group, but no transfusion was needed in the erythropoietin group. Local toxicities remained at the level expected with irradiation alone. Chemotherapy toxicity was moderate. Forty-two complete responses were achieved. At two years actuarial local control, cause-specific survival and overall survival are respectively 85%, 69%, and 68%. At four years estimated probabilities of local control, cause-specific survival and overall survival are also 85%, 69%, and 68%. Conclusions: These results compare favorably with those of most reported studies. The addition of carbogen breathing appears to improve the results of chemoradiation alone. Erythropoietin therapy avoided transfusions

  14. Influence of rotational setup error on tumor shift in bony anatomy matching measured with pulmonary point registration in stereotactic body radiotherapy for early lung cancer

    International Nuclear Information System (INIS)

    Suzuki, Osamu; Nishiyama, Kinji; Ueda, Yoshihiro; Miyazaki, Masayoshi; Tsujii, Katsutomo

    2012-01-01

    The objective of this study was to examine the correlation between the patient rotational error measured with pulmonary point registration and tumor shift after bony anatomy matching in stereotactic body radiotherapy for lung cancer. Twenty-six patients with lung cancer who underwent stereotactic body radiotherapy were the subjects. On 104 cone-beam computed tomography measurements performed prior to radiation delivery, rotational setup errors were measured with point registration using pulmonary structures. Translational registration using bony anatomy matching was done and the three-dimensional vector of tumor displacement was measured retrospectively. Correlation among the three-dimensional vector and rotational error and vertebra-tumor distance was investigated quantitatively. The median and maximum rotational errors of the roll, pitch and yaw were 0.8, 0.9 and 0.5, and 6.0, 4.5 and 2.5, respectively. Bony anatomy matching resulted in a 0.2-1.6 cm three-dimensional vector of tumor shift. The shift became larger as the vertebra-tumor distance increased. Multiple regression analysis for the three-dimensional vector indicated that in the case of bony anatomy matching, tumor shifts of 5 and 10 mm were expected for vertebra-tumor distances of 4.46 and 14.1 cm, respectively. Using pulmonary point registration, it was found that the rotational setup error influences the tumor shift. Bony anatomy matching is not appropriate for hypofractionated stereotactic body radiotherapy with a tight margin. (author)

  15. Analysis of the numbers of B, T and subpopulation lymphocytes in patients with breast cancer submitted to a different radiotherapy schedules

    International Nuclear Information System (INIS)

    Andrade, J.M. de.

    1989-01-01

    The behaviour of T and B lymphocytes subpopulations was evaluated in patients with breast cancer submitted to 3 different schedules of radiotherapy. The assays were carried out before and immediately after the end of treatment. T lymphocytes and the helper/inducer (CD 4 ) and suppressor/cytotoxic (CD 8 ) subpopulations were counted by indirect immunofluorescence with monoclonal antibodies of the OKT series. The number of B lymphocytes was obtained by direct immunofluorescence with fluorescein-conjugated anti-human Ig antibodies. The patients were divided into 3 groups: irradiation of the breast only; irradiation of the lymph-draining areas; irradiation of the breast, of the lymph-draining area and of the sternal area. (author)

  16. The Effect of Shift Work on Urogenital Disease: a Systematic Review.

    Science.gov (United States)

    Deng, Nanfu; Haney, Nora M; Kohn, Taylor P; Pastuszak, Alexander W; Lipshultz, Larry I

    2018-05-28

    Non-standard shift work schedules negatively impact the overall health of shift workers, and several studies have shown that shift work, specifically, is detrimental to urogenital health. The aims of this study are to systematically review the literature and determine the effect of shift work on the outcomes of hypogonadism, male infertility, lower urinary tract symptoms, and urogenital cancers. Recent evidence supports associations between non-standard shift work and an increase in the frequency of prostate cancer and the severity of erectile dysfunction, lower urinary tract symptoms, and hypogonadal symptoms, as well as worsening of semen parameters and fertility. These associations are strengthened by the presence of shift work sleep disorder (SWSD) which affects up to 20% of shift workers. No studies have assessed the impact of shift work on the frequency or severity of nephrolithiasis, interstitial cystitis, pelvic pain, prostatitis, or urinary tract infections. Non-standard shift work has been associated with a variety of negative health outcomes and urologic complications, especially with concurrent shift work sleep disorder. Recognition of these elevated risks among shift workers can aid in more effective screening for urologic conditions.

  17. Adjuvant chemotherapy with 5-fluorouracil, L-folinic acid and levamisole for patients with colorectal cancer: non-randomised comparison of weekly versus four-weekly schedules--less pain, same gain. QUASAR Colorectal Cancer Study Group.

    Science.gov (United States)

    Kerr, D J; Gray, R; McConkey, C; Barnwell, J

    2000-08-01

    QUASAR is a large trial of adjuvant chemotherapy for colorectal cancer in which clinicians could choose to deliver a standard adjuvant cytotoxic chemotherapy regimen, 5-fluorouracil (5-FU) and L-folinic acid (L-FA), in either a once-weekly or a four-weekly schedule. We report results of a non-randomised comparison between these schedules with respect to survival, recurrence and differential toxicity. In a factorial (2 x 2) trial design, QUASAR compared high-dose (175 mg) versus low-dose (25 mg) L-FA and levamisole versus placebo. The dose of 5-FU was fixed at 370 mg/m2 and although the recommended schedule was i.v. bolus delivery, daily for 5 days repeated four-weekly for 6 months, a significant proportion of randomising clinicians were constrained to deliver once-weekly 5-FU-L-FA for 30 weeks. Four thousand nine hundred twenty-seven patients were entered into QUASAR between May 1994 and October 1997, eighteen hundred twenty-nine of whom have recurred and sixteen hundred eighty-nine died. Similar numbers 2370 vs. 2559 were treated with the once-weekly and four-weekly schedules and the demographic features of the 2 groups were well balanced: stage C, 73.3% once-weekly vs. 71.0% four-weekly; colon, 68.0% vs. 68.3%; high-dose FA, 50.1% vs. 49.9%; levamisole, 49.3% vs. 49.3%; females, 40.2% vs. 41.7%; median age (years) 62 vs. 61. The risk of recurrence and survival were similar regardless of schedule: three-year survival was 70.6% once-weekly vs. 71.0% four-weekly; three-year recurrence risk was 35.6% once-weekly vs. 35.5% four-weekly; But, the once-weekly regimen was much less toxic: number of patients for whom toxicity was reported (once-weekly: four-weekly), stomatitis, 37 vs. 337; diarrhoea, 260 vs. 440; neutropenia, 20 vs. 153. The once-weekly regimen is much less toxic than and, apparently, about as effective as the four-weekly schedule. This suggests that the toxicity of 5-FU-L-FA adjuvant chemotherapy could be reduced substantially by weekly scheduling without

  18. Sensitization of human cancer cells to gemcitabine by the Chk1 inhibitor MK-8776: cell cycle perturbation and impact of administration schedule in vitro and in vivo

    International Nuclear Information System (INIS)

    Montano, Ryan; Thompson, Ruth; Chung, Injae; Hou, Huagang; Khan, Nadeem; Eastman, Alan

    2013-01-01

    Chk1 inhibitors have emerged as promising anticancer therapeutic agents particularly when combined with antimetabolites such as gemcitabine, cytarabine or hydroxyurea. Here, we address the importance of appropriate drug scheduling when gemcitabine is combined with the Chk1 inhibitor MK-8776, and the mechanisms involved in the schedule dependence. Growth inhibition induced by gemcitabine plus MK-8776 was assessed across multiple cancer cell lines. Experiments used clinically relevant “bolus” administration of both drugs rather than continuous drug exposures. We assessed the effect of different treatment schedules on cell cycle perturbation and tumor cell growth in vitro and in xenograft tumor models. MK-8776 induced an average 7-fold sensitization to gemcitabine in 16 cancer cell lines. The time of MK-8776 administration significantly affected the response of tumor cells to gemcitabine. Although gemcitabine induced rapid cell cycle arrest, the stalled replication forks were not initially dependent on Chk1 for stability. By 18 h, RAD51 was loaded onto DNA indicative of homologous recombination. Inhibition of Chk1 at 18 h rapidly dissociated RAD51 leading to the collapse of replication forks and cell death. Addition of MK-8776 from 18–24 h after a 6-h incubation with gemcitabine induced much greater sensitization than if the two drugs were incubated concurrently for 6 h. The ability of this short incubation with MK-8776 to sensitize cells is critical because of the short half-life of MK-8776 in patients’ plasma. Cell cycle perturbation was also assessed in human pancreas tumor xenografts in mice. There was a dramatic accumulation of cells in S/G 2 phase 18 h after gemcitabine administration, but cells had started to recover by 42 h. Administration of MK-8776 18 h after gemcitabine caused significantly delayed tumor growth compared to either drug alone, or when the two drugs were administered with only a 30 min interval. There are two reasons why delayed

  19. Night shift work and breast cancer: a pooled analysis of population-based case-control studies with complete work history.

    Science.gov (United States)

    Cordina-Duverger, Emilie; Menegaux, Florence; Popa, Alexandru; Rabstein, Sylvia; Harth, Volker; Pesch, Beate; Brüning, Thomas; Fritschi, Lin; Glass, Deborah C; Heyworth, Jane S; Erren, Thomas C; Castaño-Vinyals, Gemma; Papantoniou, Kyriaki; Espinosa, Ana; Kogevinas, Manolis; Grundy, Anne; Spinelli, John J; Aronson, Kristan J; Guénel, Pascal

    2018-04-01

    Night shift work has been suspected to increase breast cancer risk but epidemiological studies have been inconsistent due to heterogeneous assessment of exposure to night work. To overcome this limitation, we pooled data of five population-based case-control studies from Australia, Canada, France, Germany, and Spain into a single harmonized dataset using a common definition of night work including 6093 breast cancer cases and 6933 population controls. The odds ratio for breast cancer in women who ever worked at night for at least 3 h between midnight and 5 a.m. as compared to never night workers was 1.12 (95% CI 1.00-1.25). Among pre-menopausal women, this odds ratio was 1.26 [1.06-1.51], increasing to 1.36 [1.07-1.74] for night shifts ≥ 10 h, 1.80 [1.20-2.71] for work ≥ 3 nights/week, and 2.55 [1.03-6.30] for both duration of night work ≥ 10 years and exposure intensity ≥ 3 nights/week. Breast cancer risk in pre-menopausal women was higher in current or recent night workers (OR = 1.41 [1.06-1.88]) than in those who had stopped night work more than 2 years ago. Breast cancer in post-menopausal women was not associated with night work whatever the exposure metric. The increase in risk was restricted to ER+ tumors, particularly those who were both ER+ and HER2+ . These results support the hypothesis that night shift work increases the risk of breast cancer in pre-menopausal women, particularly those with high intensity and long duration of exposure. Risk difference between pre- and post-menopausal women deserves further scrutiny.

  20. The Relationship Between Shift Work and Men's Health.

    Science.gov (United States)

    Deng, Nanfu; Kohn, Taylor P; Lipshultz, Larry I; Pastuszak, Alexander W

    2018-01-19

    More than 21 million Americans and nearly 20% of the U.S. workforce are shift workers. Non-standard shift work, defined as work that falls outside of 6 am-6 pm, can lead to poor diet, exercise, and sleep habits that lead to decreased productivity, increased workplace accidents, and a variety of negative health outcomes. To investigate the associations between shift work exposure and chronic medical conditions such as metabolic syndromes, cardiovascular disease, gastrointestinal disturbances, and depression as well as urologic complications including hypogonadism, male infertility, lower urinary tract symptoms, and prostate cancer with a focus on the effects of shift work sleep disorder (SWSD) on the severity of these negative health outcomes. We reviewed the literature examining effects of shift work and SWSD on general and urologic health. We produced a summary of effects of shift work on health with focus on the increased risk of negative health outcomes in non-standard shift workers, particularly those with SWSD, when compared to daytime workers or workers without SWSD. Studies have associated non-standard shift work schedules and poor health outcomes, including increased risks of diabetes mellitus, dyslipidemia, hypertension, heart disease, peptic ulcer disease, and depression, in shift workers. However, few studies have focused on the role that shift work plays in men's urologic health. Current evidence supports associations between non-standard shift work and increased hypogonadal symptoms, poor semen parameters, decreased fertility, lower urinary tract symptoms, and prostate cancer. These associations are strengthened by the presence of SWSD, which affects up to 20% of shift workers. Unfortunately, interventions, such as planned naps, timed light exposure, melatonin, and sedative hypnotics, aimed at alleviating excessive nighttime sleepiness and daytime insomnia in non-standard shift workers experiencing SWSD, are limited and lack strong evidence to support

  1. An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting

    Energy Technology Data Exchange (ETDEWEB)

    Allal, A.S. [Geneva Univ. Hospital (Switzerland). Div. of Radiation Oncology; Monney, M.; Rosset, A.; Ozsahin, M. [Hopital Cantonal Universitaire, Lausanne (Switzerland). Inst. de Radiographie; Guillemin, C. [Cantonal Radiotherapy Department Sion (Switzerland)

    2000-01-01

    Background: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. Patients and Methods: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.9 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2x1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). Results: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. Conclusions: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials. (orig.) [German] Hintergrund: Die Wirksamkeit der akzelerierten Bestrahlung in bezug auf die Bewaeltigung der Tumorzellrepopulation waehrend einer Radiotherapie ist vor kurzem nachgewiesen worden. Das Verhaeltnis zwischen therapeutischem Effekt und Toxizitaet duerfte fuer fuenfwoechige Schemen

  2. Schedule-selective biochemical modulation of 5-fluorouracil in advanced colorectal cancer – a phase II study

    Directory of Open Access Journals (Sweden)

    Savage Paul

    2002-05-01

    Full Text Available Abstract Background 5-fluorouracil remains the standard therapy for patients with advanced/metastatic colorectal cancer. Pre-clinical studies have demonstrated the biological modulation of 5-fluorouracil by methotrexate and leucovorin. This phase II study was initiated to determine the activity and toxicity of sequential methotrexate – leucovorin and 5-fluorouracil chemotherapy in patients with advanced colorectal cancer. Methods Ninety-seven patients with metastatic colorectal cancer were enrolled onto the study. Methotrexate – 30 mg/m2 was administered every 6 hours for 6 doses followed by a 2 hour infusion of LV – 500 mg/m2. Midway through the leucovorin infusion, patients received 5-fluorouracil – 600 mg/m2. This constituted a cycle of therapy and was repeated every 2 weeks until progression. Results The median age was 64 yrs (34–84 and the Eastern Cooperative Group Oncology performance score was 0 in 37%, 1 in 55% and 2 in 8% of patients. Partial and complete responses were seen in 31% of patients with a median duration of response of 6.4 months. The overall median survival was 13.0 months. The estimated 1-year survival was 53.7%. Grade III and IV toxic effects were modest and included mucositis, nausea and vomiting. Conclusions This phase II study supports previously reported data demonstrating the modest clinical benefit of 5-FU modulation utilizing methotrexate and leucovorin in patients with metastatic colorectal cancer. Ongoing studies evaluating 5-fluorouracil modulation with more novel agents (Irinotecan and/or oxaliplatin are in progress and may prove encouraging.

  3. Rotating shift work associated with obesity in men from northeastern Ontario.

    Science.gov (United States)

    Grundy, Anne; Cotterchio, Michelle; Kirsh, Victoria A; Nadalin, Victoria; Lightfoot, Nancy; Kreiger, Nancy

    2017-08-01

    While some studies have suggested associations between shift work and obesity, few have been population-based or considered multiple shift schedules. Since obesity is linked with several chronic health conditions, understanding which types of shift work influence obesity is important and additional work with more detailed exposure assessment of shift work is warranted. Using multivariate polytomous logistic regression, we investigated the associations between shift work (evening/night, rotating and other shift schedules) and overweight and obesity as measured by body mass index cross-sectionally among 1561 men. These men had previously participated as population controls in a prostate cancer case-control study conducted in northeastern Ontario from 1995 to 1999. We obtained information on work history (including shift work), height and weight from the existing self-reported questionnaire data. We observed an association for ever (vs. never) having been employed in rotating shift work for both the overweight (OR [odds ratio] = 1.34; 95% CI [confidence interval]: 1.05-1.73) and obese (OR = 1.57; 95% CI: 1.12-2.21) groups. We also observed nonsignificant associations for ever (vs. never) having been employed in permanent evening/night shifts. In addition, we found a significant trend of increased risk for both overweight and obesity with increasing duration of rotating shift work. Both the positive association between rotating shift work and obesity and the suggested positive association for permanent evening/night shift work in this study are consistent with previous findings. Future population-based research that is able to build on our results while examining additional shift work characteristics will further clarify whether some shift patterns have a greater impact on obesity than others.

  4. Rotating shift work associated with obesity in men from northeastern Ontario

    Directory of Open Access Journals (Sweden)

    Anne Grundy

    2017-08-01

    Full Text Available Introduction: While some studies have suggested associations between shift work and obesity, few have been population-based or considered multiple shift schedules. Since obesity is linked with several chronic health conditions, understanding which types of shift work influence obesity is important and additional work with more detailed exposure assessment of shift work is warranted. Methods: Using multivariate polytomous logistic regression, we investigated the associations between shift work (evening/night, rotating and other shift schedules and overweight and obesity as measured by body mass index cross-sectionally among 1561 men. These men had previously participated as population controls in a prostate cancer case-control study conducted in northeastern Ontario from 1995 to 1999. We obtained information on work history (including shift work, height and weight from the existing self-reported questionnaire data. Results: We observed an association for ever (vs. never having been employed in rotating shift work for both the overweight (OR [odds ratio] = 1.34; 95% CI [confidence interval]: 1.05–1.73 and obese (OR = 1.57; 95% CI: 1.12–2.21 groups. We also observed nonsignificant associations for ever (vs. never having been employed in permanent evening/night shifts. In addition, we found a significant trend of increased risk for both overweight and obesity with increasing duration of rotating shift work. Conclusion: Both the positive association between rotating shift work and obesity and the suggested positive association for permanent evening/night shift work in this study are consistent with previous findings. Future population-based research that is able to build on our results while examining additional shift work characteristics will further clarify whether some shift patterns have a greater impact on obesity than others.

  5. Shift work as an oxidative stressor

    OpenAIRE

    Pasalar Parvin; Farahani Saeed; Sharifian Akbar; Gharavi Marjan; Aminian Omid

    2005-01-01

    Abstract Background Some medical disorders have higher prevalence in shift workers than others. This study was designed to evaluate the effect of night-shift-working on total plasma antioxidant capacity, with respect to the causative role of oxidative stress in induction of some of these disorders. Methods Two blood samples were taken from 44 workers with a rotational shift schedule, one after their day shift and one after their night shift. The total plasma antioxidant capacity of each worke...

  6. [(18)F]Fluorodeoxyglucose - positron emission tomography/computed tomography improves staging in patients with high-risk muscle-invasive bladder cancer scheduled for radical cystectomy.

    Science.gov (United States)

    Kollberg, Petter; Almquist, Helen; Bläckberg, Mats; Cronberg, Carin; Garpered, Sabine; Gudjonsson, Sigurdur; Kleist, Jakob; Lyttkens, Kerstin; Patschan, Oliver; Liedberg, Fredrik

    2015-01-01

    The aim of this study was to evaluate the clinical use of [(18)F]fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in addition to conventional preoperative radiological investigations in a defined group of patients with high-risk muscle-invasive bladder cancer. In total, 103 patients with high-risk muscle-invasive bladder cancer defined as stage T3/T4 disease or as stage T2 with hydronephrosis or high-risk histological features, who were provisionally scheduled to undergo cystectomy, were prospectively recruited to the study. The patients were referred to FDG-PET/CT in addition to standard preoperative investigation with computed tomography (CT). The final treatment decision was reached at a multidisciplinary conference based on all available information including the FDG-PET/CT findings. Compared to CT alone, FDG-PET/CT provided more supplemental findings suggesting malignant manifestations in 48 (47%) of the 103 patients. The additional FDG-PET/CT findings led to an altered provisional treatment plan in 28 out of 103 patients (27%), detection of disseminated bladder cancer and subsequent cancellation of the initially intended cystectomy in 16 patients, and identification of disseminated disease and treatment with induction chemotherapy before radical cystectomy in 12 patients. Preoperative FDG-PET/CT changed the treatment plan for a considerable proportion (27%) of the present patients. Accordingly, such examination can potentially improve the preoperative staging of cystectomy patients with high-risk features, and may also reduce the number of futile operations in patients with advanced disease who are beyond cure.

  7. A retrospective analysis of survival outcomes for two different radiotherapy fractionation schedules given in the same overall time for limited stage small cell lung cancer

    International Nuclear Information System (INIS)

    Bettington, Catherine S.; Bryant, Guy; Hickey, Brigid; Tripcony, Lee; Pratt, Gary; Fay, Michael

    2013-01-01

    To compare survival outcomes for two fractionation schedules of thoracic radiotherapy, both given over 3 weeks, in patients with limited stage small cell lung cancer (LS-SCLC). At Radiation Oncology Mater Centre (ROMC) and the Royal Brisbane and Women's Hospital (RBWH), patients with LS-SCLC treated with curative intent are given radiotherapy (with concurrent chemotherapy) to a dose of either 40Gy in 15 fractions ('the 40Gy/15⧣group') or 45Gy in 30 fractions ('the 45Gy/30⧣group'). The choice largely depends on institutional preference. Both these schedules are given over 3 weeks, using daily and twice-daily fractionation respectively. The records of all such patients treated from January 2000 to July 2009 were retrospectively reviewed and survival outcomes between the two groups compared. Of 118 eligible patients, there were 38 patients in the 40Gy/15⧣ group and 41 patients in the 45Gy/30⧣ group. The median relapse-free survival time was 12 months in both groups. Median overall survival was 21 months (95% CI 2–37 months) in the 40Gy/15⧣ group and 26 months (95% CI 1–48 months) in the 45Gy/30⧣ group. The 5-year overall survival rates were 20% and 25%, respectively (P=0.24). On multivariate analysis, factors influencing overall survival were: whether prophylactic cranial irradiation (PCI) was given (P=0.01) and whether salvage chemotherapy was given at the time of relapse (P=0.057). Given the small sample size, the potential for selection bias and the retrospective nature of our study it is not possible to draw firm conclusions regarding the efficacy of hypofractionated thoracic radiotherapy compared with hyperfractionated accelerated thoracic radiotherapy however hypofractionated radiotherapy may result in equivalent relapse-free survival.

  8. An open, randomised, multicentre, phase 3 trial comparing the efficacy of two tamoxifen schedules in preventing gynaecomastia induced by bicalutamide monotherapy in prostate cancer patients.

    Science.gov (United States)

    Bedognetti, Davide; Rubagotti, Alessandra; Conti, Giario; Francesca, Francesco; De Cobelli, Ottavio; Canclini, Luca; Gallucci, Michele; Aragona, Francesco; Di Tonno, Pasquale; Cortellini, Pietro; Martorana, Giuseppe; Lapini, Alberto; Boccardo, Francesco

    2010-02-01

    Bicalutamide monotherapy is a valuable option for prostate cancer (PCa) patients who wish to avoid the consequences of androgen deprivation; however, this treatment induces gynaecomastia and mastalgia in most patients. Tamoxifen is safe and effective in preventing breast events induced by bicalutamide monotherapy without affecting antitumor activity, but possible interference between bicalutamide and tamoxifen remains a matter of concern. To reduce the exposure to tamoxifen, we considered the putative advantages of weekly administration. To compare the efficacy of two different schedules of tamoxifen in preventing breast events. Toxicity, prostate-specific antigen behaviour, and sexual-functioning scores were also evaluated. This was a noninferiority trial. From December 2003 to February 2006, 80 patients with localised/locally advanced or biochemically recurrent PCa who were also candidates for bicalutamide single therapy were randomised to receive two different schedules of tamoxifen: daily (n=41) and weekly (n=39). Median follow-up was 24.2 mo. Daily bicalutamide (150 mg) plus daily tamoxifen 20mg continuously (daily group) or the same but with tamoxifen at 20mg weekly after the first 8 wk of daily treatment (weekly group). Three patients in the weekly group and one in the daily group were discontinued for adverse events. For gynaecomastia, we used ultrasonography. For mastalgia and sexual functioning, we used questionnaires. Gynaecomastia developed in 31.7% of patients in the daily group and in 74.4% of patients in the weekly group (p<0.0001), and it was more severe in patients who switched to weekly tamoxifen (p=0.001). Mastalgia occurred in 12.2% and 46.1% of patients, respectively (p=0.001). There were no major differences among treatment schedules relative to sexual functioning scores and incidence and severity of adverse events. No differences between groups in PSA behaviour and disease progression have been detected so far. This study demonstrated that

  9. 12-hour shifts: an ethical dilemma for the nurse executive.

    Science.gov (United States)

    Lorenz, Susan G

    2008-06-01

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

  10. Letter in reference to: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data".

    Science.gov (United States)

    Stevens, Richard G

    2017-01-01

    There are major flaws with the analyses in the Vistisen et al (1) cohort study examining if night shift work is a short-term risk factor for breast cancer. The crucial problem is the potential for exposure misclassification, which is very high. The authors' definition of day shift is "≥3 hours of work between 06:00-20:00 hours". This means that a worker on an 8-hour shift that begins at 03:00 hours would be classified as a day rather than night shift worker because he/she worked only two hours between 24:00-05:00 hours. Similarly, a second shifter might start work at 17:00 but not get off until 01:00 and yet still be classified as a "day shift" worker. This does not make sense as a baseline comparison group "unexposed" to work during the night hours. A sensible classification system would be to define "day shift" as any shift that begins after 07:00 and ends before 18:00 hours. This is straightforward and avoids all of the ambiguities inherent in the definition used by the authors. In addition, the authors claim that the "inception population" is less likely to have had past prior non-day work hours. However, this group has an average age of >35 years. It is inconceivable that all of these women were new graduates who started a public health sector job for the first time. Rather, the majority must surely have worked elsewhere for many years but then started in the regions covered only after 2006. This topic is too important, and this cohort too valuable, not to carefully define the baseline comparison group of "day workers" in a sensible manner. All the inferences rely crucially on this definition. The authors have the data to define the day-working baseline group in a way that avoids these obvious biases. That is why it is so frustrating that the authors chose to conduct the analyses as they did, with a highly flawed definition of "day work", when they could have done so much better. A highly flawed epidemiological report is worse than no report at all because

  11. Small-cell lung cancer patients are just ‘a little bit’ tired: response shift and self-presentation in the measurement of fatigue

    Science.gov (United States)

    The, Anne-Mei; Sprangers, Mirjam A. G.; Groen, Harry J. M.; van der Wal, Gerrit; Hak, Tony

    2007-01-01

    Background Response shift has gained increasing attention in the measurement of health-related quality of life (QoL) as it may explain counter-intuitive findings as a result of adaptation to deteriorating health. Objective To search for response shift type explanations to account for counter-intuitive findings in QoL measurement. Methods Qualitative investigation of the response behaviour of small-cell lung cancer (SCLC) patients (n = 23) in the measurement of fatigue with The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) question ‘were you tired’. Interviews were conducted at four points during 1st line chemotherapy: at the start of chemotherapy, 4 weeks later, at the end of chemotherapy, and 6 weeks later. Patients were asked to ‘think aloud’ when filling in the questionnaire. Results Fifteen patients showed discrepancies between their answer to the EORTC question ‘were you tired’ and their level of fatigue spontaneously reported during the interview. These patients chose the response options ‘not at all’ or ‘a little’ and explained their answers in various ways. In patients with and without discrepancies, we found indications of recalibration response shift (e.g. using a different comparison standard over time) and of change in perspective (e.g. change towards a more optimistic perspective). Patients in the discrepancy group reported spontaneously how they dealt with diagnosis and treatment, i.e. by adopting protective and assertive behaviour and by fighting the stigma. They distanced themselves from the image of the stereotypical cancer patient and presented themselves as not suffering and accepting fatigue as consequence of treatment. Conclusion In addition to response shift, this study suggests that ‘self-presentation’ might be an important mechanism affecting QoL measurement, particularly during phases when a new equilibrium needs to be found. PMID:17450423

  12. Night-shift work increases morbidity of breast cancer and all-cause mortality: a meta-analysis of 16 prospective cohort studies.

    Science.gov (United States)

    Lin, Xiaoti; Chen, Weiyu; Wei, Fengqin; Ying, Mingang; Wei, Weidong; Xie, Xiaoming

    2015-11-01

    Night-shift work (NSW) has previously been related to incidents of breast cancer and all-cause mortality, but many published studies have reported inconclusive results. The aim of the present study was to quantify a potential dose-effect relationship between NSW and morbidity of breast cancer, and to evaluate the association between NSW and risk of all-cause mortality. The outcomes included NSW, morbidity of breast cancer, cardiovascular mortality, cancer-related mortality, and all-cause mortality. Sixteen investigations were included, involving 2,020,641 participants, 10,004 incident breast cancer cases, 7185 cancer-related deaths, 4820 cardiovascular end points, and 2480 all-cause mortalities. The summary risk ratio (RR) of incident breast cancer for an increase of NSW was 1.057 [95% confidence interval (CI) 1.014-1.102; test for heterogeneity p = 0.358, I(2) = 9.2%]. The combined RR (95% CI) of breast cancer risk for NSW vs daytime work was: 1.029 (0.969-1.093) in the 20-year exposure lengths. The overall RR was 1.089 (95% CI 1.016-1.166) in a fixed-effects model (test for heterogeneity p = 0.838, I(2) = 0%) comparing rotating NSW and day work. Night-shift work was associated with an increased risk of cardiovascular death (RR 1.027, 95% CI 1.001-1.053), and all-cause death 1.253 (95% CI 0.786-1.997). In summary, NSW increased the risk of breast cancer morbidity by: 1.9% for 5 years, 2.5% for 5-10 years, 7.4% for 10-20 years, and 8.8% for >20-years of NSW. Additionally, rotating NSW enhanced the morbidity of breast cancer by 8.9%. Moreover, NSW was associated with a 2.7% increase in cardiovascular death. Copyright © 2015. Published by Elsevier B.V.

  13. Investigation of the dosimetric accuracy of the isocenter shifting method in prostate cancer patients with and without hip prostheses

    International Nuclear Information System (INIS)

    Hwang, Andrew B.; Kinsey, Erica; Xia Ping

    2009-01-01

    Purpose: The use of image guided radiation therapy (IGRT) enables compensation for prostate movement by shifting the treatment isocenter to track the prostate on a daily basis. Although shifting the isocenter can alter the source to skin distances (SSDs) and the effective depth of the target volume, it is commonly assumed that these changes have a negligible dosimetric effect, and therefore, the number of monitor units delivered is usually not adjusted. However, it is unknown whether or not this assumption is valid for patient with hip prostheses, which frequently contain high density materials. Methods: The authors conducted a retrospective study to investigate dosimetric effect of the isocenter shifting method for prostate patients with and without hip prostheses. For each patient, copies of the prostate volume were shifted by up to 1.5 cm from the original position to simulate prostate movement in 0.5 cm increments. Subsequently, 12 plans were created for each patient by creating a copy of the original plan for each prostate position with the isocenter shifted to track the position of the shifted prostate. The dose to the prostate was then recalculated for each plan. For patients with hip prostheses, plans were created both with and without lateral beam angles entering through the prostheses. Results: Without isocenter shifting to compensate for prostate motion of 1.5 cm, the dose to the 95% of the prostate (D-95%) changed by an average of 30% and by up to 64%. This was reduced to less than 3% with the isocenter shifting method. It was found that for patients with hip prostheses, this technique worked best for treatment plans that avoided beam angles passing through the prostheses. Conclusions: The results demonstrated that the isocenter shifting method can accurately deliver dose to the prostate even in patients with hip prostheses.

  14. Scheduling the powering tests

    CERN Document Server

    Barbero-Soto, E; Casas-Lino, M P; Fernandez-Robles, C; Foraz, K; Pojer, M; Saban, R; Schmidt, R; Solfaroli-Camillocci, M; Vergara-Fernandez, A

    2008-01-01

    The Large Hadron Collider is now entering in its final phase before receiving beam, and the activities at CERN between 2007 and 2008 have shifted from installation work to the commissioning of the technical systems ("hardware commissioning"). Due to the unprecedented complexity of this machine, all the systems are or will be tested as far as possible before the cool-down starts. Systems are firstly tested individually before being globally tested together. The architecture of LHC, which is partitioned into eight cryogenically and electrically independent sectors, allows the commissioning on a sector by sector basis. When a sector reaches nominal cryogenic conditions, commissioning of the magnet powering system to nominal current for all magnets can be performed. This paper briefly describes the different activities to be performed during the powering tests of the superconducting magnet system and presents the scheduling issues raised by co-activities as well as the management of resources.

  15. A randomized phase III multicenter trial comparing irinotecan in combination with the Nordic bolus 5-FU and folinic acid schedule or the bolus/infused de Gramont schedule (Lv5FU2) in patients with metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Glimelius, B; Sørbye, H; Balteskard, L

    2008-01-01

    not differ (4% versus 6%, P = 0.3). Grade 3/4 neutropenia (11% versus 5%, P = 0.01) and grade 2 alopecia (18% versus 9%, P = 0.002) were more common in the FLIRI group. The 60-day mortality was 2.4% versus 2.1%. CONCLUSIONS: Irinotecan with the bolus Nordic schedule (FLIRI) is a convenient treatment with PFS...... and OS comparable to irinotecan with the Lv5FU2 schedule. Neutropenia and alopecia are more prevalent, but both regimens are equally well tolerated....

  16. The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses.

    Science.gov (United States)

    Pijpe, Anouk; Slottje, Pauline; van Pelt, Cres; Stehmann, Floor; Kromhout, Hans; van Leeuwen, Flora E; Vermeulen, Roel C H; Rookus, Matti A

    2014-01-29

    Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks.

  17. The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses

    Science.gov (United States)

    2014-01-01

    Background Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. Methods/Design The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Discussion Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks. PMID:24475944

  18. [Burden and health effects of shift work].

    Science.gov (United States)

    Heitmann, Jörg

    2010-10-01

    In Germany aprox. 15% of all employees have irregular or flexible working hours. Disturbed sleep and/or hypersomnia are direct consequences of shift work and therefore described as shift work disorder. Beyond this, shift work can also be associated with specific pathological disorders. There are individual differences in tolerance to shift work. Optimization of both shift schedules and sleep to "non-physiological" times of the day are measures to counteract the negative effects of shift work. There is still not enough evidence to recommend drugs for routine use in shift workers. © Georg Thieme Verlag Stuttgart · New York.

  19. HEMŞİRE ÇİZELGELEMESİNDE ESNEK VARDİYA PLANLAMASI VE HASTANE UYGULAMASI (FLEXIBLE SHIFT PLANNING IN NURSE SCHEDULING AND AN APPLICATION OF THE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Yücel ÖZTÜRKOĞLU

    2014-01-01

    Full Text Available ÖZ: Müşteri tatmininin her geçen gün daha da zorlaştığı hizmet sektörlerinde, işverenler sunulan hizmetin kalitesini arttırmak ve hizmetin devamlılığını sağlamak için yeni arayışlar içine girmekteler. İşverenler, müşteriden önce hizmeti sunan kişilerin memnuniyetini sağlayarak rekabet gücünü arttırma yollarına başvurmaktadırlar. Bu yollardan biri de çalışma sürelerinin esnekleştirilmesidir. Bu çalışmada, hizmet sektörleri arasında önemli bir yere sahip olan hastanelerde ki hemşire çizelgeleme problemi için tam sayılı matematiksel bir model oluşturulmuştur. Oluşturulan modelde, klasik çizelgeleme modellerinin aksine hemşirelerin işe başlama saatlerine esneklik getirilmiştir. Modelin başlıca amacı, hemşirelerin kendi tercihlerine göre haftalık çizelgelerinin oluşturulmasıdır. Oluşturulan model, gerçek veriler kullanılarak bir üniversite hastanesinin genel cerrahi bölümünde denenmiştir. Modelin, %99,6 oranında hemşire tercihlerini yerine getirdiği görülmektedir. Anahtar Kelimeler: Esnek Çalışma Saatleri, Hemşire Çizelgelemesi, Matematiksel Model, Tam Sayılı Programlama. ABSTRACT: In the service industry, customer satisfaction becomes more difficult with each passing day, employers have looked for new paradigms and ways to make service quality better and to keep service facilities reliable. Therefore, with the purpose of increasing their competitive power, employers give more importance to their employees who have direct relation with customers than they do to their customer. One of the new paradigms is make working hours flexible. In this study, an integer programming model is proposed for the nurse scheduling problem in the hospitals which are one of the most important service industries. On the contrary of classical nurse scheduling model, developed model has made flexible to starting time. The main aim of the model is make a schedule for nurses according to

  20. Clinical outcomes in endometrial cancer care when the standard of care shifts from open surgery to robotics.

    Science.gov (United States)

    Mok, Zhun Wei; Yong, Eu Leong; Low, Jeffrey Jen Hui; Ng, Joseph Soon Yau

    2012-06-01

    In Singapore, the standard of care for endometrial cancer staging remains laparotomy. Since the introduction of gynecologic robotic surgery, there have been more data comparing robotic surgery to laparoscopy in the management of endometrial cancer. This study reviewed clinical outcomes in endometrial cancer in a program that moved from laparotomy to robotic surgery. A retrospective review was performed on 124 consecutive endometrial cancer patients. Preoperative data and postoperative outcomes of 34 patients undergoing robotic surgical staging were compared with 90 patients who underwent open endometrial cancer staging during the same period and in the year before the introduction of robotics. There were no significant differences in the mean age, body mass index, rates of diabetes, hypertension, previous surgery, parity, medical conditions, size of specimens, histologic type, or stage of cancer between the robotic and the open surgery groups. The first 20 robotic-assisted cases had a mean (SD) operative time of 196 (60) minutes, and the next 14 cases had a mean time of 124 (64) minutes comparable to that for open surgery. The mean number of lymph nodes retrieved during robot-assisted staging was smaller than open laparotomy in the first 20 cases but not significantly different for the subsequent 14 cases. Robot-assisted surgery was associated with lower intraoperative blood loss (110 [24] vs 250 [83] mL, P robot-assisted endometrial cancer staging after a relatively small number of cases.

  1. Shifting Attention

    Science.gov (United States)

    Ingram, Jenni

    2014-01-01

    This article examines the shifts in attention and focus as one teacher introduces and explains an image that represents the processes involved in a numeric problem that his students have been working on. This paper takes a micro-analytic approach to examine how the focus of attention shifts through what the teacher and students do and say in the…

  2. Review of job shop scheduling research and its new perspectives under Industry 4.0

    OpenAIRE

    Zhang, Jian; Ding, Guofu; Zou, Yisheng; Qin, Sheng-feng; Fu, Jianlin

    2017-01-01

    Traditional job shop scheduling is concentrated on centralized scheduling or semi-distributed scheduling. Under the Industry 4.0, the scheduling should deal with a smart and distributed manufacturing system supported by novel and emerging manufacturing technologies such as mass customization, Cyber-Physics Systems, Digital Twin, and SMAC (Social, Mobile, Analytics, Cloud). The scheduling research needs to shift its focus to smart distributed scheduling modeling and optimization. In order to t...

  3. Prescribed Travel Schedules for Fatigue Management

    Science.gov (United States)

    Whitmire, Alexandra; Johnston, Smith; Lockley, Steven

    2011-01-01

    The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.

  4. Adaptation of Shift Sequence Based Method for High Number in Shifts Rostering Problem for Health Care Workers

    Directory of Open Access Journals (Sweden)

    Mindaugas Liogys

    2013-08-01

    Full Text Available Purpose—is to investigate a shift sequence-based approach efficiency then problem consisting of a high number of shifts.Research objectives:• Solve health care workers rostering problem using a shift sequence based method.• Measure its efficiency then number of shifts increases.Design/methodology/approach—Usually rostering problems are highly constrained. Constraints are classified to soft and hard constraints. Soft and hard constraints of the problem are additionally classified to: sequence constraints, schedule constraints and roster constraints. Sequence constraints are considered when constructing shift sequences. Schedule constraints are considered when constructing a schedule. Roster constraints are applied, then constructing overall solution, i.e. combining all schedules.Shift sequence based approach consists of two stages:• Shift sequences construction,• The construction of schedules.In the shift sequences construction stage, the shift sequences are constructed for each set of health care workers of different skill, considering sequence constraints. Shifts sequences are ranked by their penalties for easier retrieval in later stage.In schedules construction stage, schedules for each health care worker are constructed iteratively, using the shift sequences produced in stage 1.Shift sequence based method is an adaptive iterative method where health care workers who received the highest schedule penalties in the last iteration are scheduled first at the current iteration.During the roster construction, and after a schedule has been generated for the current health care worker, an improvement method based on an efficient greedy local search is carried out on the partial roster. It simply swaps any pair of shifts between two health care workers in the (partial roster, as long as the swaps satisfy hard constraints and decrease the roster penalty.Findings—Using shift sequence method for solving health care workers rostering problem

  5. Adaptation of Shift Sequence Based Method for High Number in Shifts Rostering Problem for Health Care Workers

    Directory of Open Access Journals (Sweden)

    Mindaugas Liogys

    2011-08-01

    Full Text Available Purpose—is to investigate a shift sequence-based approach efficiency then problem consisting of a high number of shifts. Research objectives:• Solve health care workers rostering problem using a shift sequence based method.• Measure its efficiency then number of shifts increases. Design/methodology/approach—Usually rostering problems are highly constrained.Constraints are classified to soft and hard constraints. Soft and hard constraints of the problem are additionally classified to: sequence constraints, schedule constraints and roster constraints. Sequence constraints are considered when constructing shift sequences. Schedule constraints are considered when constructing a schedule. Roster constraints are applied, then constructing overall solution, i.e. combining all schedules.Shift sequence based approach consists of two stages:• Shift sequences construction,• The construction of schedules.In the shift sequences construction stage, the shift sequences are constructed for each set of health care workers of different skill, considering sequence constraints. Shifts sequences are ranked by their penalties for easier retrieval in later stage.In schedules construction stage, schedules for each health care worker are constructed iteratively, using the shift sequences produced in stage 1. Shift sequence based method is an adaptive iterative method where health care workers who received the highest schedule penalties in the last iteration are scheduled first at the current iteration. During the roster construction, and after a schedule has been generated for the current health care worker, an improvement method based on an efficient greedy local search is carried out on the partial roster. It simply swaps any pair of shifts between two health care workers in the (partial roster, as long as the swaps satisfy hard constraints and decrease the roster penalty.Findings—Using shift sequence method for solving health care workers rostering

  6. Early breast cancer

    International Nuclear Information System (INIS)

    Dongen, J.A. van

    1989-01-01

    The therapy of early breast cancer has been changing during the last decennium. It requires a multi-disciplinary approach and in each of these disciplines improvements have been implemented. The result is that treatment schedules can now be adapted to specific subgroups. In this review early breast cancer is defined as operable disease, using the criteria set out by Haagensen. Emphasis is given to describing the new developments in prognostic criteria, since these form the basis for creating subgroups for specific treatment schedules. Distinction is made between the factors relating to growth rate and those relating to metastatic potential. Data on screening promises a beneficial effect of the implementation of screening in national health care programs. Important shifts are seen in treatment schedules; the place of postoperative radiotherapy after classic ablative treatment is being challenged, whereas it plays a major role in the new breast conserving therapy schedules. The data mentioned in the review suggest that a large proportion of 'operable' cases can be treated with breast conservation but details in the technique of breast conserving therapy are still under investigation. They form a major part of the coming prospective studies in breast cancer. Improvements in reconstruction techniques, creating better cosmetic results, make reconstruction more competitive with breast conserving therapy. The use of chemotherapy and endocrine manipulation in early breast cancer has now been clearly confirmed by the overview technique by the Peto-group, thanks to all efforts of individual trialists together. (orig.)

  7. Liver cancer-derived hepatitis C virus core proteins shift TGF-beta responses from tumor suppression to epithelial-mesenchymal transition.

    Directory of Open Access Journals (Sweden)

    Serena Battaglia

    Full Text Available BACKGROUND: Chronic hepatitis C virus (HCV infection and associated liver cirrhosis represent a major risk factor for hepatocellular carcinoma (HCC development. TGF-beta is an important driver of liver fibrogenesis and cancer; however, its actual impact in human cancer progression is still poorly known. The aim of this study was to investigate the role of HCC-derived HCV core natural variants on cancer progression through their impact on TGF-beta signaling. PRINCIPAL FINDINGS: We provide evidence that HCC-derived core protein expression in primary human or mouse hepatocyte alleviates TGF-beta responses in terms or growth inhibition or apoptosis. Instead, in these hepatocytes TGF-beta was still able to induce an epithelial to mesenchymal transition (EMT, a process that contributes to the promotion of cell invasion and metastasis. Moreover, we demonstrate that different thresholds of Smad3 activation dictate the TGF-beta responses in hepatic cells and that HCV core protein, by decreasing Smad3 activation, may switch TGF-beta growth inhibitory effects to tumor promoting responses. CONCLUSION/SIGNIFICANCE: Our data illustrate the capacity of hepatocytes to develop EMT and plasticity under TGF-beta, emphasize the role of HCV core protein in the dynamic of these effects and provide evidence for a paradigm whereby a viral protein implicated in oncogenesis is capable to shift TGF-beta responses from cytostatic effects to EMT development.

  8. Personnel shift assignment: Existence conditions and network models

    NARCIS (Netherlands)

    van den Berg, Jeroen P.; van den Berg, J.P.; Panton, David M.

    1994-01-01

    The personnel scheduling problem is known to be a five-stage process in which the final stage involves the assignment of shifts to the days worked in the schedule. This paper discusses the existence conditions for both continuous and forward rotating shift assignments and heuristic network

  9. Immunization Schedules for Adults

    Science.gov (United States)

    ... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedule for Adults (19 Years of Age and ... diseases that can be prevented by vaccines . 2018 Immunization Schedule Recommended Vaccinations for Adults by Age and ...

  10. Instant Childhood Immunization Schedule

    Science.gov (United States)

    ... Recommendations Why Immunize? Vaccines: The Basics Instant Childhood Immunization Schedule Recommend on Facebook Tweet Share Compartir Get ... date. See Disclaimer for additional details. Based on Immunization Schedule for Children 0 through 6 Years of ...

  11. Toxicity Profile and Pharmacokinetic Study of A Phase I Low-Dose Schedule-Dependent Radiosensitizing Paclitaxel Chemoradiation Regimen for Inoperable Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Chen, Yuhchyau; Pandya, Kishan J.; Feins, Richard; Johnstone, David W.; Watson, Thomas; Smudzin, Therese; Keng, Peter C.

    2008-01-01

    Purpose: We report the toxicity profile and pharmacokinetic data of a schedule-dependent chemoradiation regimen using pulsed low-dose paclitaxel for radiosensitization in a Phase I study for inoperable non-small-cell lung cancer. Methods and Materials: Paclitaxel at escalating doses of 15 mg/m 2 , 20 mg/m 2 , and 25 mg/m 2 were infused on Monday, Wednesday, and Friday with daily chest radiation in cohorts of 6 patients. Daily radiation was delayed for maximal G2/M arrest and apoptotic effect, an observation from preclinical investigations. Plasma paclitaxel concentration was determined by high-performance liquid chromatography. Results: Dose-limiting toxicities included 3 of 18 patients with Grade 3 pneumonitis and 3 of 18 patients with Grade 3 esophagitis. There was no Grade 4 or 5 pneumonitis or esophagitis. There was also no Grade 3 or 4 neutropenia, thrombocytopenia, anemia or neuropathy. For Dose Levels I (15 mg/m 2 ), II (20 mg/m 2 ), and III (25 mg/m 2 ), the mean peak plasma level was 0.23 ± 0.06 μmol/l, 0.32 ± 0.05 μmol/l, and 0.52 ± 0.14 μmol/l, respectively; AUC was 0.44 ± 0.09 μmol/l, 0.61 ± 0.1 μmol/l, and 0.96 ± 0.23 μmol/l, respectively; and duration of drug concentration >0.05 μmol/l (t > 0.05 μmol/l) was 1.6 ± 0.3 h, 1.9 ± 0.2 h, and 3.0 ± 0.9 h, respectively. Conclusion: Pulsed low-dose paclitaxel chemoradiation is associated with low toxicity. Pharmacokinetic data showed that plasma paclitaxel concentration >0.05 μmol/l for a minimum of 1.6 h was sufficient for effective radiosensitization

  12. 1H NMR metabolomics identification of markers of hypoxia-induced metabolic shifts in a breast cancer model system

    International Nuclear Information System (INIS)

    Weljie, Aalim M.; Bondareva, Alla; Zang, Ping; Jirik, Frank R.

    2011-01-01

    Hypoxia can promote invasive behavior in cancer cells and alters the response to therapeutic intervention as a result of changes in the expression many genes, including genes involved in intermediary metabolism. Although metabolomics technologies are capable of simultaneously measuring a wide range of metabolites in an untargeted manner, these methods have been relatively under utilized in the study of cancer cell responses to hypoxia. Thus, 1 H NMR metabolomics was used to examine the effects of hypoxia in the MDA-MB-231 human breast cancer cell line, both in vitro and in vivo. Cell cultures were compared with respect to their metabolic responses during growth under either hypoxic (1% O 2 ) or normoxic conditions. Orthogonal partial least squares discriminant analysis (OPLS-DA) was used to identify a set of metabolites that were responsive to hypoxia. Via intracardiac administration, MDA-MB-231 cells were also used to generate widespread metastatic disease in immuno-compromised mice. Serum metabolite analysis was conducted to compare animals with and without a large tumor burden. Intriguingly, using a cross-plot of the OPLS loadings, both the in vitro and in vivo samples yielded a subset of metabolites that were significantly altered by hypoxia. These included primarily energy metabolites and amino acids, indicative of known alterations in energy metabolism, and possibly protein synthesis or catabolism. The results suggest that the metabolite pattern identified might prove useful as a marker for intra-tumoral hypoxia.

  13. Maternal Nonstandard Work Schedules and Breastfeeding Behaviors.

    Science.gov (United States)

    Zilanawala, Afshin

    2017-06-01

    Objectives Although maternal employment rates have increased in the last decade in the UK, there is very little research investigating the linkages between maternal nonstandard work schedules (i.e., work schedules outside of the Monday through Friday, 9-5 schedule) and breastfeeding initiation and duration, especially given the wide literature citing the health advantages of breastfeeding for mothers and children. Methods This paper uses a population-based, UK cohort study, the Millennium Cohort Study (n = 17,397), to investigate the association between types of maternal nonstandard work (evening, night, away from home overnight, and weekends) and breastfeeding behaviors. Results In unadjusted models, exposure to evening shifts was associated with greater odds of breastfeeding initiation (OR 1.71, CI 1.50-1.94) and greater odds of short (OR 1.55, CI 1.32-1.81), intermediate (OR 2.01, CI 1.64-2.47), prolonged partial duration (OR 2.20, CI 1.78-2.72), and prolonged exclusive duration (OR 1.53, CI 1.29-1.82), compared with mothers who were unemployed and those who work other types of nonstandard shifts. Socioeconomic advantage of mothers working evening schedules largely explained the higher odds of breastfeeding initiation and duration. Conclusions Socioeconomic characteristics explain more breastfeeding behaviors among mothers working evening shifts. Policy interventions to increase breastfeeding initiation and duration should consider the timing of maternal work schedules.

  14. Web Publishing Schedule

    Science.gov (United States)

    Section 207(f)(2) of the E-Gov Act requires federal agencies to develop an inventory and establish a schedule of information to be published on their Web sites, make those schedules available for public comment. To post the schedules on the web site.

  15. Preemptive scheduling with rejection

    NARCIS (Netherlands)

    Hoogeveen, H.; Skutella, M.; Woeginger, Gerhard

    2003-01-01

    We consider the problem of preemptively scheduling a set of n jobs on m (identical, uniformly related, or unrelated) parallel machines. The scheduler may reject a subset of the jobs and thereby incur job-dependent penalties for each rejected job, and he must construct a schedule for the remaining

  16. Preemptive scheduling with rejection

    NARCIS (Netherlands)

    Hoogeveen, J.A.; Skutella, M.; Woeginger, G.J.; Paterson, M.

    2000-01-01

    We consider the problem of preemptively scheduling a set of n jobs on m (identical, uniformly related, or unrelated) parallel machines. The scheduler may reject a subset of the jobs and thereby incur job-dependent penalties for each rejected job, and he must construct a schedule for the remaining

  17. Outage scheduling and implementation

    International Nuclear Information System (INIS)

    Allison, J.E.; Segall, P.; Smith, R.R.

    1986-01-01

    Successful preparation and implementation of an outage schedule and completion of scheduled and emergent work within an identified critical path time frame is a result of careful coordination by Operations, Work Control, Maintenance, Engineering, Planning and Administration and others. At the Fast Flux Test Facility (FFTF) careful planning has been responsible for meeting all scheduled outage critical paths

  18. Scheduling with Time Lags

    NARCIS (Netherlands)

    X. Zhang (Xiandong)

    2010-01-01

    textabstractScheduling is essential when activities need to be allocated to scarce resources over time. Motivated by the problem of scheduling barges along container terminals in the Port of Rotterdam, this thesis designs and analyzes algorithms for various on-line and off-line scheduling problems

  19. Review of 12-hour shifts at nuclear generating stations

    International Nuclear Information System (INIS)

    Smiley, A.; Moray, N.P.

    1989-04-01

    This project reviewed the practice of 12-hour shift work schedules at nuclear power plants, and its relationship to safety. The current literature was examined for information on accidents, fatigue and personal preferences. Interviews with operators and maintainers showed that these groups had attitude and preference differences related to both 12 hour shift schedules and overtime work opportunities. Several factors related to 12-hour schedules were identified which could affect safety, but which have not been adequately considered. (24 refs.)

  20. The glycolytic shift in fumarate-hydratase-deficient kidney cancer lowers AMPK levels, increases anabolic propensities and lowers cellular iron levels

    KAUST Repository

    Tong, Winghang; Sourbier, Carole; Kovtunovych, Gennadiy; Jeong, Suhyoung; Vira, Manish A.; Ghosh, Manik Chandra; Romero, Vladimir Valera; Sougrat, Rachid; Vaulont, Sophie; Viollet, Benoî t; Kim, Yeongsang; Lee, Sunmin; Trepel, Jane B.; Srinivasan, Ramaprasad; Bratslavsky, Gennady; Yang, Youfeng; Linehan, William Marston; Rouault, Tracey A.

    2011-01-01

    Inactivation of the TCA cycle enzyme, fumarate hydratase (FH), drives a metabolic shift to aerobic glycolysis in FH-deficient kidney tumors and cell lines from patients with hereditary leiomyomatosis renal cell cancer (HLRCC), resulting in decreased levels of AMP-activated kinase (AMPK) and p53 tumor suppressor, and activation of the anabolic factors, acetyl-CoA carboxylase and ribosomal protein S6. Reduced AMPK levels lead to diminished expression of the DMT1 iron transporter, and the resulting cytosolic iron deficiency activates the iron regulatory proteins, IRP1 and IRP2, and increases expression of the hypoxia inducible factor HIF-1α, but not HIF-2α. Silencing of HIF-1α or activation of AMPK diminishes invasive activities, indicating that alterations of HIF-1α and AMPK contribute to the oncogenic growth of FH-deficient cells. © 2011 Elsevier Inc.

  1. The glycolytic shift in fumarate-hydratase-deficient kidney cancer lowers AMPK levels, increases anabolic propensities and lowers cellular iron levels

    KAUST Repository

    Tong, Winghang

    2011-09-01

    Inactivation of the TCA cycle enzyme, fumarate hydratase (FH), drives a metabolic shift to aerobic glycolysis in FH-deficient kidney tumors and cell lines from patients with hereditary leiomyomatosis renal cell cancer (HLRCC), resulting in decreased levels of AMP-activated kinase (AMPK) and p53 tumor suppressor, and activation of the anabolic factors, acetyl-CoA carboxylase and ribosomal protein S6. Reduced AMPK levels lead to diminished expression of the DMT1 iron transporter, and the resulting cytosolic iron deficiency activates the iron regulatory proteins, IRP1 and IRP2, and increases expression of the hypoxia inducible factor HIF-1α, but not HIF-2α. Silencing of HIF-1α or activation of AMPK diminishes invasive activities, indicating that alterations of HIF-1α and AMPK contribute to the oncogenic growth of FH-deficient cells. © 2011 Elsevier Inc.

  2. The technical feasibility of an image-guided intensity-modulated radiotherapy (IG-IMRT) to perform a hypofractionated schedule in terms of toxicity and local control for patients with locally advanced or recurrent pancreatic cancer

    International Nuclear Information System (INIS)

    Son, Seok Hyun; Song, Jin Ho; Choi, Byung Ock; Kang, Young-nam; Lee, Myung Ah; Kang, Ki Mun; Jang, Hong Seok

    2012-01-01

    The purpose of this study was to evaluate the technical feasibility of an image-guided intensity modulated radiotherapy (IG-IMRT) using involved-field technique to perform a hypofractionated schedule for patients with locally advanced or recurrent pancreatic cancer. From May 2009 to November 2011, 12 patients with locally advanced or locally recurrent pancreatic cancer received hypofractionated CCRT using TomoTherapy Hi-Art with concurrent and sequential chemotherapy at Seoul St. Mary’s Hospital, the Catholic University of Korea. The total dose delivered was 45 Gy in 15 fractions or 50 Gy in 20 fractions. The target volume did not include the uninvolved regional lymph nodes. Treatment planning and delivery were performed using the IG-IMRT technique. The follow-up duration was a median of 31.1 months (range: 5.7-36.3 months). Grade 2 or worse acute toxicities developed in 7 patients (58%). Grade 3 or worse gastrointestinal and hematologic toxicity occurred in 0% and 17% of patients, respectively. In the response evaluation, the rates of partial response and stable disease were 58% and 42%, respectively. The rate of local failure was 8% and no regional failure was observed. Distant failure was the main cause of treatment failure. The progression-free survival and overall survival durations were 7.6 and 12.1 months, respectively. The involved-field technique and IG-IMRT delivered via a hypofractionated schedule are feasible for patients with locally advanced or recurrent pancreatic cancer

  3. Rapid and Simple Detection of Hot Spot Point Mutations of Epidermal Growth Factor Receptor, BRAF, and NRAS in Cancers Using the Loop-Hybrid Mobility Shift Assay

    Science.gov (United States)

    Matsukuma, Shoichi; Yoshihara, Mitsuyo; Kasai, Fumio; Kato, Akinori; Yoshida, Akira; Akaike, Makoto; Kobayashi, Osamu; Nakayama, Haruhiko; Sakuma, Yuji; Yoshida, Tsutomu; Kameda, Yoichi; Tsuchiya, Eiju; Miyagi, Yohei

    2006-01-01

    A simple and rapid method to detect the epidermal growth factor receptor hot spot mutation L858R in lung adenocarcinoma was developed based on principles similar to the universal heteroduplex generator technology. A single-stranded oligonucleotide with an internal deletion was used to generate heteroduplexes (loop-hybrids) bearing a loop in the complementary strand derived from the polymerase chain reaction product of the normal or mutant allele. By placing deletion in the oligonucleotide adjacent to the mutational site, difference in electrophoretic mobility between loop-hybrids with normal and mutated DNA was distinguishable in a native polyacrylamide gel. The method was also modified to detect in-frame deletion mutations of epidermal growth factor receptor in lung adenocarcinomas. In addition, the method was adapted to detect hot spot mutations in the B-type Raf kinase (BRAF) at V600 and in a Ras-oncogene (NRAS) at Q61, the mutations commonly found in thyroid carcinomas. Our mutation detection system, designated the loop-hybrid mobility shift assay was sensitive enough to detect mutant DNA comprising 7.5% of the total DNA. As a simple and straightforward mutation detection technique, loop-hybrid mobility shift assay may be useful for the molecular diagnosis of certain types of clinical cancers. Other applications are also discussed. PMID:16931592

  4. Market shifting

    Energy Technology Data Exchange (ETDEWEB)

    Forst, Michael

    2013-11-01

    After years of oversupply and artificially low module pricing, market analysts believe that the solar industry will begin to stabilize by 2017. While the market activities are shifting from Europe to the Asia Pacific region and the United States, the solar shakeout continues to be in full swing including solar cell and module manufacturing. (orig.)

  5. Tough Shift

    DEFF Research Database (Denmark)

    Brewer, Robert S.; Verdezoto, Nervo; Holst, Thomas

    2015-01-01

    people to change their behavior at home. Leveraging prior research on encouraging reductions in residential energy use through game play, we introduce ShareBuddy: a casual mobile game intended to encourage players not only to reduce, but also to shift their electricity use. We conducted two field studies...... real-world resource use into a game....

  6. paradigm shift

    Indian Academy of Sciences (India)

    2015-07-17

    Jul 17, 2015 ... Cancer research in need of a scientific revolution: .... 'scientific revolution' is not exclusive. For example, ..... Stroma in breast development and disease. Semin. ..... Welch HG and Passow HJ 2014 Quantifying the benefits and.

  7. NASA scheduling technologies

    Science.gov (United States)

    Adair, Jerry R.

    1994-01-01

    This paper is a consolidated report on ten major planning and scheduling systems that have been developed by the National Aeronautics and Space Administration (NASA). A description of each system, its components, and how it could be potentially used in private industry is provided in this paper. The planning and scheduling technology represented by the systems ranges from activity based scheduling employing artificial intelligence (AI) techniques to constraint based, iterative repair scheduling. The space related application domains in which the systems have been deployed vary from Space Shuttle monitoring during launch countdown to long term Hubble Space Telescope (HST) scheduling. This paper also describes any correlation that may exist between the work done on different planning and scheduling systems. Finally, this paper documents the lessons learned from the work and research performed in planning and scheduling technology and describes the areas where future work will be conducted.

  8. Adaptation to shift work: physiologically based modeling of the effects of lighting and shifts' start time.

    Directory of Open Access Journals (Sweden)

    Svetlana Postnova

    Full Text Available Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers' sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8 in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers' adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21:00 instead of 00:00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters.

  9. Adaptation to shift work: physiologically based modeling of the effects of lighting and shifts' start time.

    Science.gov (United States)

    Postnova, Svetlana; Robinson, Peter A; Postnov, Dmitry D

    2013-01-01

    Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers' sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8) in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers' adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21:00 instead of 00:00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters.

  10. Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P

    Directory of Open Access Journals (Sweden)

    Kuechler Thomas

    2009-08-01

    Full Text Available Abstract Background The PORPUS-P is a short questionnaire for measuring prostate-specific quality of life (QoL, which was designed in Canada for use in prostate cancer (PC patients. We aimed to generate a German version and compare PORPUS-P scores of German reference men from the general population, and German and Canadian patients with newly diagnosed PC who were scheduled to receive radical prostatectomy (RP or radiotherapy (RT. Methods The study sample consisted of 988 reference men, 121 German and 66 Canadian PC patients scheduled for RT, and 371 German and 68 Canadian PC patients scheduled for RP. All men completed the PORPUS-P (German postal questionnaire, Canada personal interview. Data were gathered from PC patients before the start of therapy. Results Canadian patients were better educated than the German patients, and fewer were retired. Patients scheduled to receive RT were older and more were retired. German RT patients had lower D'Amico risk scores and pre-treatment Gleason scores than RP patients, and Canadian RT patients had higher pre-treatment PSA than RP patients. Urinary and sexual dysfunction were seen in PC patients (especially RT patients, but were also common in the German reference men. Crude mean PORPUS-P scores differed statistically significant between German RT and RP and Canadian RP and RT patients, with RT patients having higher QoL scores. The differences in age-adjusted mean PORPUS-P scores between reference men and RP patients were not clinically significant, while RT patients had (clinically significantly lower scores than the reference men. Conclusion The German translation of the PORPUS-P appears to be a short and feasible tool for assessing prostate-specific QoL. Although we found a similar response pattern, Canadian and German PC patients scheduled to receive RT or RP rated their pre-treatment quality of life on different levels, which reveals the need for national reference data. Problems in several Qo

  11. Scheduling for decommissioning projects

    International Nuclear Information System (INIS)

    Podmajersky, O.E.

    1987-01-01

    This paper describes the Project Scheduling system being employed by the Decommissioning Operations Contractor at the Shippingport Station Decommissioning Project (SSDP). Results from the planning system show that the project continues to achieve its cost and schedule goals. An integrated cost and schedule control system (C/SCS) which uses the concept of earned value for measurement of performance was instituted in accordance with DOE orders. The schedule and cost variances generated by the C/SCS system are used to confirm management's assessment of project status. This paper describes the types of schedules and tools used on the SSDP project to plan and monitor the work, and identifies factors that are unique to a decommissioning project that make scheduling critical to the achievement of the project's goals. 1 fig

  12. Program reference schedule baseline

    International Nuclear Information System (INIS)

    1986-07-01

    This Program Reference Schedule Baseline (PRSB) provides the baseline Program-level milestones and associated schedules for the Civilian Radioactive Waste Management Program. It integrates all Program-level schedule-related activities. This schedule baseline will be used by the Director, Office of Civilian Radioactive Waste Management (OCRWM), and his staff to monitor compliance with Program objectives. Chapter 1 includes brief discussions concerning the relationship of the PRSB to the Program Reference Cost Baseline (PRCB), the Mission Plan, the Project Decision Schedule, the Total System Life Cycle Cost report, the Program Management Information System report, the Program Milestone Review, annual budget preparation, and system element plans. Chapter 2 includes the identification of all Level 0, or Program-level, milestones, while Chapter 3 presents and discusses the critical path schedules that correspond to those Level 0 milestones

  13. Robust Optimization for Household Load Scheduling with Uncertain Parameters

    Directory of Open Access Journals (Sweden)

    Jidong Wang

    2018-04-01

    Full Text Available Home energy management systems (HEMS face many challenges of uncertainty, which have a great impact on the scheduling of home appliances. To handle the uncertain parameters in the household load scheduling problem, this paper uses a robust optimization method to rebuild the household load scheduling model for home energy management. The model proposed in this paper can provide the complete robust schedules for customers while considering the disturbance of uncertain parameters. The complete robust schedules can not only guarantee the customers’ comfort constraints but also cooperatively schedule the electric devices for cost minimization and load shifting. Moreover, it is available for customers to obtain multiple schedules through setting different robust levels while considering the trade-off between the comfort and economy.

  14. Developing optimal nurses work schedule using integer programming

    Science.gov (United States)

    Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena

    2017-08-01

    Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.

  15. Approximating Preemptive Stochastic Scheduling

    OpenAIRE

    Megow Nicole; Vredeveld Tjark

    2009-01-01

    We present constant approximative policies for preemptive stochastic scheduling. We derive policies with a guaranteed performance ratio of 2 for scheduling jobs with release dates on identical parallel machines subject to minimizing the sum of weighted completion times. Our policies as well as their analysis apply also to the recently introduced more general model of stochastic online scheduling. The performance guarantee we give matches the best result known for the corresponding determinist...

  16. Revisiting Symbiotic Job Scheduling

    OpenAIRE

    Eyerman , Stijn; Michaud , Pierre; Rogiest , Wouter

    2015-01-01

    International audience; —Symbiotic job scheduling exploits the fact that in a system with shared resources, the performance of jobs is impacted by the behavior of other co-running jobs. By coscheduling combinations of jobs that have low interference, the performance of a system can be increased. In this paper, we investigate the impact of using symbiotic job scheduling for increasing throughput. We find that even for a theoretically optimal scheduler, this impact is very low, despite the subs...

  17. Improved human performance through appropriate work scheduling

    International Nuclear Information System (INIS)

    Morisseau, D.S.; Lewis, P.M.; Persensky, J.J.

    1987-01-01

    The Nuclear Regulatory Commission (NRC) has had a policy, Generic Letter 82-12, on hours of work since 1982. The policy states that licensees should establish controls to prevent situations where fatigue could reduce the ability of operating personnel to perform their duties safely (USNRC 1982). While that policy does give guidance on hours of work and overtime, it does not address periods of longer than 7 days or work schedules other than the routine 8-hour day, 40-hour week. Recognizing that NRC policy could provide broader guidance for shift schedules and hours of overtime work, the Division of Human Factors Safety conducted a project with Pacific Northwest Laboratories (PNL) to help the NRC better understand the human factors principles and issues concerning hours of work so that the NRC could consider updating their policy as necessary. The results of this project are recommendations for guidelines and limits for periods of 14 days, 28 days, and 1 year to take into account the cumulative effects of fatigue. In addition, routine 12-hour shifts are addressed. This latter type of shift schedule has been widely adopted in the petroleum and chemical industries and several utilities operating nuclear power plants have adopted it as well. Since this is the case, it is important to consider including guidelines for implementing this type of schedule. This paper discusses the bases for the PNL recommendations which are currently being studied by the NRC

  18. Health and Occupational Outcomes Among Injured, Nonstandard Shift Workers.

    Science.gov (United States)

    Wong, Imelda S; Smith, Peter M; Mustard, Cameron A; Gignac, Monique A M

    2015-11-01

    This study compares health and occupational outcomes following a work-related injury for nonstandard and day-shift workers. National Population Health Survey data were used to explore outcomes 2 years post-work injury. Retrospective-matched cohort analyses examined main effects and interactions of shift schedule and work injury with changes in health, shift schedule, and labor force status. Models were adjusted for respondent characteristics, baseline health status, and occupational strength requirements. Injured nonstandard shift workers reported lower health utility index scores, compared with uninjured and injured daytime workers and uninjured nonstandard-shift workers. No significant interactions between shift and injury were found with schedule change and leaving the labor force. Injured nonstandard-shift workers are as likely to remain employed as other groups, but may be vulnerable in terms of diminished health.

  19. Fluid Shifts

    Science.gov (United States)

    Stenger, M. B.; Hargens, A. R.; Dulchavsky, S. A.; Arbeille, P.; Danielson, R. W.; Ebert, D. J.; Garcia, K. M.; Johnston, S. L.; Laurie, S. S.; Lee, S. M. C.; hide

    2017-01-01

    Introduction. NASA's Human Research Program is focused on addressing health risks associated with long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight and to determine if a relation exists with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. Methods. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid

  20. Shifting paradigms in the estimation of survival for castration-resistant prostate cancer: A tertiary academic center experience.

    Science.gov (United States)

    Afshar, Mehran; Evison, Felicity; James, Nicholas D; Patel, Prashant

    2015-08-01

    Castration-resistant prostate cancer (CRPC) has retained a guarded prognosis, with historical survival estimates of 18 to 24 months. However, the landscape of available therapy has changed, and the emphasis has altered from supportive to active treatment. Few large series from real-world populations exist in the contemporary era with fully mature survival data to confirm the indication based on clinical trials that patients with CRPC are surviving far longer than the historical estimates. We aim to review a large patient cohort with CRPC and provide mature survival data. Using the electronic histopathology database at Queen Elizabeth Hospital, Birmingham, UK, all prostate-specific antigentest results between April 2006 and September 2007 were extracted, and patients satisfying the American Society for Radiation Oncology (ASTRO) definition of hormone failure were identified. Electronic records were reviewed and variables were collected, including survival, treatment, biochemistry, histopathology, and demographics. Probability of survival, and of developing metastasis or CRPC, was determined using the Kaplan-Meier method. Patients were stratified into 3 groups, namely, D0--no metastasis at diagnosis but later appearance, D1--no metastasis at diagnosis or at last follow-up, and D2--metastasis at diagnosis. From 8,062 patient-prostate-specific antigen episodes, we identified 447 patients meeting the criteria. A notes review revealed 147 patients with CRPC. Median overall survival (OS) from diagnosis was 84.7 months (95% CI: 73-89), and 129 deaths had occurred (88%). Median OS from diagnosis for D0, D1, and D2 patients was 100.4, 180.1, and 58.9 months, respectively (Pdata benefit clinicians and patients in understanding prognosis and treatment choices. Importantly, our patients were diagnosed before the current wave of novel therapeutics for CRPC, so survival for men diagnosed today may be more than our findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Solving cyclical nurse scheduling problem using preemptive goal programming

    Science.gov (United States)

    Sundari, V. E.; Mardiyati, S.

    2017-07-01

    Nurse scheduling system in a hospital is being modeled as a preemptive goal programming problem that is solved by using LINGO software with the objective function to minimize deviation variable at each goal. The scheduling is done cyclically, so every nurse is treated fairly since they have the same work shift portion with the other nurses. By paying attention to the hospital's rules regarding nursing work shift cyclically, it can be obtained that numbers of nurse needed in every ward are 18 nurses and the numbers of scheduling periods are 18 periods where every period consists of 21 days.

  2. Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients

    Science.gov (United States)

    2014-01-01

    Background The occurrence of response shift (RS) in longitudinal health-related quality of life (HRQoL) studies, reflecting patient adaptation to disease, has already been demonstrated. Several methods have been developed to detect the three different types of response shift (RS), i.e. recalibration RS, 2) reprioritization RS, and 3) reconceptualization RS. We investigated two complementary methods that characterize the occurrence of RS: factor analysis, comprising Principal Component Analysis (PCA) and Multiple Correspondence Analysis (MCA), and a method of Item Response Theory (IRT). Methods Breast cancer patients (n = 381) completed the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires at baseline, immediately following surgery, and three and six months after surgery, according to the “then-test/post-test” design. Recalibration was explored using MCA and a model of IRT, called the Linear Logistic Model with Relaxed Assumptions (LLRA) using the then-test method. Principal Component Analysis (PCA) was used to explore reconceptualization and reprioritization. Results MCA highlighted the main profiles of recalibration: patients with high HRQoL level report a slightly worse HRQoL level retrospectively and vice versa. The LLRA model indicated a downward or upward recalibration for each dimension. At six months, the recalibration effect was statistically significant for 11/22 dimensions of the QLQ-C30 and BR23 according to the LLRA model (p ≤ 0.001). Regarding the QLQ-C30, PCA indicated a reprioritization of symptom scales and reconceptualization via an increased correlation between functional scales. Conclusions Our findings demonstrate the usefulness of these analyses in characterizing the occurrence of RS. MCA and IRT model had convergent results with then-test method to characterize recalibration component of RS. PCA is an indirect method in investigating the reprioritization and reconceptualization components of RS. PMID:24606836

  3. Safety of a 3-weekly schedule of carboplatin plus pegylated liposomal doxorubicin as first line chemotherapy in patients with ovarian cancer: preliminary results of the MITO-2 randomized trial

    International Nuclear Information System (INIS)

    Pignata, Sandro; Del Gaizo, Filomena; Naglieri, Emanuele; Ferro, Antonella; Musso, Pietro; D'Arco, Alfonso Maria; Sorio, Roberto; Pisano, Carmela; Di Maio, Massimo; Signoriello, Giuseppe; Annunziata, Annalisa; Scambia, Giovanni; Perrone, Francesco; Savarese, Antonella; Breda, Enrico; Scollo, Paolo; De Vivo, Rocco; Rossi, Emanuela; Gebbia, Vittorio; Natale, Donato

    2006-01-01

    The MITO-2 (Multicentre Italian Trials in Ovarian cancer) study is a randomized phase III trial comparing carboplatin plus paclitaxel to carboplatin plus pegylated liposomal doxorubicin in first-line chemotherapy of patients with ovarian cancer. Due to the paucity of published phase I data on the 3-weekly experimental schedule used, an early safety analysis was planned. Patients with ovarian cancer (stage Ic-IV), aged < 75 years, ECOG performance status ≤ 2, were randomized to carboplatin AUC 5 plus paclitaxel 175 mg/m 2 , every 3 weeks or to carboplatin AUC 5 plus pegylated liposomal doxorubicin 30 mg/m 2 , every 3 weeks. Treatment was planned for 6 cycles. Toxicity was coded according to the NCI-CTC version 2.0. The pre-planned safety analysis was performed in July 2004. Data from the first 50 patients treated with carboplatin plus pegylated liposomal doxorubicin were evaluated. Median age was 60 years (range 34–75). Forty-three patients (86%) completed 6 cycles. Two thirds of the patients had at least one cycle delayed due to toxicity, but 63% of the cycles were administered on time. In most cases the reason for chemotherapy delay was neutropenia or other hematological toxicity. No delay due to palmar-plantar erythrodysesthesia (PPE) was recorded. No toxic death was recorded. Reported hematological toxicities were: grade (G) 3 anemia 16%, G3/G4 neutropenia 36% and 10% respectively, G3/4 thrombocytopenia 22% and 4% respectively. Non-haematological toxicity was infrequent: pulmonary G1 6%, heart rhythm G1 4%, liver toxicity G1 6%, G2 4% and G3 2%. Complete hair loss was reported in 6% of patients, and G1 neuropathy in 2%. PPE was recorded in 14% of the cases (G1 10%, G2 2%, G3 2%). This safety analysis shows that the adopted schedule of carboplatin plus pegylated liposomal doxorubicin given every 3 weeks is feasible as first line treatment in ovarian cancer patients, although 37% of the cycles were delayed due to haematological toxicity. Toxicities that are

  4. Safety of a 3-weekly schedule of carboplatin plus pegylated liposomal doxorubicin as first line chemotherapy in patients with ovarian cancer: preliminary results of the MITO-2 randomized trial

    Directory of Open Access Journals (Sweden)

    D'Arco Alfonso

    2006-08-01

    Full Text Available Abstract Background The MITO-2 (Multicentre Italian Trials in Ovarian cancer study is a randomized phase III trial comparing carboplatin plus paclitaxel to carboplatin plus pegylated liposomal doxorubicin in first-line chemotherapy of patients with ovarian cancer. Due to the paucity of published phase I data on the 3-weekly experimental schedule used, an early safety analysis was planned. Methods Patients with ovarian cancer (stage Ic-IV, aged 2, every 3 weeks or to carboplatin AUC 5 plus pegylated liposomal doxorubicin 30 mg/m2, every 3 weeks. Treatment was planned for 6 cycles. Toxicity was coded according to the NCI-CTC version 2.0. Results The pre-planned safety analysis was performed in July 2004. Data from the first 50 patients treated with carboplatin plus pegylated liposomal doxorubicin were evaluated. Median age was 60 years (range 34–75. Forty-three patients (86% completed 6 cycles. Two thirds of the patients had at least one cycle delayed due to toxicity, but 63% of the cycles were administered on time. In most cases the reason for chemotherapy delay was neutropenia or other hematological toxicity. No delay due to palmar-plantar erythrodysesthesia (PPE was recorded. No toxic death was recorded. Reported hematological toxicities were: grade (G 3 anemia 16%, G3/G4 neutropenia 36% and 10% respectively, G3/4 thrombocytopenia 22% and 4% respectively. Non-haematological toxicity was infrequent: pulmonary G1 6%, heart rhythm G1 4%, liver toxicity G1 6%, G2 4% and G3 2%. Complete hair loss was reported in 6% of patients, and G1 neuropathy in 2%. PPE was recorded in 14% of the cases (G1 10%, G2 2%, G3 2%. Conclusion This safety analysis shows that the adopted schedule of carboplatin plus pegylated liposomal doxorubicin given every 3 weeks is feasible as first line treatment in ovarian cancer patients, although 37% of the cycles were delayed due to haematological toxicity. Toxicities that are common with standard combination of carboplatin

  5. Shift work-related health problems in

    Directory of Open Access Journals (Sweden)

    S. Khavaji

    2010-04-01

    Full Text Available Background and aimsShift work is a major feature of working life that affects diverse aspects of human life. The main purposes of this study were to investigate shift work-related health problems and their risk factors among workers of "12-hour shift" schedule.MethodsThis cross-sectional study was carried out at 8 petrochemical industries in Asalooyeh area. Study population consisted of 1203 workers including 549 shift worker (46% and 654 day worker (54%. Data on personal details, shift schedule and adverse effects of shift work werecollected by anonymous questionnaire. Statistical analyses were performed using SPSS, version 11.5. The level of significance was set at 5%.ResultsAlthough, the results showed that health problems among shift workers was more prevalent than day workers, but the differences were just significant in gastrointestinal and musculoskeletal disorders (p<0.05. Multiple linear regressions indicated that in addition to shift working, other variants such as long work hours, type of employment, second job, number of children and job title were associated with health problems.ConclusionPrevalence rates of gastrointestinal and musculoskeletal problems among shift workers were significantly higher than that of day workers. Although, working in shift system was the main significant factor associated with the reported problems, but other demographic andwork variables were also found to have association.

  6. Anesthesiology Nurse Scheduling using Particle Swarm Optimization

    Directory of Open Access Journals (Sweden)

    Leopoldo Altamirano

    2012-02-01

    Full Text Available In this article we present an approach designed to solve a real world problem: the Anesthesiology Nurse Scheduling Problem (ANSP at a public French hospital. The anesthesiology nurses are one of the most shared resources in the hospital and we attempt to find a fair/balanced schedule for them, taking into account a set of constraints and the nursesarsquo; stated preferences, concerning the different shifts. We propose a particle swarm optimization algorithm to solve the ANSP. Finally, we compare our technique with previous results obtained using integer programming.

  7. Range Scheduling Aid (RSA)

    Science.gov (United States)

    Logan, J. R.; Pulvermacher, M. K.

    1991-01-01

    Range Scheduling Aid (RSA) is presented in the form of the viewgraphs. The following subject areas are covered: satellite control network; current and new approaches to range scheduling; MITRE tasking; RSA features; RSA display; constraint based analytic capability; RSA architecture; and RSA benefits.

  8. The triangle scheduling problem

    NARCIS (Netherlands)

    Dürr, Christoph; Hanzálek, Zdeněk; Konrad, Christian; Seddik, Yasmina; Sitters, R.A.; Vásquez, Óscar C.; Woeginger, Gerhard

    2017-01-01

    This paper introduces a novel scheduling problem, where jobs occupy a triangular shape on the time line. This problem is motivated by scheduling jobs with different criticality levels. A measure is introduced, namely the binary tree ratio. It is shown that the Greedy algorithm solves the problem to

  9. Rectal cancer delivery of radiotherapy in adequate time and with adequate dose is influenced by treatment center, treatment schedule, and gender and is prognostic parameter for local control: Results of study CAO/ARO/AIO-94

    International Nuclear Information System (INIS)

    Fietkau, Rainer; Roedel, Claus; Hohenberger, Werner; Raab, Rudolf; Hess, Clemens; Liersch, Torsten; Becker, Heinz; Wittekind, Christian; Hutter, Matthias; Hager, Eva; Karstens, Johann; Ewald, Hermann; Christen, Norbert; Jagoditsch, Michael; Martus, Peter; Sauer, Rolf

    2007-01-01

    Purpose: The impact of the delivery of radiotherapy (RT) on treatment results in rectal cancer patients is unknown. Methods and Materials: The data from 788 patients with rectal cancer treated within the German CAO/AIO/ARO-94 phase III trial were analyzed concerning the impact of the delivery of RT (adequate RT: minimal radiation RT dose delivered, 4300 cGy for neoadjuvant RT or 4700 cGy for adjuvant RT; completion of RT in <44 days for neoadjuvant RT or <49 days for adjuvant RT) in different centers on the locoregional recurrence rate (LRR) and disease-free survival (DFS) at 5 years. The LRR, DFS, and delivery of RT were analyzed as endpoints in multivariate analysis. Results: A significant difference was found between the centers and the delivery of RT. The overall delivery of RT was a prognostic factor for the LRR (no RT, 29.6% ± 7.8%; inadequate RT, 21.2% ± 5.6%; adequate RT, 6.8% ± 1.4%; p = 0.0001) and DFS (no RT, 55.1% ± 9.1%; inadequate RT, 57.4% ± 6.3%; adequate RT, 69.1% ± 2.3%; p = 0.02). Postoperatively, delivery of RT was a prognostic factor for LRR on multivariate analysis (together with pathologic stage) but not for DFS (independent parameters, pathologic stage and age). Preoperatively, on multivariate analysis, pathologic stage, but not delivery of RT, was an independent prognostic parameter for LRR and DFS (together with adequate chemotherapy). On multivariate analysis, the treatment center, treatment schedule (neoadjuvant vs. adjuvant RT), and gender were prognostic parameters for adequate RT. Conclusion: Delivery of RT should be regarded as a prognostic factor for LRR in rectal cancer and is influenced by the treatment center, treatment schedule, and patient gender

  10. Real life working shift assignment problem

    Science.gov (United States)

    Sze, San-Nah; Kwek, Yeek-Ling; Tiong, Wei-King; Chiew, Kang-Leng

    2017-07-01

    This study concerns about the working shift assignment in an outlet of Supermarket X in Eastern Mall, Kuching. The working shift assignment needs to be solved at least once in every month. Current approval process of working shifts is too troublesome and time-consuming. Furthermore, the management staff cannot have an overview of manpower and working shift schedule. Thus, the aim of this study is to develop working shift assignment simulation and propose a working shift assignment solution. The main objective for this study is to fulfill manpower demand at minimum operation cost. Besides, the day off and meal break policy should be fulfilled accordingly. Demand based heuristic is proposed to assign working shift and the quality of the solution is evaluated by using the real data.

  11. Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.

    Science.gov (United States)

    Klerman, Elizabeth B; Beckett, Scott A; Landrigan, Christopher P

    2016-09-13

    In 2011 the U.S. Accreditation Council for Graduate Medical Education began limiting first year resident physicians (interns) to shifts of ≤16 consecutive hours. Controversy persists regarding the effectiveness of this policy for reducing errors and accidents while promoting education and patient care. Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, we quantitatively compared predictions for traditional intern schedules to those that limit work to ≤ 16 consecutive hours. We simulated two traditional schedules and three novel schedules using the mathematical model. The traditional schedules had extended duration work shifts (≥24 h) with overnight work shifts every second shift (including every third night, Q3) or every third shift (including every fourth night, Q4) night; the novel schedules had two different cross-cover (XC) night team schedules (XC-V1 and XC-V2) and a Rapid Cycle Rotation (RCR) schedule. Predicted objective performance and subjective alertness for each work shift were computed for each individual's schedule within a team and then combined for the team as a whole. Our primary outcome was the amount of time within a work shift during which a team's model-predicted objective performance and subjective alertness were lower than that expected after 16 or 24 h of continuous wake in an otherwise rested individual. The model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either the traditional Q3 or Q4 schedules. Three proposed schedules that eliminate extended shifts may improve performance and alertness compared with traditional Q3 or Q4 schedules. Predicted times of worse performance and alertness were at night, which is also a time when supervision of trainees is lower. Mathematical modeling provides a quantitative comparison approach with potential to aid

  12. Efficacy and Safety of Regorafenib With 2/1 Schedule for Patients ≥ 75 Years With Metastatic Colorectal Cancer (mCRC) After Failure of 2 Lines of Chemotherapy.

    Science.gov (United States)

    Petrioli, Roberto; Chirra, Martina; Messuti, Luciana; Fiaschi, Anna Ida; Savelli, Vinno; Martellucci, Ignazio; Francini, Edoardo

    2018-02-21

    In the CORRECT (patients with metastatic COloRectal Cancer treated with REgorafenib or plaCebo after failure of standard Therapy) trial, regorafenib was proven to extend survival of patients with metastatic colorectal cancer (mCRC) that progressed after all available therapies. Grade 3 to 4 toxicity occurred in 54% of patients, and data on the activity and tolerability of regorafenib in elderly patients were scarce. The aim of this study was to evaluate the efficacy and safety of an alternative schedule, 2-week-on treatment and 1 week-off (2/1 schedule), of regorafenib for elderly patients with mCRC. Patients ≥ 75 years with mCRC who progressed after oxaliplatin- and irinotecan-based chemotherapy received regorafenib on a 2/1 schedule. Potentially frail subjects were identified by G8 screening tool and excluded. The 2-month disease-control rate was the primary endpoint, and the secondary endpoints included safety, progression-free survival (PFS), overall survival (OS), and objective response rate. Between February 2014 and May 2017, 23 patients with mCRC were recruited at our institution. No partial or complete responses were observed, and the stable disease and disease-control rate were 52.2%. The median PFS was 4.8 months (95% confidence interval, 3.8-6.3 months), and the median OS was 8.9 months (95% confidence interval, 6.9-10.6 months). Adverse events were uncommon, and the most frequent grade 3 toxicity adverse events were hand-foot skin reaction (9%) and fatigue (9%). Toxicity-related dose reductions and discontinuations occurred in 5 and 2 patients, respectively. Regorafenib administered with a modified 2/1 schedule to patients who were aged ≥ 75 years and non-frail with treatment-refractory mCRC seems to be tolerable and achieve encouraging results in terms of PFS and OS. Copyright © 2018. Published by Elsevier Inc.

  13. Self-scheduling with Microsoft Excel.

    Science.gov (United States)

    Irvin, S A; Brown, H N

    1999-01-01

    Excessive time was being spent by the emergency department (ED) staff, head nurse, and unit secretary on a complex 6-week manual self-scheduling system. This issue, plus inevitable errors and staff dissatisfaction, resulted in a manager-lead initiative to automate elements of the scheduling process using Microsoft Excel. The implementation of this initiative included: common coding of all 8-hour and 12-hour shifts, with each 4-hour period represented by a cell; the creation of a 6-week master schedule using the "count-if" function of Excel based on current staffing guidelines; staff time-off requests then entered by the department secretary; the head nurse, with staff input, then fine-tuned the schedule to provide even unit coverage. Outcomes of these changes included an increase in staff satisfaction, time saved by the head nurse, and staff work time saved because there was less arguing about the schedule. Ultimately, the automated self-scheduling method was expanded to the entire 700-bed hospital.

  14. Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hongmei; Zhang, Chongda; Ye, Feng; Liu, Yuan; Zhou, Chunwu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zheng, Zhaoxu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Colorectal Oncology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zou, Shuangmei [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Pathology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China)

    2017-09-15

    To evaluate the value of the chemical shift effect (CSE) as well as other criteria for the prediction of lymph node status. Twenty-nine patients who underwent radical surgery of rectal cancers were studied with pre- and postoperative specimen MRI. Lymph nodes were harvested from transverse whole-mount specimens and compared with in vivo and ex vivo images to obtain a precise slice-for-section match. Preoperative MR characteristics including CSE, as well as other predictors, were evaluated by two readers independently between benign and metastatic nodes. A total of 255 benign and 35 metastatic nodes were obtained; 71.4% and 69.4% of benign nodes were detected with regular CSE for two readers, whereas 80.0% and 74.3% of metastatic nodes with absence of CSE. The CSE rendered areas under the ROC curve (AUC) of 0.879 and 0.845 for predicting nodal status for two readers. The criteria of nodal location, border, signal intensity and minimum distance to the rectal wall were also useful but with AUCs (0.629-0.743) lower than those of CSE. CSE is a reliable predictor for differentiating benign from metastatic nodes. Additional criteria should be taken into account when it is difficult to determine the nodal status by using only a single predictor. (orig.)

  15. NASA Schedule Management Handbook

    Science.gov (United States)

    2011-01-01

    The purpose of schedule management is to provide the framework for time-phasing, resource planning, coordination, and communicating the necessary tasks within a work effort. The intent is to improve schedule management by providing recommended concepts, processes, and techniques used within the Agency and private industry. The intended function of this handbook is two-fold: first, to provide guidance for meeting the scheduling requirements contained in NPR 7120.5, NASA Space Flight Program and Project Management Requirements, NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Requirements, NPR 7120.8, NASA Research and Technology Program and Project Management Requirements, and NPD 1000.5, Policy for NASA Acquisition. The second function is to describe the schedule management approach and the recommended best practices for carrying out this project control function. With regards to the above project management requirements documents, it should be noted that those space flight projects previously established and approved under the guidance of prior versions of NPR 7120.5 will continue to comply with those requirements until project completion has been achieved. This handbook will be updated as needed, to enhance efficient and effective schedule management across the Agency. It is acknowledged that most, if not all, external organizations participating in NASA programs/projects will have their own internal schedule management documents. Issues that arise from conflicting schedule guidance will be resolved on a case by case basis as contracts and partnering relationships are established. It is also acknowledged and understood that all projects are not the same and may require different levels of schedule visibility, scrutiny and control. Project type, value, and complexity are factors that typically dictate which schedule management practices should be employed.

  16. Shifting Sugars and Shifting Paradigms

    Science.gov (United States)

    Siegal, Mark L.

    2015-01-01

    No organism lives in a constant environment. Based on classical studies in molecular biology, many have viewed microbes as following strict rules for shifting their metabolic activities when prevailing conditions change. For example, students learn that the bacterium Escherichia coli makes proteins for digesting lactose only when lactose is available and glucose, a better sugar, is not. However, recent studies, including three PLOS Biology papers examining sugar utilization in the budding yeast Saccharomyces cerevisiae, show that considerable heterogeneity in response to complex environments exists within and between populations. These results join similar recent results in other organisms that suggest that microbial populations anticipate predictable environmental changes and hedge their bets against unpredictable ones. The classical view therefore represents but one special case in a range of evolutionary adaptations to environmental changes that all organisms face. PMID:25688600

  17. Shifting sugars and shifting paradigms.

    Directory of Open Access Journals (Sweden)

    Mark L Siegal

    2015-02-01

    Full Text Available No organism lives in a constant environment. Based on classical studies in molecular biology, many have viewed microbes as following strict rules for shifting their metabolic activities when prevailing conditions change. For example, students learn that the bacterium Escherichia coli makes proteins for digesting lactose only when lactose is available and glucose, a better sugar, is not. However, recent studies, including three PLOS Biology papers examining sugar utilization in the budding yeast Saccharomyces cerevisiae, show that considerable heterogeneity in response to complex environments exists within and between populations. These results join similar recent results in other organisms that suggest that microbial populations anticipate predictable environmental changes and hedge their bets against unpredictable ones. The classical view therefore represents but one special case in a range of evolutionary adaptations to environmental changes that all organisms face.

  18. Medications for Sleep Schedule Adjustments in Athletes.

    Science.gov (United States)

    Baird, Matthew B; Asif, Irfan M

    Sleep schedule adjustments are common requirements of modern-day athletes. Many nonpharmacologic and pharmacologic strategies exist to facilitate circadian rhythm shifts to maximize alertness and performance during competition. This review summarizes the evidence for commonly used pharmacologic agents and presents recommendations for the sports medicine provider. MEDLINE searches were performed using the following keywords: sleep aids, circadian rhythm adjustment, athletes and sleep, caffeine and sports, melatonin and athletes, and sleep aids and sports. Pertinent articles were extracted and discussed. Clinical review. Level 2. There are very few available studies investigating pharmacologic sleep aids in athletes. Data from studies involving shift workers and airline personnel are more abundant and were used to formulate recommendations and conclusions. Melatonin, caffeine, and nonbenzodiazepine sleep aids have a role in facilitating sleep schedule changes in athletes and maximizing sports performance through sleep enhancement.

  19. Shift Work in Nurses: Contribution of Phenotypes and Genotypes to Adaptation

    Science.gov (United States)

    Gamble, Karen L.; Motsinger-Reif, Alison A.; Hida, Akiko; Borsetti, Hugo M.; Servick, Stein V.; Ciarleglio, Christopher M.; Robbins, Sam; Hicks, Jennifer; Carver, Krista; Hamilton, Nalo; Wells, Nancy; Summar, Marshall L.; McMahon, Douglas G.; Johnson, Carl Hirschie

    2011-01-01

    Background Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. Methods Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses. Results Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25%) were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work). Conclusions Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental “stress” to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy. PMID:21533241

  20. Shift work in nurses: contribution of phenotypes and genotypes to adaptation.

    Science.gov (United States)

    Gamble, Karen L; Motsinger-Reif, Alison A; Hida, Akiko; Borsetti, Hugo M; Servick, Stein V; Ciarleglio, Christopher M; Robbins, Sam; Hicks, Jennifer; Carver, Krista; Hamilton, Nalo; Wells, Nancy; Summar, Marshall L; McMahon, Douglas G; Johnson, Carl Hirschie

    2011-04-13

    Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses. Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25%) were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work). Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental "stress" to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy.

  1. Shift work in nurses: contribution of phenotypes and genotypes to adaptation.

    Directory of Open Access Journals (Sweden)

    Karen L Gamble

    2011-04-01

    Full Text Available Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work.Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses.Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25% were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work.Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental "stress" to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy.

  2. Physician Fee Schedule Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...

  3. Clinical Laboratory Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Outpatient clinical laboratory services are paid based on a fee schedule in accordance with Section 1833(h) of the Social Security Act. The clinical laboratory fee...

  4. CERN confirms LHC schedule

    CERN Document Server

    2003-01-01

    The CERN Council held its 125th session on 20 June. Highlights of the meeting included confirmation that the LHC is on schedule for a 2007 start-up, and the announcement of a new organizational structure in 2004.

  5. DMEPOS Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — The list contains the fee schedule amounts, floors, and ceilings for all procedure codes and payment category, jurisdication, and short description assigned to each...

  6. Project Schedule Simulation

    DEFF Research Database (Denmark)

    Mizouni, Rabeb; Lazarova-Molnar, Sanja

    2015-01-01

    overrun both their budget and time. To improve the quality of initial project plans, we show in this paper the importance of (1) reflecting features’ priorities/risk in task schedules and (2) considering uncertainties related to human factors in plan schedules. To make simulation tasks reflect features......’ priority as well as multimodal team allocation, enhanced project schedules (EPS), where remedial actions scenarios (RAS) are added, were introduced. They reflect potential schedule modifications in case of uncertainties and promote a dynamic sequencing of involved tasks rather than the static conventional...... this document as an instruction set. The electronic file of your paper will be formatted further at Journal of Software. Define all symbols used in the abstract. Do not cite references in the abstract. Do not delete the blank line immediately above the abstract; it sets the footnote at the bottom of this column....

  7. Decentralized Ground Staff Scheduling

    DEFF Research Database (Denmark)

    Sørensen, M. D.; Clausen, Jens

    2002-01-01

    scheduling is investigated. The airport terminal is divided into zones, where each zone consists of a set of stands geographically next to each other. Staff is assigned to work in only one zone and the staff scheduling is planned decentralized for each zone. The advantage of this approach is that the staff...... work in a smaller area of the terminal and thus spends less time walking between stands. When planning decentralized the allocation of stands to flights influences the staff scheduling since the workload in a zone depends on which flights are allocated to stands in the zone. Hence solving the problem...... depends on the actual stand allocation but also on the number of zones and the layout of these. A mathematical model of the problem is proposed, which integrates the stand allocation and the staff scheduling. A heuristic solution method is developed and applied on a real case from British Airways, London...

  8. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-11-01

    This single page document is the November 1, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the production reactor.

  9. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-10-01

    This single page document is the October 1, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the Production Reactor.

  10. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-10-15

    This single page document is the October 15, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the Production Reactor.

  11. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-09-15

    This single page document is the September 15, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the Production Reactor.

  12. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-12-15

    This single page document is the December 16, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the Production reactor.

  13. Reactor outage schedule (tentative)

    Energy Technology Data Exchange (ETDEWEB)

    Walton, R.P.

    1969-12-01

    This single page document is the December 1, 1969 reactor refueling outage schedule for the Hanford Production Reactor. It also contains data on the amounts and types of fuels to be loaded and relocated in the Production reactor.

  14. Fee Schedules - General Information

    Data.gov (United States)

    U.S. Department of Health & Human Services — A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers-suppliers. This comprehensive listing of fee maximums is used to...

  15. CMS Records Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — The CMS Records Schedule provides disposition authorizations approved by the National Archives and Records Administration (NARA) for CMS program-related records...

  16. Goal programming for cyclical auxiliary police scheduling at UiTM Cawangan Perlis

    Science.gov (United States)

    Mustapar, Wasilatul Effah; Nasir, Diana Sirmayunie Mohd; Nor, Nor Azriani Mohamad; Abas, Sharifah Fhahriyah Syed

    2017-11-01

    Constructing a good and fair schedule for shift workers poses a great challenge as it requires a lot of time and effort. In this study, goal programming has been applied on scheduling to achieve the hard and soft constraints for a cyclical schedule that would ease the head of auxiliary police at building new schedules. To accomplish this goal, shift types were assigned in order to provide a fair schedule that takes into account the auxiliary police's policies and preferences. The model was run using Lingo software. Three out of four goals set for the study were achieved. In addition, the results considered an equal allocation for every auxiliary police, namely 70% for total duty and 30% for the day. Furthermore, the schedule was able to cyclically generate another 10 sets schedule. More importantly, the model has provided unbiased scheduling of auxiliary policies which led to high satisfaction in auxiliary police management.

  17. Phase I/II Study Evaluating Early Tolerance in Breast Cancer Patients Undergoing Accelerated Partial Breast Irradiation Treated With the MammoSite Balloon Breast Brachytherapy Catheter Using a 2-Day Dose Schedule

    International Nuclear Information System (INIS)

    Wallace, Michelle; Martinez, Alvaro; Mitchell, Christina; Chen, Peter Y.; Ghilezan, Mihai; Benitez, Pamela; Brown, Eric; Vicini, Frank

    2010-01-01

    Purpose: Initial Phase I/II results using balloon brachytherapy to deliver accelerated partial breast irradiation (APBI) in 2 days in patients with early-stage breast cancer are presented. Materials and Methods: Between March 2004 and August 2007, 45 patients received adjuvant radiation therapy after lumpectomy with balloon brachytherapy in a Phase I/II trial delivering 2800 cGy in four fractions of 700 cGy. Toxicities were evaluated using the National Cancer Institute Common Toxicity Criteria for Adverse Events v3.0 scale and cosmesis was documented at ≥6 months. Results: The median age was 66 years (range, 48-83) and median skin spacing was 12 mm (range, 8-24). The median follow-up was 11.4 months (5.4-48 months) with 21 patients (47%) followed ≥1 year, 11 (24%) ≥2 years, and 7 (16%) ≥3 years. At <6 months (n = 45), Grade II toxicity rates were 9% radiation dermatitis, 13% breast pain, 2% edema, and 2% hyperpigmentation. Grade III breast pain was reported in 13% (n = 6). At ≥6 months (n = 43), Grade II toxicity rates were: 2% radiation dermatitis, 2% induration, and 2% hypopigmentation. Grade III breast pain was reported in 2%. Infection was 13% (n = 6) at <6 months and 5% (n = 2) at ≥6 months. Persistent seroma ≥6 months was 30% (n = 13). Fat necrosis developed in 4 cases (2 symptomatic). Rib fractures were seen in 4% (n = 2). Cosmesis was good/excellent in 96% of cases. Conclusions: Treatment with balloon brachytherapy using a 2-day dose schedule resulted acceptable rates of Grade II/III chronic toxicity rates and similar cosmetic results observed with a standard 5-day accelerated partial breast irradiation schedule.

  18. ATLAS construction schedule

    CERN Multimedia

    Kotamaki, M

    The goal during the last few months has been to freeze and baseline as much as possible the schedules of various ATLAS systems and activities. The main motivations for the re-baselining of the schedules have been the new LHC schedule aiming at first collisions in early 2006 and the encountered delays in civil engineering as well as in the production of some of the detectors. The process was started by first preparing a new installation schedule that takes into account all the new external constraints and the new ATLAS staging scenario. The installation schedule version 3 was approved in the March EB and it provides the Ready For Installation (RFI) milestones for each system, i.e. the date when the system should be available for the start of the installation. TCn is now interacting with the systems aiming at a more realistic and resource loaded version 4 before the end of the year. Using the new RFI milestones as driving dates a new summary schedule has been prepared, or is under preparation, for each system....

  19. Shift work in a security environment

    International Nuclear Information System (INIS)

    Longhouser, G.A. Jr.

    1993-01-01

    Human beings are diurnal species, normally active by day and asleep by night. Yet over thirty million Americans struggle with work schedules that include an off-normal work effort. The railroads, law enforcement, health services, Department of Defense, factory workers, chemical plants and public services, communications and utility workers must provide some form of around-the-clock effort. Shift work has been around since the advent of recorded history. There has always been a need for some type of off-normal service and assistance. The impact of shift work is replete with tales and factual evidence of an increased personnel error rate; disorders, both personal and family, and of course, increased accident events. In recent memory, the Three Mile Island Nuclear Plant incident, Union Carbide's explosion in Bhopal, and the Chernobyl Nuclear Plant catastrophe all occurred during off-normal working hours. Yet management overall has done little to correct the production-driven twelve hour, seven day week shift mentality of the nineteenth century. Most schedules in use today are nothing more than cosmetic variations of the old production schedules. This could be driven by a management consideration of the worker's response to change coupled with a reluctant buy-in of responsibility for the effects of change. Florida Power Corporation has developed for its nuclear security force, a unique work schedule which attempts to employ the sound principles of circadian rhythms coupled with a comprehensive training program to counter the problems associated with shift work. The results over the last four years have seen a marked reduction in the generic problems of personnel errors, absenteeism, unscheduled overtime and turnover rates. Utilization and understanding of this scheduling process for rotational shift work needs to be assessed to determine if the benefits are site specific or provide an expected response to the problems of shift work

  20. Shift Work and Health: Current Problems and Preventive Actions

    Directory of Open Access Journals (Sweden)

    Giovanni Costa

    2010-12-01

    Full Text Available The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers’ health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

  1. Changed nursing scheduling for improved safety culture and working conditions - patients' and nurses' perspectives.

    Science.gov (United States)

    Kullberg, Anna; Bergenmar, Mia; Sharp, Lena

    2016-05-01

    To evaluate fixed scheduling compared with self-scheduling for nursing staff in oncological inpatient care with regard to patient and staff outcomes. Various scheduling models have been tested to attract and retain nursing staff. Little is known about how these schedules affect staff and patients. Fixed scheduling and self-scheduling have been studied to a small extent, solely from a staff perspective. We implemented fixed scheduling on two of four oncological inpatient wards. Two wards kept self-scheduling. Through a quasi-experimental design, baseline and follow-up measurements were collected among staff and patients. The Safety Attitudes Questionnaire was used among staff, as well as study-specific questions for patients and staff. Fixed scheduling was associated with less overtime and fewer possibilities to change shifts. Self-scheduling was associated with more requests from management for short notice shift changes. The type of scheduling did not affect patient-reported outcomes. Fixed scheduling should be considered in order to lower overtime. Further research is necessary and should explore patient outcomes to a greater extent. Scheduling is a core task for nurse managers. Our study suggests fixed scheduling as a strategy for managers to improve the effective use of resources and safety. © 2016 John Wiley & Sons Ltd.

  2. Gemcitabine and cisplatin in a concomitant alternating chemoradiotherapy program for locally advanced head-and-neck cancer: A pharmacology-guided schedule

    International Nuclear Information System (INIS)

    Numico, Gianmauro; Russi, Elvio G.; Vitiello, Raffele; Sorrentino, Raffaele; Colantonio, Ida; Cipolat, Marco; Taglianti, Riccardo Vigna; Pelissero, Antonio; Fea, Elena; Granetto, Cristina; Di Costanzo, Gianna; Gasco, Milena; Garrone, Ornella; Occelli, Marcella; Merlano, Marco

    2006-01-01

    Purpose: Administration of gemcitabine together with cisplatin at cytotoxic doses in a chemoradiotherapy regimen is hampered by a high degree of local toxicity. Using the pharmacologic properties of the drug we designed a modified schedule aimed at reducing toxicity while preserving activity. Methods and Materials: Patients with squamous cell carcinomas of the oral cavity, pharynx and larynx, bulky T4, and/or N2 to N3 were eligible. Gemcitabine was administered at a dose of 800 mg/m 2 on Days 1 and 12 and cisplatin at a dose of 20 mg/m 2 on Days 2 to 5, every 21 days for 3 courses. Radiotherapy, delivered with standard fractionation, was given on Days 8 to 12 and 15 to 19 and was repeated 3 times up to a total dose of ≥60 Gy. Results: A total of 28 patients were selected. Grade 3 to 4 stomatitis was recorded in 25 patients (89%). Thirteen patients (46%) experienced Grade 3 to 4 neutropenia. Febrile neutropenia occurred in 8 patients (29%) and in 2 was complicated by infection and death. The overall complete response rate was 79%. At a median follow up of 71 months, 11 patients had a locoregional relapse (3-year locoregional control, 64%); 6 patients had distant metastases, among whom only 2 were without locoregional recurrence. The 3-year progression-free survival is 39% and 3-year overall survival has been 43%. Conclusion: The schedule modification did not attenuate local toxicity. Moreover, infections and especially pneumonia, were a major problem. The high activity of gemcitabine when combined with radiotherapy would most likely be better exploited in the context of modified radiation schemes

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

    Science.gov (United States)

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

    1998-01-01

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

  4. Association between rotating night shift work and metabolic syndrome in Korean workers: differences between 8-hour and 12-hour rotating shift work.

    Science.gov (United States)

    Oh, Jae-Il; Yim, Hyeon Woo

    2018-02-07

    This study aimed to analyze the association between the shift work schedule and metabolic syndrome (MetS). This is a retrospective longitudinal study based on the 2015 health checkup data of 2,090 workers evaluated for MetS in 2010 at a general hospital in Korea. The participants were divided according to their shift work schedule into daytime, three-shift (8-h rotation), and two-shift (12-h rotation) workers. The index that indicates the association between the shift work schedule and MetS is the odds ratio (OR) calculated using multivariate logistic regression. The analysis for the entire group of workers indicated that there was positive association between two-shift rotation and MetS (OR=1.58, 95% confidence interval [CI]: 1.09, 2.29). In the analysis of rotating night-shift workers, the years of rotating night shifts, frequency of night-shift work, and sleep disturbance were added to the confounding variables, and two-shift work remained positively associated with MetS (OR=1.72, 95% CI: 1.10, 2.70). The risk of MetS differs based on the shift work schedules they engage in. Hence, structural changes to the shift work schedules are required to prevent MetS in night-shift workers.

  5. Constraint-based job shop scheduling with ILOG SCHEDULER

    NARCIS (Netherlands)

    Nuijten, W.P.M.; Le Pape, C.

    1998-01-01

    We introduce constraint-based scheduling and discuss its main principles. An approximation algorithm based on tree search is developed for the job shop scheduling problem using ILOG SCHEDULER. A new way of calculating lower bounds on the makespan of the job shop scheduling problem is presented and

  6. Planning and scheduling - A schedule's performance

    International Nuclear Information System (INIS)

    Whitman, N.M.

    1993-01-01

    Planning and scheduling is a process whose time has come to PSI Energy. With an awareness of the challenges ahead, individuals must look for ways to enhance the corporate competitiveness. Working toward this goal means that each individual has to dedicate themselves to this more competitive corporate environment. Being competitive may be defined as the ability of each employee to add value to the corporation's economic well being. The timely and successful implementation of projects greatly enhances competitiveness. Those projects that do not do well often suffer from lack of proper execution - not for lack of talent or strategic vision. Projects are consumers of resources such as cash and people. They produce a return when completed and will generate a better return when properly completed utilizing proven project management techniques. Completing projects on time, within budget and meeting customer expectations is the way a corporation builds it's future. This paper offers suggestions on implementing planning and scheduling and provides a review of results in the form of management reports

  7. Scheduling mammograms for asymptomatic women

    International Nuclear Information System (INIS)

    Gohagan, J.K.; Darby, W.P.; Spitznagel, E.L.; Tome, A.E.

    1988-01-01

    A decision theoretic model was used to investigate the relative importance of risk level, radiation hazard, mammographic accuracy, and cost in mammographic screening decision. The model uses woman-specific medical and family history facts and clinic-specific information regarding mammographic accuracy and practice to profile both woman and clinic, and to formulate periodic screening recommendations. Model parameters were varied extensively to investigate the sensitivity of screening schedules to input values. Multivariate risk was estimated within the program using published data from the Breast Cancer Detection Demonstration Project 5-year follow-up study. Radiation hazard estimates were developed from published radiation physics and radioepidemiologic risk data. Benchmark values for mammographic sensitivity and specificity under screening conditions were calculated from Breast Cancer Detection Demonstration Project data. Procedural costs used in the analysis were varied around values reflecting conditions at the Washington University Medical Center. Mortality advantages of early versus late breast cancer detection were accounted for using Health Insurance Plan of New York case survival rates. Results are compared with published screening policies to provide insight into implicit assumptions behind those policies. This analysis emphasizes the importance of accounting for variations in clinical accuracy under screening circumstances, in costs, in radiation exposure, and in woman-specific risk when recommending mammographic screening

  8. Constraint-based scheduling

    Science.gov (United States)

    Zweben, Monte

    1993-01-01

    The GERRY scheduling system developed by NASA Ames with assistance from the Lockheed Space Operations Company, and the Lockheed Artificial Intelligence Center, uses a method called constraint-based iterative repair. Using this technique, one encodes both hard rules and preference criteria into data structures called constraints. GERRY repeatedly attempts to improve schedules by seeking repairs for violated constraints. The system provides a general scheduling framework which is being tested on two NASA applications. The larger of the two is the Space Shuttle Ground Processing problem which entails the scheduling of all the inspection, repair, and maintenance tasks required to prepare the orbiter for flight. The other application involves power allocation for the NASA Ames wind tunnels. Here the system will be used to schedule wind tunnel tests with the goal of minimizing power costs. In this paper, we describe the GERRY system and its application to the Space Shuttle problem. We also speculate as to how the system would be used for manufacturing, transportation, and military problems.

  9. SPANR planning and scheduling

    Science.gov (United States)

    Freund, Richard F.; Braun, Tracy D.; Kussow, Matthew; Godfrey, Michael; Koyama, Terry

    2001-07-01

    SPANR (Schedule, Plan, Assess Networked Resources) is (i) a pre-run, off-line planning and (ii) a runtime, just-in-time scheduling mechanism. It is designed to support primarily commercial applications in that it optimizes throughput rather than individual jobs (unless they have highest priority). Thus it is a tool for a commercial production manager to maximize total work. First the SPANR Planner is presented showing the ability to do predictive 'what-if' planning. It can answer such questions as, (i) what is the overall effect of acquiring new hardware or (ii) what would be the effect of a different scheduler. The ability of the SPANR Planner to formulate in advance tree-trimming strategies is useful in several commercial applications, such as electronic design or pharmaceutical simulations. The SPANR Planner is demonstrated using a variety of benchmarks. The SPANR Runtime Scheduler (RS) is briefly presented. The SPANR RS can provide benefit for several commercial applications, such as airframe design and financial applications. Finally a design is shown whereby SPANR can provide scheduling advice to most resource management systems.

  10. An effective deep-inspiration breath-hold radiotherapy technique for left-breast cancer: impact of post-mastectomy treatment, nodal coverage, and dose schedule on organs at risk

    Directory of Open Access Journals (Sweden)

    Rice L

    2017-06-01

    Full Text Available Lynsey Rice,1,2 Christy Goldsmith,1,2 Melanie ML Green,2 Susan Cleator,1,2 Patricia M Price1,2 1Department of Radiation Oncology, The Harley Street Clinic, 2Department of Surgery and Cancer, Imperial College London, London, UK Background: We developed, applied, and prospectively evaluated a novel deep-inspiration breath-hold (DIBH screening and delivery technique to optimize cardiac sparing in left-breast radiotherapy (RT at our clinic. The impact of set-up and dose variables upon organs at risk (OAR dose in DIBH RT was investigated.Methods and materials: All patients with left-breast cancer referred between 2011 and 2014 – of all disease stages, set-up variations, and dose prescriptions – were included. Radiographers used simple screening criteria at CT simulation, to systematically assess patients for obvious DIBH benefit and capability. Selected patients received forward-planned intensity-modulated RT (IMRT based on a DIBH CT scan. A 3D-surface monitoring system with visual feedback assured reproducible DIBH positioning during gated radiation delivery. Patient, target set-up, and OAR dose information were collected at treatment.Results: Of 272 patients who were screened, 4 withdrew, 56 showed no obvious advantage, and 56 showed benefit but had suitability issues; 156 patients were selected and successfully completed DIBH treatment. The technique was compatible with complex set-up and optimal target coverage was maintained. Comparison of free-breathing (FB and DIBH treatment plans in the first five patients enrolled confirmed DIBH reduced heart radiation by ~80% (p = 0.032. Low OAR doses were achieved overall: the mean (95% confidence interval [CI] heart dose was 1.17 (1.12–1.22 Gy, and the mean ipsilateral lung dose was 5.26 (5.01–5.52 Gy. Patients who underwent a standard radiation schedule (40 Gy/15# after breast-conserving surgery had the lowest OAR doses: post-mastectomy treatment, simultaneous supraclavicular (SCV node

  11. A randomized phase 3 study on the optimization of the combination of bevacizumab with FOLFOX/OXXEL in the treatment of patients with metastatic colorectal cancer-OBELICS (Optimization of BEvacizumab scheduLIng within Chemotherapy Scheme).

    Science.gov (United States)

    Avallone, Antonio; Piccirillo, Maria Carmela; Aloj, Luigi; Nasti, Guglielmo; Delrio, Paolo; Izzo, Francesco; Di Gennaro, Elena; Tatangelo, Fabiana; Granata, Vincenza; Cavalcanti, Ernesta; Maiolino, Piera; Bianco, Francesco; Aprea, Pasquale; De Bellis, Mario; Pecori, Biagio; Rosati, Gerardo; Carlomagno, Chiara; Bertolini, Alessandro; Gallo, Ciro; Romano, Carmela; Leone, Alessandra; Caracò, Corradina; de Lutio di Castelguidone, Elisabetta; Daniele, Gennaro; Catalano, Orlando; Botti, Gerardo; Petrillo, Antonella; Romano, Giovanni M; Iaffaioli, Vincenzo R; Lastoria, Secondo; Perrone, Francesco; Budillon, Alfredo

    2016-02-08

    Despite the improvements in diagnosis and treatment, colorectal cancer (CRC) is the second cause of cancer deaths in both sexes. Therefore, research in this field remains of great interest. The approval of bevacizumab, a humanized anti-vascular endothelial growth factor (VEGF) monoclonal antibody, in combination with a fluoropyrimidine-based chemotherapy in the treatment of metastatic CRC has changed the oncology practice in this disease. However, the efficacy of bevacizumab-based treatment, has thus far been rather modest. Efforts are ongoing to understand the better way to combine bevacizumab and chemotherapy, and to identify valid predictive biomarkers of benefit to avoid unnecessary and costly therapy to nonresponder patients. The BRANCH study in high-risk locally advanced rectal cancer patients showed that varying bevacizumab schedule may impact on the feasibility and efficacy of chemo-radiotherapy. OBELICS is a multicentre, open-label, randomised phase 3 trial comparing in mCRC patients two treatment arms (1:1): standard concomitant administration of bevacizumab with chemotherapy (mFOLFOX/OXXEL regimen) vs experimental sequential bevacizumab given 4 days before chemotherapy, as first or second treatment line. Primary end point is the objective response rate (ORR) measured according to RECIST criteria. A sample size of 230 patients was calculated allowing reliable assessment in all plausible first-second line case-mix conditions, with a 80% statistical power and 2-sided alpha error of 0.05. Secondary endpoints are progression free-survival (PFS), overall survival (OS), toxicity and quality of life. The evaluation of the potential predictive role of several circulating biomarkers (circulating endothelial cells and progenitors, VEGF and VEGF-R SNPs, cytokines, microRNAs, free circulating DNA) as well as the value of the early [(18)F]-Fluorodeoxyglucose positron emission tomography (FDG-PET) response, are the objectives of the traslational project. Overall this

  12. Small-cell lung cancer patients are just 'a little bit' tired : response shift and self-presentation in the measurement of fatigue

    NARCIS (Netherlands)

    Westerman, Marjan J.; The, Anne-Mei; Sprangers, Mirjam A. G.; Groen, Harry J. M.; van der Wal, Gerrit; Hak, Tony

    Background Response shift has gained increasing attention in the measurement of health-related quality of life (QoL) as it may explain counter-intuitive findings as a result of adaptation to deteriorating health. Objective To search for response shift type explanations to account for

  13. Estimating exponential scheduling preferences

    DEFF Research Database (Denmark)

    Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid

    2015-01-01

    of car drivers' route and mode choice under uncertain travel times. Our analysis exposes some important methodological issues related to complex non-linear scheduling models: One issue is identifying the point in time where the marginal utility of being at the destination becomes larger than the marginal......Different assumptions about travelers' scheduling preferences yield different measures of the cost of travel time variability. Only few forms of scheduling preferences provide non-trivial measures which are additive over links in transport networks where link travel times are arbitrarily...... utility of being at the origin. Another issue is that models with the exponential marginal utility formulation suffer from empirical identification problems. Though our results are not decisive, they partly support the constant-affine specification, in which the value of travel time variability...

  14. The human factors of implementing shift work in logging operations.

    Science.gov (United States)

    Mitchell, D L; Gallagher, T V; Thomas, R E

    2008-10-01

    A fairly recent development in the forest industry is the use of shift work in logging in the southeastern U.S. Logging company owners are implementing shift work as an opportunity to increase production and potentially reduce the cost of producing each unit of wood, without consideration of the potential impacts on the logging crew. There are many documented physiological and psychological impacts on workers from shift work in a variety of industries, although few address forestry workers in the U.S. Semi-structured interviews were performed to gather information about how logging company owners were implementing shift work in seven southeastern states. Data collected during the interviews included employee turnover, shift hours, shift scheduling, safety considerations, and production impacts. Various work schedules were employed. The majority of the schedules encompassed less than 24 hours per day. Permanent and rotating shift schedules were found. None of the logging company owners used more than two crews in a 24-hour period. Additional safety precautions were implemented as a result of working after dark. No in-woods worker accidents or injuries were reported by any of those interviewed. Results indicate that a variety of work schedules can be successfully implemented in the southeastern logging industry.

  15. Post LS1 schedule

    CERN Document Server

    Lamont, M

    2014-01-01

    The scheduling limits for a typical long year taking into account technical stops, machine development, spe- cial physics runs are presented. An attempt is then made to outline a ten year post LS1 schedule taking into account the disparate requirements outlined in the previous talks in this session. The demands on the planned long shutdowns and the impact of these demands on their proposed length will be discussed. The option of using ion running as a pre-shutdown cool-down period will be addressed.

  16. Automated Scheduling Via Artificial Intelligence

    Science.gov (United States)

    Biefeld, Eric W.; Cooper, Lynne P.

    1991-01-01

    Artificial-intelligence software that automates scheduling developed in Operations Mission Planner (OMP) research project. Software used in both generation of new schedules and modification of existing schedules in view of changes in tasks and/or available resources. Approach based on iterative refinement. Although project focused upon scheduling of operations of scientific instruments and other equipment aboard spacecraft, also applicable to such terrestrial problems as scheduling production in factory.

  17. Parental nonstandard work schedules during infancy and children's BMI trajectories

    Directory of Open Access Journals (Sweden)

    Afshin Zilanawala

    2017-09-01

    Full Text Available Background: Empirical evidence has demonstrated adverse associations between parental nonstandard work schedules (i.e., evenings, nights, or weekends and child developmental outcomes. However, there are mixed findings concerning the relationship between parental nonstandard employment and children's body mass index (BMI, and few studies have incorporated information on paternal work schedules. Objective: This paper investigated BMI trajectories from early to middle childhood (ages 3-11 by parental work schedules at 9 months of age, using nationally representative cohort data from the United Kingdom. This study is the first to examine the link between nonstandard work schedules and children's BMI in the United Kingdom. Methods: We used data from the Millennium Cohort Study (2001‒2013, n = 13,021 to estimate trajectories in BMI, using data from ages 3, 5, 7, and 11 years. Joint parental work schedules and a range of biological, socioeconomic, and psychosocial covariates were assessed in the initial interviews at 9 months. Results: Compared to children in two-parent families where parents worked standard shifts, we found steeper BMI growth trajectories for children in two-parent families where both parents worked nonstandard shifts and children in single-parent families whose mothers worked a standard shift. Fathers' shift work, compared to standard shifts, was independently associated with significant increases in BMI. Conclusions: Future public health initiatives focused on reducing the risk of rapid BMI gain in childhood can potentially consider the disruptions to family processes resulting from working nonstandard hours. Contribution: Children in families in which both parents work nonstandard schedules had steeper BMI growth trajectories across the first decade of life. Fathers' nonstandard shifts were independently associated with increases in BMI.

  18. Shift work as an oxidative stressor

    Directory of Open Access Journals (Sweden)

    Pasalar Parvin

    2005-12-01

    Full Text Available Abstract Background Some medical disorders have higher prevalence in shift workers than others. This study was designed to evaluate the effect of night-shift-working on total plasma antioxidant capacity, with respect to the causative role of oxidative stress in induction of some of these disorders. Methods Two blood samples were taken from 44 workers with a rotational shift schedule, one after their day shift and one after their night shift. The total plasma antioxidant capacity of each worker was measured through the FRAP method. The impacts of age and weight were also assessed. Results The total plasma antioxidant capacity was measured in 44 shift-workers with a mean age of 36.57 years (SD: 10.18 and mean BMI of 26.06 (SD: 4.37 after their day and night shifts. The mean reduction of total plasma antioxidant capacity after the night shift was 105.8 μmol/L (SD: 146.39. Also, a significant correlation was shown between age and weight and total plasma antioxidant capacity. Age and weight were found to be inversely related to total plasma antioxidant capacity; as age and weight increased, the total plasma antioxidant capacity decreased. Conclusion Shift work can act as an oxidative stressor and may induce many medical disorders. Aging and obesity in shift workers makes them more sensitive to this hazardous effect.

  19. A DIFFERENTIAL EVOLUTION ALGORITHM DEVELOPED FOR A NURSE SCHEDULING PROBLEM

    Directory of Open Access Journals (Sweden)

    Shahnazari-Shahrezaei, P.

    2012-11-01

    Full Text Available Nurse scheduling is a type of manpower allocation problem that tries to satisfy hospital managers objectives and nurses preferences as much as possible by generating fair shift schedules. This paper presents a nurse scheduling problem based on a real case study, and proposes two meta-heuristics a differential evolution algorithm (DE and a greedy randomised adaptive search procedure (GRASP to solve it. To investigate the efficiency of the proposed algorithms, two problems are solved. Furthermore, some comparison metrics are applied to examine the reliability of the proposed algorithms. The computational results in this paper show that the proposed DE outperforms the GRASP.

  20. The Effect of Biologically Effective Dose and Radiation Treatment Schedule on Overall Survival in Stage I Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, John M. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Ross, Rudi [21st Century Oncology, Fort Myers, Florida (United States); Harder, Eileen M.; Mancini, Brandon R. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Soulos, Pamela R. [Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut (United States); Finkelstein, Steven E.; Shafman, Timothy D.; Dosoretz, Arie P. [21st Century Oncology, Fort Myers, Florida (United States); Evans, Suzanne B.; Husain, Zain A.; Yu, James B. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Gross, Cary P. [Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut (United States); Decker, Roy H., E-mail: roy.decker@yale.edu [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)

    2016-12-01

    Purpose: To determine the effect of biologically effective dose (BED{sub 10}) and radiation treatment schedule on overall survival (OS) in patients with early-stage non-small cell lung cancer (NSCLC) undergoing stereotactic body radiation therapy (SBRT). Methods and Materials: Using data from 65 treatment centers in the United States, we retrospectively reviewed the records of T1-2 N0 NSCLC patients undergoing SBRT alone from 2006 to 2014. Biologically relevant covariates, including dose per fraction, number of fractions, and time between fractions, were used to quantify BED{sub 10} and radiation treatment schedule. The linear-quadratic equation was used to calculate BED{sub 10} and to generate a dichotomous dose variable of <105 Gy versus ≥105 Gy BED{sub 10}. The primary outcome was OS. We used the Kaplan-Meier method, the log–rank test, and Cox proportional hazards regression with propensity score matching to determine whether prescription BED{sub 10} was associated with OS. Results: We identified 747 patients who met inclusion criteria. The median BED{sub 10} was 132 Gy, and 59 (7.7%) had consecutive-day fractions. Median follow-up was 41 months, and 452 patients (60.5%) had died by the conclusion of the study. The 581 patients receiving ≥105 Gy BED{sub 10} had a median survival of 28 months, whereas the 166 patients receiving <105 Gy BED{sub 10} had a median survival of 22 months (log–rank, P=.01). Radiation treatment schedule was not a significant predictor of OS on univariable analysis. After adjusting for T stage, sex, tumor histology, and Eastern Cooperative Oncology Group performance status, BED{sub 10} ≥105 Gy versus <105 Gy remained significantly associated with improved OS (hazard ratio 0.78, 95% confidence interval 0.62-0.98, P=.03). Propensity score matching on imbalanced variables within high- and low-dose cohorts confirmed a survival benefit with higher prescription dose. Conclusions: We found that dose escalation to 105 Gy BED

  1. CMS multicore scheduling strategy

    International Nuclear Information System (INIS)

    Yzquierdo, Antonio Pérez-Calero; Hernández, Jose; Holzman, Burt; Majewski, Krista; McCrea, Alison

    2014-01-01

    In the next years, processor architectures based on much larger numbers of cores will be most likely the model to continue 'Moore's Law' style throughput gains. This not only results in many more jobs in parallel running the LHC Run 1 era monolithic applications, but also the memory requirements of these processes push the workernode architectures to the limit. One solution is parallelizing the application itself, through forking and memory sharing or through threaded frameworks. CMS is following all of these approaches and has a comprehensive strategy to schedule multicore jobs on the GRID based on the glideinWMS submission infrastructure. The main component of the scheduling strategy, a pilot-based model with dynamic partitioning of resources that allows the transition to multicore or whole-node scheduling without disallowing the use of single-core jobs, is described. This contribution also presents the experiences made with the proposed multicore scheduling schema and gives an outlook of further developments working towards the restart of the LHC in 2015.

  2. "Creative" Work Schedules.

    Science.gov (United States)

    Blai, Boris

    Many creative or flexible work scheduling options are becoming available to the many working parents, students, handicapped persons, elderly individuals, and others who are either unable or unwilling to work a customary 40-hour work week. These options may be broadly categorized as either restructured or reduced work time options. The three main…

  3. [Sleep quality of nurses working in shifts - Hungarian adaptation of the Bergen Shift Work Sleep Questionnaire].

    Science.gov (United States)

    Fusz, Katalin; Tóth, Ákos; Fullér, Noémi; Müller, Ágnes; Oláh, András

    2015-12-06

    Sleep disorders among shift workers are common problems due to the disturbed circadian rhythm. The Bergen Shift Work Sleep Questionnaire assesses discrete sleep problems related to work shifts (day, evening and night shifts) and rest days. The aim of the study was to develop the Hungarian version of this questionnaire and to compare the sleep quality of nurses in different work schedules. 326 nurses working in shifts filled in the questionnaire. The authors made convergent and discriminant validation of the questionnaire with the Athens Insomnia Scale and the Perceived Stress Questionnaire. The questionnaire based on psychometric characteristics was suitable to assess sleep disorders associated with shift work in a Hungarian sample. The frequency of discrete symptoms significantly (pshifts. Nurses experienced the worst sleep quality and daytime fatigue after the night shift. Nurses working in irregular shift system had worse sleep quality than nurses working in regular and flexible shift system (pworking in shifts should be assessed with the Hungarian version of the Bergen Shift Work Sleep Questionnaire on a nationally representative sample, and the least burdensome shift system could be established.

  4. Physician satisfaction with a multi-platform digital scheduling system.

    Directory of Open Access Journals (Sweden)

    Rodrigo Octávio Deliberato

    Full Text Available Physician shift schedules are regularly created manually, using paper or a shared online spreadsheet. Mistakes are not unusual, leading to last minute scrambles to cover a shift. We developed a web-based shift scheduling system and a mobile application tool to facilitate both the monthly scheduling and shift exchanges between physicians. The primary objective was to compare physician satisfaction before and after the mobile application implementation.Over a 9-month period, three surveys, using the 4-point Likert type scale were performed to assess the physician satisfaction. The first survey was conducted three months prior mobile application release, a second survey three months after implementation and the last survey six months after.51 (77% of the physicians answered the baseline survey. Of those, 32 (63% were males with a mean age of 37.8 ± 5.5 years. Prior to the mobile application implementation, 36 (70% of the responders were using more than one method to carry out shift exchanges and only 20 (40% were using the official department report sheet to document shift exchanges. The second and third survey were answered by 48 (73% physicians. Forty-eight (98% of them found the mobile application easy or very easy to install and 47 (96% did not want to go back to the previous method. Regarding physician satisfaction, at baseline 37% of the physicians were unsatisfied or very unsatisfied with shift scheduling. After the mobile application was implementation, only 4% reported being unsatisfied (OR = 0.11, p < 0.001. The satisfaction level improved from 63% to 96% between the first and the last survey. Satisfaction levels significantly increased between the three time points (OR = 13.33, p < 0.001.Our web and mobile phone-based scheduling system resulted in better physician satisfaction.

  5. The shifting beverage landscape.

    Science.gov (United States)

    Storey, Maureen

    2010-04-26

    STOREY, M.L. The shifting beverage landscape. PHYSIOL BEHAV, 2010. - Simultaneous lifestyle changes have occurred in the last few decades, creating an imbalance in energy intake and energy expenditure that has led to overweight and obesity. Trends in the food supply show that total daily calories available per capita increased 28% since 1970. Total energy intake among men and women has also increased dramatically since that time. Some have suggested that intake of beverages has had a disproportional impact on obesity. Data collected by the Beverage Marketing Corporation between 1988-2008 demonstrate that, in reality, fewer calories per ounce are being produced by the beverage industry. Moreover, data from the National Cancer Institute show that soft drink intake represents 5.5% of daily calories. Data from NHANES 1999-2003 vs. 2003-06 may demonstrate a shift in beverage consumption for age/gender groups, ages 6 to>60years. The beverages provided in schools have significantly changed since 2006 when the beverage industry implemented School Beverage Guidelines. This voluntary action has removed full-calorie soft drinks from participating schools across the country. This shift to lower-calorie and smaller-portion beverages in school has led to a significant decrease in total beverage calories in schools. These data support the concept that to prevent and treat obesity, public health efforts should focus on energy balance and that a narrow focus on sweetened beverages is unlikely to have any meaningful impact on this complex problem. Copyright 2010 Elsevier Inc. All rights reserved.

  6. Cost-efficient scheduling of FAST observations

    Science.gov (United States)

    Luo, Qi; Zhao, Laiping; Yu, Ce; Xiao, Jian; Sun, Jizhou; Zhu, Ming; Zhong, Yi

    2018-03-01

    A cost-efficient schedule for the Five-hundred-meter Aperture Spherical radio Telescope (FAST) requires to maximize the number of observable proposals and the overall scientific priority, and minimize the overall slew-cost generated by telescope shifting, while taking into account the constraints including the astronomical objects visibility, user-defined observable times, avoiding Radio Frequency Interference (RFI). In this contribution, first we solve the problem of maximizing the number of observable proposals and scientific priority by modeling it as a Minimum Cost Maximum Flow (MCMF) problem. The optimal schedule can be found by any MCMF solution algorithm. Then, for minimizing the slew-cost of the generated schedule, we devise a maximally-matchable edges detection-based method to reduce the problem size, and propose a backtracking algorithm to find the perfect matching with minimum slew-cost. Experiments on a real dataset from NASA/IPAC Extragalactic Database (NED) show that, the proposed scheduler can increase the usage of available times with high scientific priority and reduce the slew-cost significantly in a very short time.

  7. In vitro study on the schedule-dependency of the interaction between pemetrexed, gemcitabine and irradiation in non-small cell lung cancer and head and neck cancer cells

    International Nuclear Information System (INIS)

    Wouters, An; Pauwels, Bea; Lardon, Filip; Pattyn, Greet GO; Lambrechts, Hilde AJ; Baay, Marc; Meijnders, Paul; Vermorken, Jan B

    2010-01-01

    Based on their different mechanisms of action, non-overlapping side effects and radiosensitising potential, combining the antimetabolites pemetrexed (multitargeted antifolate, MTA) and gemcitabine (2',2'-difluorodeoxycytidine, dFdC) with irradiation (RT) seems promising. This in vitro study, for the first time, presents the triple combination of MTA, dFdC and irradiation using various treatment schedules. The cytotoxicity, radiosensitising potential and cell cycle effect of MTA were investigated in A549 (NSCLC) and CAL-27 (SCCHN) cells. Using simultaneous or sequential exposure schedules, the cytotoxicity and radiosensitising effect of 24 h MTA combined with 1 h or 24 h dFdC were analysed. Including a time interval between MTA exposure and irradiation seemed favourable to MTA immediately preceding or following radiotherapy. MTA induced a significant S phase accumulation that persisted for more than 8 h after drug removal. Among different MTA/dFdC combinations tested, the highest synergistic interaction was produced by 24 h MTA followed by 1 h dFdC. Combined with irradiation, this schedule showed a clear radiosensitising effect. Results from our in vitro model suggest that the sequence 24 h MTA → 1 h dFdC → RT is the most rational design and would, after confirmation in an in vivo setting, possibly provide the greatest benefit in the clinic

  8. Does the pretreatment tumor sampling location correspond with metabolic activity on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy?

    Energy Technology Data Exchange (ETDEWEB)

    Koolen, Bas B., E-mail: b.koolen@nki.nl [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Elshof, Lotte E. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vrancken Peeters, Marie-Jeanne T.F.D. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vogel, Wouter V. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Valdés Olmos, Renato A. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands)

    2013-12-01

    Purpose: To define the correlation between the core biopsy location and the area with highest metabolic activity on 18F-FDG PET/CT in stage II–III breast cancer patients before neoadjuvant chemotherapy. Also, we would like to select a subgroup of patients in which PET/CT information may optimize tumor sampling. Methods: A PET/CT in prone position was acquired in 199 patients with 203 tumors. The distance and relative difference in standardized uptake value (SUV) between core biopsy localization (indicated by a marker) and area with highest degree of FDG uptake were evaluated. A distance ≥2 cm and a relative difference in SUV ≥25% were considered clinically relevant and a combination of both was defined as non-correspondence. Non-correspondence for different tumor characteristics (TNM stage, lesion morphology on MRI and PET/CT, histology, subtype, grade, and Ki-67) was assessed. Results: Non-correspondence was found in 28 (14%) of 203 tumors. Non-correspondence was significantly associated with T-stage, lesion morphology on MRI and PET/CT, tumor diameter, and histologic type. It was more often seen in tumors with a higher T-stage (p = 0.028), diffuse (non-mass) and multifocal tumors on MRI (p = 0.001), diffuse and multifocal tumors on PET/CT (p < 0.001), tumors >3 cm (p < 0.001), and lobular carcinomas (p < 0.001). No association was found with other features. Conclusion: Non-correspondence between the core biopsy location and area with highest FDG uptake is regularly seen in stage II–III breast cancer patients. PET/CT information and possibly FDG-guided biopsies are most likely to improve pretreatment tumor sampling in tumors >3 cm, lobular carcinomas, and diffuse and multifocal tumors.

  9. Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules

    International Nuclear Information System (INIS)

    Groome, Patti A.; O'Sullivan, Brian; Mackillop, William J.; Jackson, Lynda D.; Schulze, Karleen M.Math.; Irish, Jonathan C.; Warde, Padraig R.; Schneider, Ken M.; Mackenzie, Robert G.; Hodson, D. Ian; Hammond, J. Alex; Gulavita, Sunil P.P.; Eapen, Libni J.; Dixon, Peter F. M.B.; Bissett, Randy J.

    2006-01-01

    Purpose: This population-based study describes the treatment of early glottic cancer in Ontario, Canada and assesses whether treatment variations were associated with treatment effectiveness. Methods and Materials: We studied 491 T1N0 and 213 T2N0 patients. Data abstracted from charts included age, sex, stage, treatment details, disease control, and survival. Results: The total dose ranged from 50 to 70 Gy, and the daily dose ranged from 1.9 to 2.8 Gy. In 90%, treatment duration was between 25 and 50 days. Field sizes, field reductions, beam arrangement, and beam energy varied. Late treatment breaks occurred in 13.6% of T1N0 and 27.1% of T2N0 cases. Local control was comparable to other reports for T1N0 (82% at 5 years), but was only 63.2% in T2N0. Variables associated with local failure in T1N0 were age less than 49 years (relative risk [RR], 3.21; 95% confidence interval [CI], 1.49-6.90) and >3 treatment interruption days (RR, 2.43; 95% CI, 1.00-5.91). In T2N0, these were field reduction (RR, 2.33; 95% CI, 1.23-4.42) and late treatment breaks (RR, 2.19; 95% CI, 1.09-4.41). Conclusion: Some aspects of treatment for early glottic cancer were associated with worse local control. Problems with protracted treatment are of particular concern, underscoring the need for randomized studies to intensify radiotherapy

  10. Shift Work Disorder and Mental and Physical Effects of Shift Work

    Directory of Open Access Journals (Sweden)

    Pinar Guzel Ozdemir

    2018-03-01

    Full Text Available With the growing prevalence of shift work all over the the world, the relationship between the daily lives of irregular lifestyles and rhythms is being investigated for those working as shift workers and their families. The effect of shift work on physical and mental health is a very important field of research in recent years. The onset and persistence of medical complications in shift workers includes impaired synchronization between work schedule rhythms and circadian clock. In this context, studies have been carried out showing the increased risk of sleep-wake disorders, gastrointestinal problems, and cardiovascular diseases. There is little information about the actual frequency, effect on health and treatment of shift work disorder, known as circadian rhythm sleep disorder. Shift work disorder includes insomnia and/or excessive sleepiness related with the work schedule. The aim of this rewiev, mentioning about the physical and mental effects of shift work, and to provide information about the diagnosis, clinic and treatment methods of shift-work disorder.

  11. A new typology of work schedules: Evidence from a cross-sectional study among nurses working in residential elder care.

    Science.gov (United States)

    Peters, V; de Rijk, A; Engels, J; Heerkens, Y; Nijhuis, F

    2016-04-07

    Work schedules contribute substantially to the health and well-being of nurses. Too broad typologies are used in research that do not meet the current variety in work schedules. To develop a new typology for nurses' work schedules based on five requirements and to validate the typology. This study is based on a questionnaire returned by 498 nurses (response 51%) including questions regarding nurses' work schedule, socio-demographic, and family characteristics and their appraisal of the work schedule. Frequencies of the different schedules were computed to determine the typology. To validate the typology, differences between the types were tested with ANOVAs, Chi2 and Kruskal-Wallis tests. Five main types can be distinguished based on predetermined requirements and frequencies, namely: (1) fixed early shift, (2) rotating two shift pattern without night shift, (3) rotating three shift pattern, (4) fixed and rotating two shift pattern including night shift, and (5) fixed normal day or afternoon shifts. Nurses in these types of work schedule differed significantly with respect to hours worked, days off between shifts, age, education, years in the job, commuting time, contribution to household income, satisfaction with work schedule and work schedule control. Especially nurses with type 3 schedules differed from other types. A typology of five main types of work schedules is proposed. Content validity of the typology is sufficient and the new typology seems useful for research on work-related aspects of nursing.

  12. Scheduled meals and scheduled palatable snacks synchronize circadian rhythms: consequences for ingestive behavior.

    Science.gov (United States)

    Escobar, Carolina; Salgado, Roberto; Rodriguez, Katia; Blancas Vázquez, Aurea Susana; Angeles-Castellanos, Manuel; Buijs, Ruud M

    2011-09-26

    Food is a potent time signal for the circadian system and has shown to entrain and override temporal signals transmitted by the biological clock, the suprachiasmatic nucleus, which adjusts mainly to the daily light/dark (LD) alternation. Organisms mostly ingest food in their active period and this permits a correct coordination between the LD and the food elicited time signals with the circadian system. Under conditions when feeding opportunities are shifted to the usual resting/sleep phase, the potent entraining force of food, shifts circadian fluctuations in several tissues, organs, and brain structures toward meal time, resulting a desynchrony within the body and between the organism and the external LD cycle. The daily scheduled access to a palatable snack exerts similar changes specifically to brain areas involved in motivation and reward responses. This review describes the phenomenology of food entrainment and entrainment by a palatable snack. It suggests how scheduled feeding can lead to food addiction and how shifted feeding schedules toward the sleep phase can result in altered ingestive behavior, obesity and disturbed metabolic responses. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    1988-06-01

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

  14. Scheduling techniques in the Request Oriented Scheduling Engine (ROSE)

    Science.gov (United States)

    Zoch, David R.

    1991-01-01

    Scheduling techniques in the ROSE are presented in the form of the viewgraphs. The following subject areas are covered: agenda; ROSE summary and history; NCC-ROSE task goals; accomplishments; ROSE timeline manager; scheduling concerns; current and ROSE approaches; initial scheduling; BFSSE overview and example; and summary.

  15. A retrospective review of pain control by a two-step irradiance schedule during topical ALA-photodynamic therapy of non-melanoma skin cancer.

    Science.gov (United States)

    Zeitouni, Nathalie C; Paquette, Anne D; Housel, Joseph P; Shi, Yi; Wilding, Gregory E; Foster, Thomas H; Henderson, Barbara W

    2013-02-01

    Photodynamic therapy (PDT) with topical δ-aminolevulinic acid (ALA) of non-melanoma skin cancers is often associated with treatment-limiting pain. A previous study on basal cell carcinomas (BCCs) at Roswell Park Cancer Institute evaluated a two-step irradiance scheme as a means of minimizing pain, preserving outcomes, and limiting treatment time. We used an initial low irradiance until 90% of the protoporphyrin IX was photobleached, followed by a high irradiance interval until the prescribed fluence was delivered. Success of this pilot investigation motivated integration of the protocol into routine practice. Here, we present a retrospective review of recent clinical experience in a broad patient population. This was a retrospective review of an existing dermatology database. Fourteen caucasion patients-nine men and five women, ages 18-80, with a total of 51 superficial and 73 nodular BCCs, and three Bowen's disease lesions-were included. ALA was applied to each lesion for approximately 4 hours. Lesions received an initial irradiance of 30-50 mW/cm(2) for 20 J/cm(2) , followed by 150 mW/cm(2) for a total fluence of 200-300 J/cm(2) . Pain was assessed using a visual analog scale (VAS). Clinical outcome was determined at 6-12 months. Median VAS scores were 1.0 for both irradiances. Five of 127 lesions required pain control with 1% xylocaine. Pain was strongly influenced by lesion location but not by lesion type, number, or size. Complete responses were achieved in 84.1% of BCCs, which compares favorably with reported results for single ALA-PDT treatments. Two of three Bowen's disease lesions showed a complete response. Complete responses for nodular BCCs were 37%, which are also within the range of reported outcomes. A two-step irradiance protocol in ALA-PDT effectively minimizes pain, maintains excellent clinical outcomes in superficial lesions, and adds minimal treatment time. Copyright © 2013 Wiley Periodicals, Inc.

  16. Mode Shift Control for a Hybrid Heavy-Duty Vehicle with Power-Split Transmission

    Directory of Open Access Journals (Sweden)

    Kun Huang

    2017-02-01

    Full Text Available Given that power-split transmission (PST is considered to be a major powertrain technology for hybrid heavy-duty vehicles (HDVs, the development and application of PST in the HDVs make mode shift control an essential aspect of powertrain system design. This paper presents a shift schedule design and torque control strategy for a hybrid HDV with PST during mode shift, intended to reduce the output torque variation and improve the shift quality (SQ. Firstly, detailed dynamic models of the hybrid HDV are developed to analyze the mode shift characteristics. Then, a gear shift schedule calculation method including a dynamic shift schedule and an economic shift schedule is provided. Based on the dynamic models and the designed shift schedule, a mode shift performance simulator is built using MATLAB/Simulink, and simulations are carried out. Through analysis of the dynamic equations, it is seen that the inertia torques of the motor–generator lead to the occurrence of transition torque. To avoid the unwanted transition torque, we use a mode shift control strategy that coordinates the motor–generator torque to compensate for the transition torque. The simulation and experimental results demonstrate that the output torque variation during mode shift is effectively reduced by the proposed control strategy, thereby improving the SQ.

  17. Modelling altered fractionation schedules

    International Nuclear Information System (INIS)

    Fowler, J.F.

    1993-01-01

    The author discusses the conflicting requirements of hyperfractionation and accelerated fractionation used in radiotherapy, and the development of computer modelling to predict how to obtain an optimum of tumour cell kill without exceeding normal-tissue tolerance. The present trend is to shorten hyperfractionated schedules from 6 or 7 weeks to give overall times of 4 or 5 weeks as in new schedules by Herskovic et al (1992) and Harari (1992). Very high doses are given, much higher than can be given when ultrashort schedules such as CHART (12 days) are used. Computer modelling has suggested that optimum overall times, to yield maximum cell kill in tumours ((α/β = 10 Gy) for a constant level of late complications (α/β = 3 Gy) would be X or X-1 weeks, where X is the doubling time of the tumour cells in days (Fowler 1990). For median doubling times of about 5 days, overall times of 4 or 5 weeks should be ideal. (U.K.)

  18. Non-occupational physical activity levels of shift workers compared with non-shift workers

    Science.gov (United States)

    Loef, Bette; Hulsegge, Gerben; Wendel-Vos, G C Wanda; Verschuren, W M Monique; Bakker, Marije F; van der Beek, Allard J; Proper, Karin I

    2017-01-01

    Objectives Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure–response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. Methods Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. Results Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1–4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure–response relationships were found between years of shift work and PA levels. Conclusions Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies. PMID:27872151

  19. The effects of shift work on free-living physical activity and sedentary behavior.

    Science.gov (United States)

    Loprinzi, Paul D

    2015-07-01

    Although occupation may influence physical activity and shift work schedule may influence cardiovascular disease risk factors, our understanding of the effects of shift work schedule on overall physical activity behavior and sedentary behavior is limited. Data from the 2005-2006 National Health and Nutrition Examination Survey were used. Shift work schedule was defined as regular daytime shift, evening, night, rotating or another schedule. Physical activity and sedentary behavior were assessed via accelerometry. 1536 adult participants (≥20years) indicated they currently work and provided data on all study variables. After adjustments, and compared to adults working a regular daytime shift, those working an evening (RR=0.41, p=0.001) and night (RR=0.30, p=0.001) shift, respectively, engaged in 59% and 70% less sustained (bouts) moderate-to-vigorous physical activity, but no differences occurred for overall moderate-to-vigorous physical activity. After adjustments, and compared to those working a regular daytime shift, those working a rotating shift engaged in more light-intensity physical activity (overall: β=26.3min/day; p=0.03; bouts: β=37.5, p=0.01) and less sedentary behavior (β=-28.5min/day, p=0.01). Shift work schedule differentially influences physical activity and sedentary behavior. Physical activity and sedentary intervention strategies may need to be tailored based on shift work schedule. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Adapting immunisation schedules for children undergoing chemotherapy.

    Science.gov (United States)

    Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen

    2018-02-01

    Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  1. Examining paid sickness absence by shift workers.

    Science.gov (United States)

    Catano, V M; Bissonnette, A B

    2014-06-01

    Shift workers are at greater risk than day workers with respect to psychological and physical health, yet little research has linked shift work to increased sickness absence. To investigate the relationship between shift work and sickness absence while controlling for organizational and individual characteristics and shift work attributes that have confounded previous research. The study used archive data collected from three national surveys in Canada, each involving over 20000 employees and 6000 private-sector firms in 14 different occupational groups. The employees reported the number of paid sickness absence days in the past 12 months. Data were analysed using both chi-squared statistics and hierarchical regressions. Contrary to previous research, shift workers took less paid sickness absence than day workers. There were no differences in the length of the sickness absence between both groups or in sickness absence taken by female and male workers whether working days or shifts. Only job tenure, the presence of a union in the workplace and working rotating shifts predicted sickness absence in shift workers. The results were consistent across all three samples. In general, shift work does not seem to be linked to increased sickness absence. However, such associations may be true for specific industries. Male and female workers did not differ in the amount of sickness absence taken. Rotating shifts, regardless of industry, predicted sickness absence among shift workers. Consideration should be given to implementing scheduled time off between shift changes. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Impacts of shift work on sleep and circadian rhythms.

    Science.gov (United States)

    Boivin, D B; Boudreau, P

    2014-10-01

    Shift work comprises work schedules that extend beyond the typical "nine-to-five" workday, wherein schedules often comprise early work start, compressed work weeks with 12-hour shifts, and night work. According to recent American and European surveys, between 15 and 30% of adult workers are engaged in some type of shift work, with 19% of the European population reportedly working at least 2 hours between 22:00 and 05:00. The 2005 International Classification of Sleep Disorders estimates that a shift work sleep disorder can be found in 2-5% of workers. This disorder is characterized by excessive sleepiness and/or sleep disruption for at least one month in relation with the atypical work schedule. Individual tolerance to shift work remains a complex problem that is affected by the number of consecutive work hours and shifts, the rest periods, and the predictability of work schedules. Sleepiness usually occurs during night shifts and is maximal at the end of the night. Impaired vigilance and performance occur around times of increased sleepiness and can seriously compromise workers' health and safety. Indeed, workers suffering from a shift work sleep-wake disorder can fall asleep involuntarily at work or while driving back home after a night shift. Working on atypical shifts has important socioeconomic impacts as it leads to an increased risk of accidents, workers' impairment and danger to public safety, especially at night. The aim of the present review is to review the circadian and sleep-wake disturbances associated with shift work as well as their medical impacts. Copyright © 2014. Published by Elsevier SAS.

  3. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1982-07-01

    Effective January 1, 1982, NRC will institute records retention and disposal practices in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 22 which apply to housekeeping or facilitative records. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability

  4. Mathematical modeling of sleep state dynamics in a rodent model of shift work

    Directory of Open Access Journals (Sweden)

    Michael J. Rempe

    2018-06-01

    Full Text Available Millions of people worldwide are required to work when their physiology is tuned for sleep. By forcing wakefulness out of the body’s normal schedule, shift workers face numerous adverse health consequences, including gastrointestinal problems, sleep problems, and higher rates of some diseases, including cancers. Recent studies have developed protocols to simulate shift work in rodents with the intention of assessing the effects of night-shift work on subsequent sleep (Grønli et al., 2017. These studies have already provided important contributions to the understanding of the metabolic consequences of shift work (Arble et al., 2015; Marti et al., 2016; Opperhuizen et al., 2015 and sleep-wake-specific impacts of night-shift work (Grønli et al., 2017. However, our understanding of the causal mechanisms underlying night-shift-related sleep disturbances is limited. In order to advance toward a mechanistic understanding of sleep disruption in shift work, we model these data with two different approaches. First we apply a simple homeostatic model to quantify differences in the rates at which sleep need, as measured by slow wave activity during slow wave sleep (SWS rises and falls. Second, we develop a simple and novel mathematical model of rodent sleep and use it to investigate the timing of sleep in a simulated shift work protocol (Grønli et al., 2017. This mathematical framework includes the circadian and homeostatic processes of the two-process model, but additionally incorporates a stochastic process to model the polyphasic nature of rodent sleep. By changing only the time at which the rodents are forced to be awake, the model reproduces some key experimental results from the previous study, including correct proportions of time spent in each stage of sleep as a function of circadian time and the differences in total wake time and SWS bout durations in the rodents representing night-shift workers and those representing day-shift workers

  5. A Randomized Phase 2 Study Comparing 2 Stereotactic Body Radiation Therapy Schedules for Medically Inoperable Patients With Stage I Peripheral Non-Small Cell Lung Cancer: NRG Oncology RTOG 0915 (NCCTG N0927)

    Energy Technology Data Exchange (ETDEWEB)

    Videtic, Gregory M.M., E-mail: videtig@ccf.org [The Cleveland Clinic, Cleveland, Ohio (United States); Hu, Chen [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Singh, Anurag K. [Roswell Park Cancer Institute, Buffalo, New York (United States); Chang, Joe Y. [MD Anderson Cancer Center, Houston, Texas (United States); Parker, William [McGill University Health Center, Montreal, Québec (Canada); Olivier, Kenneth R. [Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Mayo Clinic, Scottsdale, Arizona (United States); Komaki, Ritsuko [MD Anderson Cancer Center, Houston, Texas (United States); Urbanic, James J. [Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Choy, Hak [The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)

    2015-11-15

    Purpose: To compare 2 stereotactic body radiation therapy (SBRT) schedules for medically inoperable early-stage lung cancer to determine which produces the lowest rate of grade ≥3 protocol-specified adverse events (psAEs) at 1 year. Methods and Materials: Patients with biopsy-proven peripheral (≥2 cm from the central bronchial tree) T1 or T2, N0 (clinically node negative by positron emission tomography), M0 tumors were eligible. Patients were randomized to receive either 34 Gy in 1 fraction (arm 1) or 48 Gy in 4 consecutive daily fractions (arm 2). Rigorous central accreditation and quality assurance confirmed treatment per protocol guidelines. This study was designed to detect a psAEs rate >17% at a 10% significance level (1-sided) and 90% power. Secondary endpoints included rates of primary tumor control (PC), overall survival (OS), and disease-free survival (DFS) at 1 year. Designating the better of the 2 regimens was based on prespecified rules of psAEs and PC for each arm. Results: Ninety-four patients were accrued between September 2009 and March 2011. The median follow-up time was 30.2 months. Of 84 analyzable patients, 39 were in arm 1 and 45 in arm 2. Patient and tumor characteristics were balanced between arms. Four (10.3%) patients on arm 1 (95% confidence interval [CI] 2.9%-24.2%) and 6 (13.3%) patients on arm 2 (95% CI 5.1%-26.8%) experienced psAEs. The 2-year OS rate was 61.3% (95% CI 44.2%-74.6%) for arm 1 patients and 77.7% (95% CI 62.5%-87.3%) for arm 2. The 2-year DFS was 56.4% (95% CI 39.6%-70.2%) for arm 1 and 71.1% (95% CI 55.5%-82.1%) for arm 2. The 1-year PC rate was 97.0% (95% CI 84.2%-99.9%) for arm 1 and 92.7% (95% CI 80.1%-98.5%) for arm 2. Conclusions: 34 Gy in 1 fraction met the prespecified criteria and, of the 2 schedules, warrants further clinical research.

  6. Practical quantum appointment scheduling

    Science.gov (United States)

    Touchette, Dave; Lovitz, Benjamin; Lütkenhaus, Norbert

    2018-04-01

    We propose a protocol based on coherent states and linear optics operations for solving the appointment-scheduling problem. Our main protocol leaks strictly less information about each party's input than the optimal classical protocol, even when considering experimental errors. Along with the ability to generate constant-amplitude coherent states over two modes, this protocol requires the ability to transfer these modes back-and-forth between the two parties multiple times with very low losses. The implementation requirements are thus still challenging. Along the way, we develop tools to study quantum information cost of interactive protocols in the finite regime.

  7. Scheduling theory, algorithms, and systems

    CERN Document Server

    Pinedo, Michael L

    2016-01-01

    This new edition of the well-established text Scheduling: Theory, Algorithms, and Systems provides an up-to-date coverage of important theoretical models in the scheduling literature as well as important scheduling problems that appear in the real world. The accompanying website includes supplementary material in the form of slide-shows from industry as well as movies that show actual implementations of scheduling systems. The main structure of the book, as per previous editions, consists of three parts. The first part focuses on deterministic scheduling and the related combinatorial problems. The second part covers probabilistic scheduling models; in this part it is assumed that processing times and other problem data are random and not known in advance. The third part deals with scheduling in practice; it covers heuristics that are popular with practitioners and discusses system design and implementation issues. All three parts of this new edition have been revamped, streamlined, and extended. The reference...

  8. Rotating shift work associated with obesity in men from northeastern Ontario

    OpenAIRE

    Anne Grundy; Michelle Cotterchio; Victoria A. Kirsh; Victoria Nadalin; Nancy Lightfoot; Nancy Kreiger

    2017-01-01

    Introduction: While some studies have suggested associations between shift work and obesity, few have been population-based or considered multiple shift schedules. Since obesity is linked with several chronic health conditions, understanding which types of shift work influence obesity is important and additional work with more detailed exposure assessment of shift work is warranted. Methods: Using multivariate polytomous logistic regression, we investigated the associations between shift work...

  9. Taking the lag out of jet lag through model-based schedule design.

    Science.gov (United States)

    Dean, Dennis A; Forger, Daniel B; Klerman, Elizabeth B

    2009-06-01

    Travel across multiple time zones results in desynchronization of environmental time cues and the sleep-wake schedule from their normal phase relationships with the endogenous circadian system. Circadian misalignment can result in poor neurobehavioral performance, decreased sleep efficiency, and inappropriately timed physiological signals including gastrointestinal activity and hormone release. Frequent and repeated transmeridian travel is associated with long-term cognitive deficits, and rodents experimentally exposed to repeated schedule shifts have increased death rates. One approach to reduce the short-term circadian, sleep-wake, and performance problems is to use mathematical models of the circadian pacemaker to design countermeasures that rapidly shift the circadian pacemaker to align with the new schedule. In this paper, the use of mathematical models to design sleep-wake and countermeasure schedules for improved performance is demonstrated. We present an approach to designing interventions that combines an algorithm for optimal placement of countermeasures with a novel mode of schedule representation. With these methods, rapid circadian resynchrony and the resulting improvement in neurobehavioral performance can be quickly achieved even after moderate to large shifts in the sleep-wake schedule. The key schedule design inputs are endogenous circadian period length, desired sleep-wake schedule, length of intervention, background light level, and countermeasure strength. The new schedule representation facilitates schedule design, simulation studies, and experiment design and significantly decreases the amount of time to design an appropriate intervention. The method presented in this paper has direct implications for designing jet lag, shift-work, and non-24-hour schedules, including scheduling for extreme environments, such as in space, undersea, or in polar regions.

  10. Taking the lag out of jet lag through model-based schedule design.

    Directory of Open Access Journals (Sweden)

    Dennis A Dean

    2009-06-01

    Full Text Available Travel across multiple time zones results in desynchronization of environmental time cues and the sleep-wake schedule from their normal phase relationships with the endogenous circadian system. Circadian misalignment can result in poor neurobehavioral performance, decreased sleep efficiency, and inappropriately timed physiological signals including gastrointestinal activity and hormone release. Frequent and repeated transmeridian travel is associated with long-term cognitive deficits, and rodents experimentally exposed to repeated schedule shifts have increased death rates. One approach to reduce the short-term circadian, sleep-wake, and performance problems is to use mathematical models of the circadian pacemaker to design countermeasures that rapidly shift the circadian pacemaker to align with the new schedule. In this paper, the use of mathematical models to design sleep-wake and countermeasure schedules for improved performance is demonstrated. We present an approach to designing interventions that combines an algorithm for optimal placement of countermeasures with a novel mode of schedule representation. With these methods, rapid circadian resynchrony and the resulting improvement in neurobehavioral performance can be quickly achieved even after moderate to large shifts in the sleep-wake schedule. The key schedule design inputs are endogenous circadian period length, desired sleep-wake schedule, length of intervention, background light level, and countermeasure strength. The new schedule representation facilitates schedule design, simulation studies, and experiment design and significantly decreases the amount of time to design an appropriate intervention. The method presented in this paper has direct implications for designing jet lag, shift-work, and non-24-hour schedules, including scheduling for extreme environments, such as in space, undersea, or in polar regions.

  11. 29 CFR 825.205 - Increments of FMLA leave for intermittent or reduced schedule leave.

    Science.gov (United States)

    2010-07-01

    ... intermittent leave or working a reduced leave schedule to commence or end work mid-way through a shift, such as... per week, but works only 20 hours a week under a reduced leave schedule, the employee's ten hours of... 29 Labor 3 2010-07-01 2010-07-01 false Increments of FMLA leave for intermittent or reduced...

  12. Prioritizing sleep for healthy work schedules

    Science.gov (United States)

    2012-01-01

    Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work). Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules. PMID:22738292

  13. Prioritizing sleep for healthy work schedules

    Directory of Open Access Journals (Sweden)

    Takahashi Masaya

    2012-03-01

    Full Text Available Abstract Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work. Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules.

  14. Prioritizing sleep for healthy work schedules.

    Science.gov (United States)

    Takahashi, Masaya

    2012-03-13

    Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work). Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules.

  15. Perceptions of randomized security schedules.

    Science.gov (United States)

    Scurich, Nicholas; John, Richard S

    2014-04-01

    Security of infrastructure is a major concern. Traditional security schedules are unable to provide omnipresent coverage; consequently, adversaries can exploit predictable vulnerabilities to their advantage. Randomized security schedules, which randomly deploy security measures, overcome these limitations, but public perceptions of such schedules have not been examined. In this experiment, participants were asked to make a choice between attending a venue that employed a traditional (i.e., search everyone) or a random (i.e., a probability of being searched) security schedule. The absolute probability of detecting contraband was manipulated (i.e., 1/10, 1/4, 1/2) but equivalent between the two schedule types. In general, participants were indifferent to either security schedule, regardless of the probability of detection. The randomized schedule was deemed more convenient, but the traditional schedule was considered fairer and safer. There were no differences between traditional and random schedule in terms of perceived effectiveness or deterrence. Policy implications for the implementation and utilization of randomized schedules are discussed. © 2013 Society for Risk Analysis.

  16. 2007 Wholesale Power Rate Schedules : 2007 General Rate Schedule Provisions.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    2006-11-01

    This schedule is available for the contract purchase of Firm Power to be used within the Pacific Northwest (PNW). Priority Firm (PF) Power may be purchased by public bodies, cooperatives, and Federal agencies for resale to ultimate consumers, for direct consumption, and for Construction, Test and Start-Up, and Station Service. Rates in this schedule are in effect beginning October 1, 2006, and apply to purchases under requirements Firm Power sales contracts for a three-year period. The Slice Product is only available for public bodies and cooperatives who have signed Slice contracts for the FY 2002-2011 period. Utilities participating in the Residential Exchange Program (REP) under Section 5(c) of the Northwest Power Act may purchase Priority Firm Power pursuant to the Residential Exchange Program. Rates under contracts that contain charges that escalate based on BPA's Priority Firm Power rates shall be based on the three-year rates listed in this rate schedule in addition to applicable transmission charges. This rate schedule supersedes the PF-02 rate schedule, which went into effect October 1, 2001. Sales under the PF-07 rate schedule are subject to BPA's 2007 General Rate Schedule Provisions (2007 GRSPs). Products available under this rate schedule are defined in the 2007 GRSPs. For sales under this rate schedule, bills shall be rendered and payments due pursuant to BPA's 2007 GRSPs and billing process.

  17. HEALTH EFFECTS OF SLEEP DEPRIVATION ON NURSES WORKING SHIFTS.

    Science.gov (United States)

    Stanojevic, Cedomirka; Simic, Svetlana; Milutinovic, Dragana

    2016-10-01

    Atypical work schedules cause reduced sleep, leading to drowsiness, fatigue, decline of cognitive performance and health problems among the members of the nursing staff. The study was aimed at reviewing current knowledge and attitudes concerning the impact of sleep disorders on health and cognitive functions among the members of the nursing staff. Sleep and Interpersonal Relations in Modern Society. The modern 24-hour society involves more and more employees (health services, police departments, public transport) in non-standard forms of work. In European Union countries, over 50% of the nursing staff work night shifts, while in the United States of America 55% of nursing staff work more than 40 hours a week, and 30-70% of nurses sleep less than six hours before their shift. Cognitive Effects of Sleep Deprivation. Sleep deprivation impairs the performance of tasks that require intensive and prolonged attention which increases the number of errors in patients care, and nurses are subject to incre- ased risk of traffic accidents. Sleep Deprivation and Health Disorders. Sleep deprived members of the nursing staff are at risk of obesity, diabetes, gastrointestinal disorders and cardiovascular disease. The risk factors for breast cancer are increased by 1.79 times. and there is a significantly higher risk for colorectal carcinoma. Too long or repeated shifts reduce the opportunity for sleep, shorten recovery time in nurses, thus endangering their safety and health as well as the quality of care and patients' safety. Bearing in mind the significance of the problerm it is necessary to conduct the surveys of sleep quality and health of nurses in the Republic of Serbia as well in order to tackle this issue which is insufficiently recognized.

  18. Influences on Dietary Choices during Day versus Night Shift in Shift Workers: A Mixed Methods Study

    Science.gov (United States)

    Bonnell, Emily K.; Huggins, Catherine E.; Huggins, Chris T.; McCaffrey, Tracy A.; Palermo, Claire; Bonham, Maxine P.

    2017-01-01

    Shift work is associated with diet-related chronic conditions such as obesity and cardiovascular disease. This study aimed to explore factors influencing food choice and dietary intake in shift workers. A fixed mixed method study design was undertaken on a convenience sample of firefighters who continually work a rotating roster. Six focus groups (n = 41) were conducted to establish factors affecting dietary intake whilst at work. Dietary intake was assessed using repeated 24 h dietary recalls (n = 19). Interviews were audio recorded, transcribed verbatim, and interpreted using thematic analysis. Dietary data were entered into FoodWorks and analysed using Wilcoxon signed-rank test; p shift schedule; attitudes and decisions of co-workers; time and accessibility; and knowledge of the relationship between food and health. Participants reported consuming more discretionary foods and limited availability of healthy food choices on night shift. Energy intakes (kJ/day) did not differ between days that included a day or night shift but greater energy density (EDenergy, kJ/g/day) of the diet was observed on night shift compared with day shift. This study has identified a number of dietary-specific shift-related factors that may contribute to an increase in unhealthy behaviours in a shift-working population. Given the increased risk of developing chronic diseases, organisational change to support workers in this environment is warranted. PMID:28245625

  19. Rostering and Task Scheduling

    DEFF Research Database (Denmark)

    Dohn, Anders Høeg

    . The rostering process is non-trivial and especially when service is required around the clock, rostering may involve considerable effort from a designated planner. Therefore, in order to minimize costs and overstaffing, to maximize the utilization of available staff, and to ensure a high level of satisfaction...... as possible to the available staff, while respecting various requirements and rules and while including possible transportation time between tasks. This thesis presents a number of industrial applications in rostering and task scheduling. The applications exist within various contexts in health care....... Mathematical and logic-based models are presented for the problems considered. Novel components are added to existing models and the modeling decisions are justified. In one case, the model is solved by a simple, but efficient greedy construction heuristic. In the remaining cases, column generation is applied...

  20. Optimal Intermittent Dose Schedules for Chemotherapy Using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    Nadia ALAM

    2013-08-01

    Full Text Available In this paper, a design method for optimal cancer chemotherapy schedules via genetic algorithm (GA is presented. The design targets the key objective of chemotherapy to minimize the size of cancer tumor after a predefined time with keeping toxic side effects in limit. This is a difficult target to achieve using conventional clinical methods due to poor therapeutic indices of existing anti-cancer drugs. Moreover, there are clinical limitations in treatment administration to maintain continuous treatment. Besides, carefully decided rest periods are recommended to for patient’s comfort. Three intermittent drug scheduling schemes are presented in this paper where GA is used to optimize the dose quantities and timings by satisfying several treatment constraints. All three schemes are found to be effective in total elimination of cancer tumor after an agreed treatment length. The number of cancer cells is found zero at the end of the treatment for all three cases with tolerable toxicity. Finally, two of the schemes, “Fixed interval variable dose (FIVD and “Periodic dose” that are periodic in characteristic have been emphasized due to their additional simplicity in administration along with friendliness to patients. responses to the designed treatment schedules. Therefore the proposed design method is capable of planning effective, simple, patient friendly and acceptable chemotherapy schedules.

  1. Nurse scheduling in a hospital emergency department: A case study at a Thai university hospital

    Directory of Open Access Journals (Sweden)

    Aussadavut Dumrongsiri

    2018-02-01

    Full Text Available Common problems of Thai nurses are low quality of life, working long hours, and a high turnover rate. The workload imbalance among nurses also worsens the turnover rate. With careful schedule planning, nurses do not have to work in consecutive shifts and can rest more. We interviewed and collected data from an emergency department at a hospital administered by a Thai university, related to objectives and constraints of monthly nurse scheduling, and actual monthly schedules. A multi-objective mathematical model was developed using the open source “OpenSolver” software in MS-Excel for nurse schedulers to freely use. We tested the model using actual data collected from the department and found that the schedules created by the model tended to provide more balanced workloads and more days off compared to the schedules created manually by a real scheduler. The model also suggested an easy policy to increase the number of nurses for future expansion.

  2. Micropatch Antenna Phase Shifting

    National Research Council Canada - National Science Library

    Thursby, Michael

    2000-01-01

    .... We have been looking at the ability of embedded element to adjust the phase shift seen by the element with the goal of being able to remove the phase shifting devices from the antenna and replace...

  3. Micropatch Antenna Phase Shifting

    National Research Council Canada - National Science Library

    Thursby, Michael

    1999-01-01

    .... We have been looking at the ability of embedded element to adjust the phase shift seen by the element wit the goal of being able to remove the phase shifting devices from the antenna and replace...

  4. [Work schedules in the Hungarian health care system and the sleep quality of nurses].

    Science.gov (United States)

    Fusz, Katalin; Pakai, Annamária; Kívés, Zsuzsanna; Szunomár, Szilvia; Regős, Annamária; Oláh, András

    2016-03-06

    One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances. The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules. 236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire. The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044). It would be helpful if the least burdensome shift system could be established.

  5. Analysis of the numbers of B, T and subpopulation lymphocytes in patients with breast cancer submitted to a different radiotherapy schedules; Analise do numero de linfocitos B, T e subpopulacoes em pacientes com cancer da mama submetidas a esquemas diferentes de radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Andrade, J.M. de

    1990-12-31

    The behaviour of T and B lymphocytes subpopulations was evaluated in patients with breast cancer submitted to 3 different schedules of radiotherapy. The assays were carried out before and immediately after the end of treatment. T lymphocytes and the helper/inducer (CD{sub 4}) and suppressor/cytotoxic (CD{sub 8}) subpopulations were counted by indirect immunofluorescence with monoclonal antibodies of the OKT series. The number of B lymphocytes was obtained by direct immunofluorescence with fluorescein-conjugated anti-human Ig antibodies. The patients were divided into 3 groups: irradiation of the breast only; irradiation of the lymph-draining areas; irradiation of the breast, of the lymph-draining area and of the sternal area. (author).

  6. Sport Tournament Automated Scheduling System

    OpenAIRE

    Raof R. A. A; Sudin S.; Mahrom N.; Rosli A. N. C

    2018-01-01

    The organizer of sport events often facing problems such as wrong calculations of marks and scores, as well as difficult to create a good and reliable schedule. Most of the time, the issues about the level of integrity of committee members and also issues about errors made by human came into the picture. Therefore, the development of sport tournament automated scheduling system is proposed. The system will be able to automatically generate the tournament schedule as well as automatically calc...

  7. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1992-03-01

    Title 44 United States Code, ''Public Printing and Documents,'' regulations cited in the General Services Administration's (GSA) ''Federal Information Resources Management Regulations'' (FIRMR), Part 201-9, ''Creation, Maintenance, and Use of Records,'' and regulation issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter XII, Subchapter B, ''Records Management,'' require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA's General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 2, contains ''NRC's Comprehensive Records Disposition Schedule,'' and the original authorized approved citation numbers issued by NARA. Rev. 2 totally reorganizes the records schedules from a functional arrangement to an arrangement by the host office. A subject index and a conversion table have also been developed for the NRC schedules to allow staff to identify the new schedule numbers easily and to improve their ability to locate applicable schedules

  8. OpenShift Workshop

    CERN Multimedia

    CERN. Geneva; Rodriguez Peon, Alberto

    2017-01-01

    Workshop to introduce developers to the OpenShift platform available at CERN. Several use cases will be shown, including deploying an existing application into OpenShift. We expect attendees to realize about OpenShift features and general architecture of the service.

  9. Schedules of Controlled Substances: Temporary Placement of 4-Fluoroisobutyryl Fentanyl into Schedule I. Temporary scheduling order.

    Science.gov (United States)

    2017-05-03

    The Administrator of the Drug Enforcement Administration is issuing this temporary scheduling order to schedule the synthetic opioid, N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl fentanyl or para-fluoroisobutyryl fentanyl), and its isomers, esters, ethers, salts and salts of isomers, esters, and ethers, into schedule I pursuant to the temporary scheduling provisions of the Controlled Substances Act. This action is based on a finding by the Administrator that the placement of 4-fluoroisobutyryl fentanyl into schedule I of the Controlled Substances Act is necessary to avoid an imminent hazard to the public safety. As a result of this order, the regulatory controls and administrative, civil, and criminal sanctions applicable to schedule I controlled substances will be imposed on persons who handle (manufacture, distribute, reverse distribute, import, export, engage in research, conduct instructional activities or chemical analysis, or possess), or propose to handle, 4-fluoroisobutyryl fentanyl.

  10. Acquired cisplatin resistance in human ovarian A2780 cancer cells correlates with shift in taurine homeostasis and ability to volume regulate

    DEFF Research Database (Denmark)

    Sørensen, Belinda Halling; Thorsteinsdottir, Unnur Arna; Lambert, Ian Henry

    2014-01-01

    Cisplatin resistance is a major challenge in the treatment of cancer and develops through reduced drug accumulation and an increased ability to avoid drug-induced cell damage, cell shrinkage, and hence initiation of apoptosis. Uptake and release of the semiessential amino acid taurine contribute...... to cell volume homeostasis, and taurine has been reported to have antiapoptotic effects. Here we find that volume-sensitive taurine release in cisplatin-sensitive [wild-type (WT)] human ovarian cancer A2780 cells is reduced in the presence of the phospholipase A2 inhibitor bromenol lactone, the 5......-induced cell death in RES A2780 cells correlates with an increased accumulation of taurine, due to an increased taurine uptake and a concomitant impairment of the volume-sensitive taurine release pathway, as well an inability to reduce cell volume after osmotic cell swelling. Downregulation of volume...

  11. Effects of Napping During Shift Work on Sleepiness and Performance in Emergency Medical Services Personnel and Similar Shift Workers: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    2018-01-11

    Background: Scheduled napping during work shifts may be an effective way to mitigate fatigue-related risk. This study aimed to critically review and synthesize existing literature on the impact of scheduled naps on fatigue-related outcomes for EMS pe...

  12. Shifted Golgi targeting of glycosyltransferases and α-mannosidase IA from giantin to GM130-GRASP65 results in formation of high mannose N-glycans in aggressive prostate cancer cells.

    Science.gov (United States)

    Bhat, Ganapati; Hothpet, Vishwanath-Reddy; Lin, Ming-Fong; Cheng, Pi-Wan

    2017-11-01

    There is a pressing need for biomarkers that can distinguish indolent from aggressive prostate cancer to prevent over-treatment of patients with indolent tumor. Golgi targeting of glycosyltransferases was characterized by confocal microscopy after knockdown of GM130, giantin, or both. N-glycans on a trans-Golgi enzyme β4galactosyltransferase-1 isolated by immunoprecipitation from androgen-sensitive and independent prostate cancer cells were determined by matrix-assisted laser desorption-time of flight-mass spectrometry. In situ proximity ligation assay was employed to determine co-localization of (a) α-mannosidase IA, an enzyme required for processing Man 8 GlcNAc 2 down to Man 5 GlcNAc 2 to enable synthesis of complex-type N-glycans, with giantin, GM130, and GRASP65, and (b) trans-Golgi glycosyltransferases with high mannose N-glycans terminated with α3-mannose. Defective giantin in androgen-independent prostate cancer cells results in a shift of Golgi targeting of glycosyltransferases and α-mannosidase IA from giantin to GM130-GRASP65. Consequently, trans-Golgi enzymes and cell surface glycoproteins acquire high mannose N-glycans, which are absent in cells with functional giantin. In situ proximity ligation assays of co-localization of α-mannosidase IA with GM130 and GRASP65, and trans-Golgi glycosyltransferases with high mannose N-glycans are negative in androgen-sensitive LNCaP C-33 cells but positive in androgen-independent LNCaP C-81 and DU145 cells, and LNCaP C-33 cells devoid of giantin. In situ proximity ligation assays of Golgi localization of α-mannosidase IA at giantin versus GM130-GRASP65 site, and absence or presence of N-glycans terminated with α3-mannose on trans-Golgi glycosyltransferases may be useful for distinguishing indolent from aggressive prostate cancer cells. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Practical principles in appointment scheduling

    NARCIS (Netherlands)

    Kuiper, A.; Mandjes, M.

    2015-01-01

    Appointment schedules aim at achieving a proper balance between the conflicting interests of the service provider and her clients: a primary objective of the service provider is to fully utilize her available time, whereas clients want to avoid excessive waiting times. Setting up schedules that

  14. Modeling the Cray memory scheduler

    Energy Technology Data Exchange (ETDEWEB)

    Wickham, K.L.; Litteer, G.L.

    1992-04-01

    This report documents the results of a project to evaluate low cost modeling and simulation tools when applied to modeling the Cray memory scheduler. The specific tool used is described and the basics of the memory scheduler are covered. Results of simulations using the model are discussed and a favorable recommendation is made to make more use of this inexpensive technology.

  15. Flexible Work Schedules. ERIC Digest.

    Science.gov (United States)

    Kerka, Sandra

    Flexible work schedules are one response to changes in the composition of the work force, new life-styles, and changes in work attitudes. Types of alternative work schedules are part-time and temporary employment, job sharing, and flextime. Part-time workers are a diverse group--women, the very young, and older near-retirees. Although part-time…

  16. AP1000 construction schedule

    International Nuclear Information System (INIS)

    Winters, J.W.

    2001-01-01

    Westinghouse performed this study as part of EPRI interest in advancing the use of computer aided processes to reduce the cost of nuclear power plants. EPRI believed that if one could relate appropriate portions of an advanced light water reactor plant model to activities in its construction sequence, and this relationship could be portrayed visually, then optimization of the construction sequence could be developed as never before. By seeing a 3-D representation of the plant at any point in its construction sequence, more informed decisions can be made on the feasibility or attractiveness of follow on or parallel steps in the sequence. The 3-D representation of construction as a function of time (4-D) could also increase the confidence of potential investors concerning the viability of the schedule and the plant ultimate cost. This study performed by Westinghouse confirmed that it is useful to be able to visualize a plant construction in 3-D as a function of time in order to optimize the sequence of construction activities. (author)

  17. TECHNICAL COORDINATION SCHEDULE & INTEGRATION

    CERN Multimedia

    W. Zeuner

    Introduction The endgame of CMS installation in the underground cavern is in full swing, with several major milestones having been passed since the last CMS week. The Tracker was installed inside the Vactank just before the CERN end-of-year shutdown. Shortly after the reopening in 2008, the two remaining endcap disks, YE-2 and YE-1, were lowered, marking the completion of eight years of assembly in the surface building SX5. The remaining tasks, before the detector can be closed for the Cosmic Run At Four Tesla (CRAFT), are the installation of the thermal shields, the cabling of the negative endcap, the cabling of the tracker and the beam pipe installation. In addition to these installation tasks, a test closure of the positive endcap is planned just before the installation of the central beam pipe. The schedule is tight and complicated but the goal to close CMS by the end of May for a cosmic test with magnetic field remains feasible. Safety With all large components now being underground, the shortage...

  18. Shift Work, Chronotype, and Melatonin Patterns among Female Hospital Employees on Day and Night Shifts.

    Science.gov (United States)

    Leung, Michael; Tranmer, Joan; Hung, Eleanor; Korsiak, Jill; Day, Andrew G; Aronson, Kristan J

    2016-05-01

    Shift work-related carcinogenesis is hypothesized to be mediated by melatonin; however, few studies have considered the potential effect modification of this underlying pathway by chronotype or specific aspects of shift work such as the number of consecutive nights in a rotation. In this study, we examined melatonin patterns in relation to shift status, stratified by chronotype and number of consecutive night shifts, and cumulative lifetime exposure to shift work. Melatonin patterns of 261 female personnel (147 fixed-day and 114 on rotations, including nights) at Kingston General Hospital were analyzed using cosinor analysis. Urine samples were collected from all voids over a 48-hour specimen collection period for measurement of 6-sulfatoxymelatonin concentrations using the Buhlmann ELISA Kit. Chronotypes were assessed using mid-sleep time (MSF) derived from the Munich Chronotype Questionnaire (MCTQ). Sociodemographic, health, and occupational information were collected by questionnaire. Rotational shift nurses working nights had a lower mesor and an earlier time of peak melatonin production compared to day-only workers. More pronounced differences in mesor and acrophase were seen among later chronotypes, and shift workers working ≥3 consecutive nights. Among nurses, cumulative shift work was associated with a reduction in mesor. These results suggest that evening-types and/or shift workers working ≥3 consecutive nights are more susceptible to adverse light-at-night effects, whereas long-term shift work may also chronically reduce melatonin levels. Cumulative and current exposure to shift work, including nights, affects level and timing of melatonin production, which may be related to carcinogenesis and cancer risk. Cancer Epidemiol Biomarkers Prev; 25(5); 830-8. ©2016 AACR. ©2016 American Association for Cancer Research.

  19. The ageing shift worker: a prospective cohort study on need for recovery, disability, and retirement intentions.

    Science.gov (United States)

    Gommans, Fleur; Jansen, Nicole; Stynen, Dave; de Grip, Andries; Kant, Ijmert

    2015-07-01

    This study investigates whether different shift work schedules, compared to day work, are associated with need for recovery (NFR), future disability, and retirement intentions for employees employed within different economic sectors over the course of their careers. Shift work exposure duration and the healthy worker effect are also examined. Data from the prospective Maastricht Cohort Study was used. Subsamples of industry (N=1877, all men) and healthcare (N=818, 624 women and 194 men) workers were separately investigated. GEE and Cox regression analyses were performed to investigate NFR longitudinally. Future disability was investigated using Cox regression, and retirement intentions were investigated using logistic regression analysis. Three-shift industry workers were at risk of becoming a case of elevated NFR during follow-up, compared to industry day workers. Three- and five-shift industry workers were at risk for future disability. In healthcare, irregular shift work was a risk factor for disability among older shift workers. No significant results were found regarding retirement intentions. Findings were probably an underestimation as exposure duration to shift work and the healthy worker effect affected the results. Shift work was associated with higher levels of NFR and a higher risk of disability. However, shift work is a multifaceted concept as different types of shift work schedules are differently associated with these outcomes. Different shift work types exist and shift work schedules allow for optimization, indicating that measures to prevent adverse outcomes should be tailored for different types of shift work and over the course of the work career.

  20. Choice Shifts in Groups

    OpenAIRE

    Kfir Eliaz; Debraj Ray

    2004-01-01

    The phenomenon of "choice shifts" in group decision-making is fairly ubiquitous in the social psychology literature. Faced with a choice between a ``safe" and ``risky" decision, group members appear to move to one extreme or the other, relative to the choices each member might have made on her own. Both risky and cautious shifts have been identified in different situations. This paper demonstrates that from an individual decision-making perspective, choice shifts may be viewed as a systematic...

  1. Gain scheduling using the Youla parameterization

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik; Stoustrup, Jakob

    1999-01-01

    Gain scheduling controllers are considered in this paper. The gain scheduling problem where the scheduling parameter vector cannot be measured directly, but needs to be estimated is considered. An estimation of the scheduling vector has been derived by using the Youla parameterization. The use...... in connection with H_inf gain scheduling controllers....

  2. Comparison of menstrual disorders in hospital nursing staff according to shift work pattern.

    Science.gov (United States)

    Albert-Sabater, Josep Amílcar; Martínez, José Miguel; Baste, Valborg; Moen, Bente E; Ronda-Perez, Elena

    2016-11-01

    To assess the association between work in a rotating shift schedule and menstruation characteristics among nurse staff in a prospective study. Rotating shifts have been linked to alterations in the reproductive cycle. In the case of menstrual alterations, the conclusions are not clear. Prospective epidemiological study with follow-up over four months. All the female nurse staff (shifts and characteristics of their menstruation (duration, amount of blood, dysmenorrhoea). They had two types of shifts: (1) Rotating shift schedule (two mornings, two afternoons, one night and two days off) including morning shifts (8:00-15:00), afternoon/evening shifts (15:00-22:00) and night shifts (22:00-8:00), and (2) Day shift schedule including morning shifts (8:00-15:00) and/or afternoon/evening shifts (15:00-22:00). The crude and adjusted odds ratios with 95% confidence interval were calculated using logistic generalised estimating equations (GEE) taking into account the correlations of multiple cycles per worker. One hundred and thirteen workers on the rotating shift and 75 on the day shift participated, and information from 730 menstrual cycles were obtained. There were no differences in prolonged duration, dysmenorrhoea, prolonged duration dysmenorrhoea and excessive bleeding among nurses on rotating shift compared to those on the day shift. For prolonged duration of menstruation, workers with more than five years on the rotating shift showed a slightly lower (nonsignificant) risk compared with those with shift did not show increased risk of having menstrual disorders comparing with day staff. Shifts with short rotation cycles and a progressive sequence do not appear to cause menstrual disorders in nurse staff who work rotating shifts. © 2016 John Wiley & Sons Ltd.

  3. Implementing OpenShift

    CERN Document Server

    Miller, Adam

    2013-01-01

    A standard tutorial-based approach to using OpenShift and deploying custom or pre-built web applications to the OpenShift Online cloud.This book is for software developers and DevOps alike who are interested in learning how to use the OpenShift Platform-as-a-Service for developing and deploying applications, how the environment works on the back end, and how to deploy their very own open source Platform-as-a-Service based on the upstream OpenShift Origin project.

  4. Constraint-based scheduling applying constraint programming to scheduling problems

    CERN Document Server

    Baptiste, Philippe; Nuijten, Wim

    2001-01-01

    Constraint Programming is a problem-solving paradigm that establishes a clear distinction between two pivotal aspects of a problem: (1) a precise definition of the constraints that define the problem to be solved and (2) the algorithms and heuristics enabling the selection of decisions to solve the problem. It is because of these capabilities that Constraint Programming is increasingly being employed as a problem-solving tool to solve scheduling problems. Hence the development of Constraint-Based Scheduling as a field of study. The aim of this book is to provide an overview of the most widely used Constraint-Based Scheduling techniques. Following the principles of Constraint Programming, the book consists of three distinct parts: The first chapter introduces the basic principles of Constraint Programming and provides a model of the constraints that are the most often encountered in scheduling problems. Chapters 2, 3, 4, and 5 are focused on the propagation of resource constraints, which usually are responsibl...

  5. Effects of Shift Work and Sustained Operations: Operator Performance in Remotely Piloted Aircraft (OP-REPAIR)

    National Research Council Canada - National Science Library

    Thompson, William T; Lopez, Nadia; Hickey, Patrick; DaLuz, Christina; Caldwell, J. L; Tvaryanas, Anthony P

    2006-01-01

    The introduction of unmanned aircraft systems (UAS) with "inhuman endurance" has led to operational requirements for extended duty days and varying shift schedules which are likely to reduce operator effectiveness because of fatigue...

  6. Shift Work and Sleep Quality Among Urban Police Officers

    Science.gov (United States)

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

    2016-01-01

    Objective The aim of the study was to examine association of shift work with sleep quality in police officers. Methods Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n =363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. Results The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P shift (P =0.003) relative to officers working on the day shift. Conclusions Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers. PMID:26949891

  7. Comparison of diffusion-weighted images using short inversion time inversion recovery or chemical shift selective pulse as fat suppression in patients with breast cancer

    International Nuclear Information System (INIS)

    Kazama, Toshiki; Nasu, Katsuhiro; Kuroki, Yoshifumi; Nawano, Shigeru; Ito, Hisao

    2009-01-01

    Fat suppression is essential for diffusion-weighted imaging (DWI) in the body. However, the chemical shift selective (CHESS) pulse often fails to suppress fat signals in the breast. The purpose of this study was to compare DWI using CHESS and DWI using short inversion time inversion recovery (STIR) in terms of fat suppression and the apparent diffusion coefficient (ADC) value. DWI using STIR, DWI using CHESS, and contrast-enhanced T1-weighted images were obtained in 32 patients with breast carcinoma. Uniformity of fat suppression, ADC, signal intensity, and visualization of the breast tumors were evaluated. In 44% (14/32) of patients there was insufficient fat suppression in the breasts on DWI using CHESS, whereas 0% was observed on DWI using STIR (P<0.0001). The ADCs obtained for DWI using STIR were 4.3% lower than those obtained for DWI using CHESS (P<0.02); there was a strong correlation of the ADC measurement (r=0.93, P<0.001). DWI using STIR may be excellent for fat suppression; and the ADC obtained in this sequence was well correlated with that obtained with DWI using CHESS. DWI using STIR may be useful when the fat suppression technique in DWI using CHESS does not work well. (author)

  8. Non-occupational physical activity levels of shift workers compared with non-shift workers.

    Science.gov (United States)

    Loef, Bette; Hulsegge, Gerben; Wendel-Vos, G C Wanda; Verschuren, W M Monique; Vermeulen, Roel C H; Bakker, Marije F; van der Beek, Allard J; Proper, Karin I

    2017-05-01

    Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure-response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1-4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure-response relationships were found between years of shift work and PA levels. Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  9. Shifted Independent Component Analysis

    DEFF Research Database (Denmark)

    Mørup, Morten; Madsen, Kristoffer Hougaard; Hansen, Lars Kai

    2007-01-01

    Delayed mixing is a problem of theoretical interest and practical importance, e.g., in speech processing, bio-medical signal analysis and financial data modelling. Most previous analyses have been based on models with integer shifts, i.e., shifts by a number of samples, and have often been carried...

  10. Homogeneous bilateral block shifts

    Indian Academy of Sciences (India)

    Douglas class were classified in [3]; they are unilateral block shifts of arbitrary block size (i.e. dim H(n) can be anything). However, no examples of irreducible homogeneous bilateral block shifts of block size larger than 1 were known until now.

  11. OpenShift cookbook

    CERN Document Server

    Gulati, Shekhar

    2014-01-01

    If you are a web application developer who wants to use the OpenShift platform to host your next big idea but are looking for guidance on how to achieve this, then this book is the first step you need to take. This is a very accessible cookbook where no previous knowledge of OpenShift is needed.

  12. Immunization Schedules for Infants and Children

    Science.gov (United States)

    ... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedule for Infants and Children (Birth through 6 ... any questions please talk to your doctor. 2018 Immunization Schedule Recommended Vaccinations for Infants and Children Schedule ...

  13. Operating Theatre Planning and Scheduling.

    NARCIS (Netherlands)

    Hans, Elias W.; Vanberkel, P.T.; Hall, R.

    2012-01-01

    In this chapter we present a number of approaches to operating theatre planning and scheduling. We organize these approaches hierarchically which serves to illustrate the breadth of problems confronted by researchers. At each hierarchicalplanning level we describe common problems, solution

  14. Schedule Sales Query Raw Data

    Data.gov (United States)

    General Services Administration — Schedule Sales Query presents sales volume figures as reported to GSA by contractors. The reports are generated as quarterly reports for the current year and the...

  15. Multiagent scheduling models and algorithms

    CERN Document Server

    Agnetis, Alessandro; Gawiejnowicz, Stanisław; Pacciarelli, Dario; Soukhal, Ameur

    2014-01-01

    This book presents multi-agent scheduling models in which subsets of jobs sharing the same resources are evaluated by different criteria. It discusses complexity results, approximation schemes, heuristics and exact algorithms.

  16. Executive Schedule C System (ESCS)

    Data.gov (United States)

    Office of Personnel Management — Used to store information on Federal employees in the Senior Executive Service (SES) and appointed employees in the Schedule C System. Every four years, just after...

  17. Josephson shift registers

    International Nuclear Information System (INIS)

    Przybysz, J.X.

    1989-01-01

    This paper gives a review of Josephson shift register circuits that were designed, fabricated, or tested, with emphasis on work in the 1980s. Operating speed is most important, since it often limits system performance. Older designs used square-wave clocks, but most modern designs use offset sine waves, with either two or three phases. Operating margins and gate bias uniformity are key concerns. The fastest measured Josephson shift register operated at 2.3 GHz, which compares well with a GaAs shift register that consumes 250 times more power. The difficulties of high-speed testing have prevented many Josephson shift registers from being operated at their highest speeds. Computer simulations suggest that 30-GHz operation is possible with current Nb/Al 2 O 3 /Nb technology. Junctions with critical current densities near 10 kA/cm 2 would make 100-GHz shift registers feasible

  18. Sleep quality and quality of life in female shift-working nurses.

    Science.gov (United States)

    Shao, Ming-Fen; Chou, Yu-Ching; Yeh, Mei-Yu; Tzeng, Wen-Chii

    2010-07-01

    This paper is a report of a study of the factors that influence sleep quality and quality of life among shift-working nurses and the relationship between their sleep quality and quality of life. Although shift-working nurses strive to adapt their life schedules to shift rotations, they tend to suffer from severe sleep disturbances and increased rates of cancer, cardiovascular diseases, digestive disease and irregular menstrual cycles. Poor sleep is also associated with medical errors and occupational injuries. A cross-sectional study was conducted in 2008 with a convenience sample of 435 female nurses from five regional hospitals in Taiwan. Data were collected on sleep quality and quality of life using the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument-BREF Taiwan version respectively. Data were analysed using descriptive statistics, independent t-tests, analysis of variance and Pearson correlations. The majority of female shift workers (57%) had global sleep-quality scores > or = 5, indicating poor sleep and all mean scores in four domains of the quality-of-life measure were statistically significantly lower than those of females in Taiwan's general population. Scores for poor sleep quality and quality of life were related to premenstrual dysphoria, occupational injury, illness and medication use. In addition, the associations between scores on the sleep-quality and quality-of-life scales were statistically significantly inversely correlated. Advice should be included in both undergraduate programmes and continuing education to help nurses to recognize and improve their own sleep quality and life quality managers should create a supportive environment to encourage shift-working nurses to engage in healthy behaviours.

  19. Future aircraft networks and schedules

    Science.gov (United States)

    Shu, Yan

    2011-07-01

    Because of the importance of air transportation scheduling, the emergence of small aircraft and the vision of future fuel-efficient aircraft, this thesis has focused on the study of aircraft scheduling and network design involving multiple types of aircraft and flight services. It develops models and solution algorithms for the schedule design problem and analyzes the computational results. First, based on the current development of small aircraft and on-demand flight services, this thesis expands a business model for integrating on-demand flight services with the traditional scheduled flight services. This thesis proposes a three-step approach to the design of aircraft schedules and networks from scratch under the model. In the first step, both a frequency assignment model for scheduled flights that incorporates a passenger path choice model and a frequency assignment model for on-demand flights that incorporates a passenger mode choice model are created. In the second step, a rough fleet assignment model that determines a set of flight legs, each of which is assigned an aircraft type and a rough departure time is constructed. In the third step, a timetable model that determines an exact departure time for each flight leg is developed. Based on the models proposed in the three steps, this thesis creates schedule design instances that involve almost all the major airports and markets in the United States. The instances of the frequency assignment model created in this thesis are large-scale non-convex mixed-integer programming problems, and this dissertation develops an overall network structure and proposes iterative algorithms for solving these instances. The instances of both the rough fleet assignment model and the timetable model created in this thesis are large-scale mixed-integer programming problems, and this dissertation develops subproblem schemes for solving these instances. Based on these solution algorithms, this dissertation also presents

  20. Construction schedules slack time minimizing

    Science.gov (United States)

    Krzemiński, Michał

    2017-07-01

    The article presents two copyright models for minimizing downtime working brigades. Models have been developed for construction schedules performed using the method of work uniform. Application of flow shop models is possible and useful for the implementation of large objects, which can be divided into plots. The article also presents a condition describing gives which model should be used, as well as a brief example of optimization schedule. The optimization results confirm the legitimacy of the work on the newly-developed models.

  1. No first night shift effect observed following a nocturnal main sleep and a prophylactic 1-h afternoon nap.

    Science.gov (United States)

    Kosmadopoulos, Anastasi; Zhou, Xuan; Roach, Gregory D; Darwent, David; Sargent, Charli

    Neurobehavioural impairment on the first night shift is often greater than on subsequent night shifts due to extended wakefulness. The aim of the study was to determine whether a 1-h afternoon nap prior to the first night shift is sufficient to produce neurobehavioural performance at levels comparable to the second night shift. Twelve male volunteers (mean age 22.9 years) participated in a laboratory protocol that simulated two 12-h night shifts. A nap preceded the first shift and a 7-h daytime sleep was scheduled between shifts. Neurobehavioural performance and subjective sleepiness measured across each night did not significantly differ between first and second shifts.

  2. See-sawing between work and home: Shift-working mothers’ perceptions on work/family balance

    OpenAIRE

    Huhtala, Eija; Uusiautti, Satu; Määttä, Kaarina

    2012-01-01

    Recent public discourse and studies are filled with issues related to work/family balance. Shift work concretely affects family life considerably already starting from the schedule the family has to follow because of one or both parents’ work shifts. The purpose of this study is to contribute by dissecting shift worker-mothers’ perceptions on the balance between shift work and family life. This research was a qualitative study where eight shift-working mothers were interviewed. This phenomeno...

  3. Validity of self-reported exposure to shift work.

    Science.gov (United States)

    Härmä, Mikko; Koskinen, Aki; Ropponen, Annina; Puttonen, Sampsa; Karhula, Kati; Vahtera, Jussi; Kivimäki, Mika

    2017-03-01

    To evaluate the validity of widely used questionnaire items on work schedule using objective registry data as reference. A cohort study of hospital employees who responded to a self-administered questionnaire on work schedule in 2008, 2012 and 2014 and were linked to individual-level pay-roll-based records on work shifts. For predictive validity, leisure-time fatigue was assessed. According to the survey data in 2014 (n=8896), 55% of the day workers had at least 1 year of earlier shift work experience. 8% of the night shift workers changed to day work during the follow-up. Using pay-roll data as reference, questions on 'shift work with night shifts' and 'permanent night work' showed high sensitivity (96% and 90%) and specificity (92% and 97%). Self-reported 'regular day work' showed moderate sensitivity (73%), but high specificity (99%) and 'shift work without night shifts' showed low sensitivity (62%) and moderate specificity (87%). In multivariate logistic regression analysis, the age-adjusted, sex-adjusted and baseline fatigue-adjusted association between 'shift work without night shifts' and leisure-time fatigue was lower for self-reported compared with objective assessment (1.30, 95% CI 0.94 to 1.82, n=1707 vs 1.89, 95% CI 1.06 to 3.39, n=1627). In contrast, shift work with night shifts, compared with permanent day work, was similarly associated with fatigue in the two assessments (2.04, 95% CI 1.62 to 2.57, n=2311 vs 1.82, 95% CI 1.28 to 2.58, n=1804). The validity of self-reported assessment of shift work varies between work schedules. Exposure misclassification in self-reported data may contribute to bias towards the null in shift work without night shifts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Adaptation to Shift Work: Physiologically Based Modeling of the Effects of Lighting and Shifts’ Start Time

    Science.gov (United States)

    Postnova, Svetlana; Robinson, Peter A.; Postnov, Dmitry D.

    2013-01-01

    Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers’ sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8) in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers’ adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21∶00 instead of 00∶00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters. PMID:23308206

  5. Nurses' shift reports

    DEFF Research Database (Denmark)

    Buus, Niels; Hoeck, Bente; Hamilton, Bridget Elizabeth

    2017-01-01

    AIMS AND OBJECTIVES: To identify reporting practices that feature in studies of nurses' shift reports across diverse nursing specialities. The objectives were to perform an exhaustive systematic literature search and to critically review the quality and findings of qualitative field studies...... of nurses' shift reports. BACKGROUND: Nurses' shift reports are routine occurrences in healthcare organisations that are viewed as crucial for patient outcomes, patient safety and continuity of care. Studies of communication between nurses attend primarily to 1:1 communication and analyse the adequacy...... and accuracy of patient information and feature handovers at the bedside. Still, verbal reports between groups of nurses about patients are commonplace. Shift reports are obvious sites for studying the situated accomplishment of professional nursing at the group level. This review is focused exclusively...

  6. Shift Verification and Validation

    Energy Technology Data Exchange (ETDEWEB)

    Pandya, Tara M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Evans, Thomas M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Davidson, Gregory G [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Johnson, Seth R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Godfrey, Andrew T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2016-09-07

    This documentation outlines the verification and validation of Shift for the Consortium for Advanced Simulation of Light Water Reactors (CASL). Five main types of problems were used for validation: small criticality benchmark problems; full-core reactor benchmarks for light water reactors; fixed-source coupled neutron-photon dosimetry benchmarks; depletion/burnup benchmarks; and full-core reactor performance benchmarks. We compared Shift results to measured data and other simulated Monte Carlo radiation transport code results, and found very good agreement in a variety of comparison measures. These include prediction of critical eigenvalue, radial and axial pin power distributions, rod worth, leakage spectra, and nuclide inventories over a burn cycle. Based on this validation of Shift, we are confident in Shift to provide reference results for CASL benchmarking.

  7. Effects of extended work shifts on employee fatigue, health satisfaction, work/family balance, and patient safety.

    NARCIS (Netherlands)

    Estryn-Behar, M.; van der Heijden, Beatrice

    2012-01-01

    12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift

  8. Molecular Electronic Shift Registers

    Science.gov (United States)

    Beratan, David N.; Onuchic, Jose N.

    1990-01-01

    Molecular-scale shift registers eventually constructed as parts of high-density integrated memory circuits. In principle, variety of organic molecules makes possible large number of different configurations and modes of operation for such shift-register devices. Several classes of devices and implementations in some specific types of molecules proposed. All based on transfer of electrons or holes along chains of repeating molecular units.

  9. NRC comprehensive records disposition schedule

    International Nuclear Information System (INIS)

    1983-05-01

    Effective January 1, 1982, NRC will institute records retention and disposal practives in accordance with the approved Comprehensive Records Disposition Schedule (CRDS). CRDS is comprised of NRC Schedules (NRCS) 1 to 4 which apply to the agency's program or substantive records and General Records Schedules (GRS) 1 to 24 which apply to housekeeping or facilitative records. NRCS-I applies to records common to all or most NRC offices; NRCS-II applies to program records as found in the various offices of the Commission, Atomic Safety and Licensing Board Panel, and the Atomic Safety and Licensing Appeal Panel; NRCS-III applies to records accumulated by the Advisory Committee on Reactor Safeguards; and NRCS-IV applies to records accumulated in the various NRC offices under the Executive Director for Operations. The schedules are assembled functionally/organizationally to facilitate their use. Preceding the records descriptions and disposition instructions for both NRCS and GRS, there are brief statements on the organizational units which accumulate the records in each functional area, and other information regarding the schedules' applicability

  10. Multiuser switched diversity scheduling schemes

    KAUST Repository

    Shaqfeh, Mohammad; Alnuweiri, Hussein M.; Alouini, Mohamed-Slim

    2012-01-01

    Multiuser switched-diversity scheduling schemes were recently proposed in order to overcome the heavy feedback requirements of conventional opportunistic scheduling schemes by applying a threshold-based, distributed, and ordered scheduling mechanism. The main idea behind these schemes is that slight reduction in the prospected multiuser diversity gains is an acceptable trade-off for great savings in terms of required channel-state-information feedback messages. In this work, we characterize the achievable rate region of multiuser switched diversity systems and compare it with the rate region of full feedback multiuser diversity systems. We propose also a novel proportional fair multiuser switched-based scheduling scheme and we demonstrate that it can be optimized using a practical and distributed method to obtain the feedback thresholds. We finally demonstrate by numerical examples that switched-diversity scheduling schemes operate within 0.3 bits/sec/Hz from the ultimate network capacity of full feedback systems in Rayleigh fading conditions. © 2012 IEEE.

  11. Sport Tournament Automated Scheduling System

    Directory of Open Access Journals (Sweden)

    Raof R. A. A

    2018-01-01

    Full Text Available The organizer of sport events often facing problems such as wrong calculations of marks and scores, as well as difficult to create a good and reliable schedule. Most of the time, the issues about the level of integrity of committee members and also issues about errors made by human came into the picture. Therefore, the development of sport tournament automated scheduling system is proposed. The system will be able to automatically generate the tournament schedule as well as automatically calculating the scores of each tournament. The problem of scheduling the matches of a round robin and knock-out phase in a sport league are given focus. The problem is defined formally and the computational complexity is being noted. A solution algorithm is presented using a two-step approach. The first step is the creation of a tournament pattern and is based on known graph-theoretic method. The second one is an assignment problem and it is solved using a constraint based depth-first branch and bound procedure that assigns actual teams to numbers in the pattern. As a result, the scheduling process and knock down phase become easy for the tournament organizer and at the same time increasing the level of reliability.

  12. Multiuser switched diversity scheduling schemes

    KAUST Repository

    Shaqfeh, Mohammad

    2012-09-01

    Multiuser switched-diversity scheduling schemes were recently proposed in order to overcome the heavy feedback requirements of conventional opportunistic scheduling schemes by applying a threshold-based, distributed, and ordered scheduling mechanism. The main idea behind these schemes is that slight reduction in the prospected multiuser diversity gains is an acceptable trade-off for great savings in terms of required channel-state-information feedback messages. In this work, we characterize the achievable rate region of multiuser switched diversity systems and compare it with the rate region of full feedback multiuser diversity systems. We propose also a novel proportional fair multiuser switched-based scheduling scheme and we demonstrate that it can be optimized using a practical and distributed method to obtain the feedback thresholds. We finally demonstrate by numerical examples that switched-diversity scheduling schemes operate within 0.3 bits/sec/Hz from the ultimate network capacity of full feedback systems in Rayleigh fading conditions. © 2012 IEEE.

  13. Environmental surveillance master sampling schedule

    International Nuclear Information System (INIS)

    Bisping, L.E.

    1991-01-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. The routine sampling plan for the SESP has been revised this year to reflect changing site operations and priorities. Some sampling previously performed at least annually has been reduced in frequency, and some new sampling to be performed at a less than annual frequency has been added. Therefore, the SESP schedule reflects sampling to be conducted in calendar year 1991 as well as future years. The ground-water sampling schedule is for 1991. This schedule is subject to modification during the year in response to changes in Site operation, program requirements, and the nature of the observed results. Operational limitations such as weather, mechanical failures, sample availability, etc., may also require schedule modifications. Changes will be documented in the respective project files, but this plan will not be reissued. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford evirons

  14. Environmental surveillance master sampling schedule

    Energy Technology Data Exchange (ETDEWEB)

    Bisping, L.E.

    1991-01-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Ground-Water Monitoring Project. The routine sampling plan for the SESP has been revised this year to reflect changing site operations and priorities. Some sampling previously performed at least annually has been reduced in frequency, and some new sampling to be performed at a less than annual frequency has been added. Therefore, the SESP schedule reflects sampling to be conducted in calendar year 1991 as well as future years. The ground-water sampling schedule is for 1991. This schedule is subject to modification during the year in response to changes in Site operation, program requirements, and the nature of the observed results. Operational limitations such as weather, mechanical failures, sample availability, etc., may also require schedule modifications. Changes will be documented in the respective project files, but this plan will not be reissued. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford evirons.

  15. Evaluating the traditional day and night shift in an acute care surgery fellowship: Is the swing shift a better choice?

    Science.gov (United States)

    Chestovich, Paul J; McNicoll, Christopher F; Ingalls, Nichole K; Kuhls, Deborah A; Fraser, Douglas R; Morrissey, Shawna L; Fildes, John J

    2018-01-01

    Fellowship trainees in acute care surgery require experience in the management of complex and operative trauma cases. Trauma center staffing usually follows standard 12-hour or 24-hour shifts, with resident and fellow trainees following a similar schedule. Although trauma admissions can be generally unpredictable, we analyzed temporal trends of trauma patient arrival times to determine the best time frame to maximize trainee experience during each day. We reviewed 10 years (2007-2016) of trauma registry data for blunt and penetrating trauma activations. Hourly volumetric trends were observed, and three specific events were chosen for detailed analysis: (1) trauma activation with Injury Severity Score (ISS) greater than 15, (2) laparotomy for trauma, and (3) thoracotomy for trauma. A retrospective shift log was created, which included day (7:00 AM to 7:00 PM), night (7:00 PM to 7:00 AM), and swing (noon to midnight) shifts. A swing shift was chosen because it captures the peak volume for all three events. Means and 95% confidence intervals were calculated, and comparisons were made between shifts using the Wilcoxon matched-pairs signed rank test with Bonferroni correction, and p less than 0.05 considered significant. During the 10-year study period, 28,287 patients were treated at our trauma center. This included the evaluation and management of 7,874 patients with ISS greater than 15, performance of 1,766 laparotomies, and 392 thoracotomies for trauma. Swing shift was superior to both day and night shifts for ISS greater than 15 (p night shifts were superior to day shift for laparotomies (p day shift (p night shift (p = 0.031). Shifts with the highest yield of ISS greater than 15, laparotomies, and thoracotomies include night and swing shifts on Fridays and Saturdays. Projected experience of acute care surgery fellows in managing complex trauma patients increases with the integration of swing shifts into the schedule. Daily trauma volume follows a temporal pattern

  16. Schedulability Analysis for Java Finalizers

    DEFF Research Database (Denmark)

    Bøgholm, Thomas; Hansen, Rene Rydhof; Søndergaard, Hans

    2010-01-01

    Java finalizers perform clean-up and finalisation of objects at garbage collection time. In real-time Java profiles the use of finalizers is either discouraged (RTSJ, Ravenscar Java) or even disallowed (JSR-302), mainly because of the unpredictability of finalizers and in particular their impact...... on the schedulability analysis. In this paper we show that a controlled scoped memory model results in a structured and predictable execution of finalizers, more reminiscent of C++ destructors than Java finalizers. Furthermore, we incorporate finalizers into a (conservative) schedulability analysis for Predictable Java...... programs. Finally, we extend the SARTS tool for automated schedulability analysis of Java bytecode programs to handle finalizers in a fully automated way....

  17. Environmental surveillance master sampling schedule

    International Nuclear Information System (INIS)

    Bisping, L.E.

    1997-01-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL)(a) for the US Department of Energy (DOE). This document contains the planned 1997 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. In addition, Section 3.0, Biota, also reflects a rotating collection schedule identifying the year a specific sample is scheduled for collection. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, General Environmental Protection Program, and DOE Order 5400.5, Radiation Protection of the Public and the Environment. The sampling methods will be the same as those described in the Environmental Monitoring Plan, US Department of Energy, Richland Operations Office, DOE/RL91-50, Rev. 1, US Department of Energy, Richland, Washington

  18. Endogenous scheduling preferences and congestion

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Small, Kenneth

    2010-01-01

    and leisure, but agglomeration economies at home and at work lead to scheduling preferences forming endogenously. Using bottleneck congestion technology, we obtain an equilibrium queuing pattern consistent with a general version of the Vickrey bottleneck model. However, the policy implications are different....... Compared to the predictions of an analyst observing untolled equilibrium and taking scheduling preferences as exogenous, we find that both the optimal capacity and the marginal external cost of congestion have changed. The benefits of tolling are greater, and the optimal time varying toll is different....

  19. Effects of Napping During Shift Work on Sleepiness and Performance in Emergency Medical Services Personnel and Similar Shift Workers: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Martin-Gill, Christian; Barger, Laura K; Moore, Charity G; Higgins, J Stephen; Teasley, Ellen M; Weiss, Patricia M; Condle, Joseph P; Flickinger, Katharyn L; Coppler, Patrick J; Sequeira, Denisse J; Divecha, Ayushi A; Matthews, Margaret E; Lang, Eddy S; Patterson, P Daniel

    2018-02-15

    Scheduled napping during work shifts may be an effective way to mitigate fatigue-related risk. This study aimed to critically review and synthesize existing literature on the impact of scheduled naps on fatigue-related outcomes for EMS personnel and similar shift worker groups. A systematic literature review was performed of the impact of a scheduled nap during shift work on EMS personnel or similar shift workers. The primary (critical) outcome of interest was EMS personnel safety. Secondary (important) outcomes were patient safety; personnel performance; acute states of fatigue, alertness, and sleepiness; indicators of sleep duration and/or quality; employee retention/turnover; indicators of long-term health; and cost to the system. Meta-analyses were performed to evaluate the impact of napping on a measure of personnel performance (the psychomotor vigilance test [PVT]) and measures of acute fatigue. Of 4,660 unique records identified, 13 experimental studies were determined relevant and summarized. The effect of napping on reaction time measured at the end of shift was small and non-significant (SMD 0.12, 95% CI -0.13 to 0.36; p = 0.34). Napping during work did not change reaction time from the beginning to the end of the shift (SMD -0.01, 95% CI -25.0 to 0.24; p = 0.96). Naps had a moderate, significant effect on sleepiness measured at the end of shift (SMD 0.40, 95% CI 0.09 to 0.72; p = 0.01). The difference in sleepiness from the start to the end of shift was moderate and statistically significant (SMD 0.41, 95% CI 0.09 to 0.72; p = 0.01). Reviewed literature indicated that scheduled naps at work improved performance and decreased fatigue in shift workers. Further research is required to identify the optimal timing and duration of scheduled naps to maximize the beneficial outcomes.

  20. The impact of chronotype on melatonin levels among shift workers.

    Science.gov (United States)

    Bhatti, Parveen; Mirick, Dana K; Davis, Scott

    2014-03-01

    The association between shift work and cancer, which is thought to be mediated by effects on circulating melatonin levels, may be modified by chronotype (ie, the inherent preference for activity in the morning or the evening); however, few studies have examined the potential impact of chronotype on the carcinogenic effects of shift work. The authors analysed the impact of chronotype on previously reported differences in melatonin levels among healthcare workers that exclusively worked night or day shifts. The cross-sectional study included 664 men and women (310 day shift and 354 night shift workers) from which urine samples were collected throughout work and sleep periods and were assayed for 6-sulfatoxymelatonin. Participants also completed the Composite Scale of Morningness, a questionnaire used to assess chronotype. Among both morning and evening-type night shift workers, 6-sulfatoxymelatonin levels were constitutively lower during daytime sleep, night-time sleep and night work compared with day shift workers during night-time sleep. However, morning-type night shift workers consistently showed 6-sulfatoxymelatonin levels that were closer to levels in day shift workers than did evening-type night shift workers. Differences in 6-sulfatoxymelatonin levels between morning-type and evening-type night shift workers relative to day shift workers were statistically significant in every instance (pnight shift workers may be better able to maintain a 'normal' circadian pattern of melatonin production as compared with evening-type night shift workers. The impact of this chronotype effect on cancer risk among shift workers requires further study.

  1. Artificial intelligence approaches to astronomical observation scheduling

    Science.gov (United States)

    Johnston, Mark D.; Miller, Glenn

    1988-01-01

    Automated scheduling will play an increasing role in future ground- and space-based observatory operations. Due to the complexity of the problem, artificial intelligence technology currently offers the greatest potential for the development of scheduling tools with sufficient power and flexibility to handle realistic scheduling situations. Summarized here are the main features of the observatory scheduling problem, how artificial intelligence (AI) techniques can be applied, and recent progress in AI scheduling for Hubble Space Telescope.

  2. Sleep and need for recovery in shift workers: do chronotype and age matter?

    Science.gov (United States)

    van de Ven, Hardy A; van der Klink, Jac J L; Vetter, Céline; Roenneberg, Till; Gordijn, Marijke; Koolhaas, Wendy; de Looze, Michiel P; Brouwer, Sandra; Bültmann, Ute

    2016-01-01

    This study examined associations of chronotype and age with shift-specific assessments of main sleep duration, sleep quality and need for recovery in a cross-sectional study among N = 261 industrial shift workers (96.6% male). Logistic regression analyses were used, adjusted for gender, lifestyle, health, nap behaviour, season of assessment and shift schedule. Shift workers with latest versus earliest chronotype reported a shorter sleep duration (OR 11.68, 95% CI 3.31-41.17) and more awakenings complaints (OR 4.84, 95% CI 4.45-11.92) during morning shift periods. No associations were found between chronotype, sleep and need for recovery during evening and night shift periods. For age, no associations were found with any of the shift-specific outcome measures. The results stress the importance of including the concept of chronotype in shift work research and scheduling beyond the concept of age. Longitudinal research using shift-specific assessments of sleep and need for recovery are needed to confirm these results. Chronotype seems to better explain individual differences in sleep than age. In view of ageing societies, it might therefore be worthwhile to further examine the application of chronotype for individualised shift work schedules to facilitate healthy and sustainable employment.

  3. Cancer

    Science.gov (United States)

    Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...

  4. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts.

    Science.gov (United States)

    Ferri, Paola; Guadi, Matteo; Marcheselli, Luigi; Balduzzi, Sara; Magnani, Daniela; Di Lorenzo, Rosaria

    2016-01-01

    Shift work is considered necessary to ensure continuity of care in hospitals and residential facilities. In particular, the night shift is one of the most frequent reasons for the disruption of circadian rhythms, causing significant alterations of sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance. The aim of this study was to highlight if shift work with nights, as compared with day work only, is associated with risk factors predisposing nurses to poorer health conditions and lower job satisfaction. This cross-sectional study was conducted from June 1, 2015 to July 31, 2015 in 17 wards of a general hospital and a residential facility of a northern Italian city. This study involved 213 nurses working in rotating night shifts and 65 in day shifts. The instrument used for data collection was the "Standard Shift Work Index," validated in Italian. Data were statistically analyzed. The response rate was 86%. The nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelors and Masters degrees in nursing. They reported the lowest mean score in the items of job satisfaction, quality and quantity of sleep, with more frequent chronic fatigue, psychological, and cardiovascular symptoms in comparison with the day shift workers, in a statistically significant way. Our results suggest that nurses with rotating night schedule need special attention due to the higher risk for both job dissatisfaction and undesirable health effects.

  5. Human reliability and plant operating efficiency: Are 12-hour work schedules cause for concern?

    International Nuclear Information System (INIS)

    Baker, T.L.

    1992-01-01

    Since the introduction of 12-h shifts to the US nuclear power industry only 8 yr ago, compressed workweek schedules have proliferated among operations departments at a phenomenal rate. Many plants that continue to use 8-h shifts during normal operations routinely change to scheduled 12-h shifts during refueling or maintenance outages. The most critical issue in the use of extended work shifts is whether alertness, physical stamina, or mental performance are compromised to the point of reducing safety or efficiency of nuclear power plant operation. Laboratory and field research sponsored by the National Institute of Occupational Safety and Health suggests that alertness, measured by self-ratings, and mental performance, measured by computer-based performance tests, are impaired on 12-h shifts compared with 8-h shifts. In contrast to these findings, plant operating efficiency and operator performance have been rated as improved in two field studies conducted in operating nuclear power plants (Fast Flux Test Facility, Washington and Ontario Hydro, Canada). A recent Electric Power Research Institute review of nuclear industry experience with 12-h shifts also suggests an overwhelmingly positive rating of 12-h schedules from both control room operators and management

  6. Collaborative Scheduling between OSPPs and Gasholders in Steel Mill under Time-of-Use Power Price

    Directory of Open Access Journals (Sweden)

    Juxian Hao

    2017-08-01

    Full Text Available Byproduct gases generated during steel production process are the main fuels for on-site power plants (OSPPs in steel enterprises. Recently, with the implementation of time-of-use (TOU power price in China, increasing attention has been paid to the collaborative scheduling between OSPPs and gasholders. However, the load shifting potential of OSPPs has seldom been discussed in previous studies. In this paper, a mixed integer linear programming (MILP-based scheduling model is built to evaluate the load shifting potential and the corresponding economic benefits. A case study is conducted on two steel enterprises with different configurations of OSPPs, and the optimal operation strategy is also discussed.

  7. Shift work, mental distress and job satisfaction among Palestinian nurses.

    Science.gov (United States)

    Jaradat, Y M; Nielsen, M B; Kristensen, P; Bast-Pettersen, R

    2017-01-01

    Associations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described. To examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012. Detailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis. Of 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [β coefficient 3.6; 95% confidence interval (CI) 0.3-7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (-3.3; 95% CI -6.2 to -0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule. In this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine.

  8. Overnight shift work: factors contributing to diagnostic discrepancies.

    Science.gov (United States)

    Hanna, Tarek N; Loehfelm, Thomas; Khosa, Faisal; Rohatgi, Saurabh; Johnson, Jamlik-Omari

    2016-02-01

    The aims of the study are to identify factors contributing to preliminary interpretive discrepancies on overnight radiology resident shifts and apply this data in the context of known literature to draw parallels to attending overnight shift work schedules. Residents in one university-based training program provided preliminary interpretations of 18,488 overnight (11 pm–8 am) studies at a level 1 trauma center between July 1, 2013 and December 31, 2014. As part of their normal workflow and feedback, attendings scored the reports as major discrepancy, minor discrepancy, agree, and agree--good job. We retrospectively obtained the preliminary interpretation scores for each study. Total relative value units (RVUs) per shift were calculated as an indicator of overnight workload. The dataset was supplemented with information on trainee level, number of consecutive nights on night float, hour, modality, and per-shift RVU. The data were analyzed with proportional logistic regression and Fisher's exact test. There were 233 major discrepancies (1.26 %). Trainee level (senior vs. junior residents; 1.08 vs. 1.38 %; p performance. Increased workload affected more junior residents' performance, with R3 residents performing significantly worse on busier nights. Hour of the night was not significantly associated with performance, but there was a trend toward best performance at 2 am, with subsequent decreased accuracy throughout the remaining shift hours. Improved performance occurred after the first six night float shifts, presumably as residents acclimated to a night schedule. As overnight shift work schedules increase in popularity for residents and attendings, focused attention to factors impacting interpretative accuracy is warranted.

  9. Lifetime Improvement by Battery Scheduling

    NARCIS (Netherlands)

    Jongerden, M.R.; Schmitt, Jens B.; Haverkort, Boudewijn R.H.M.

    The use of mobile devices is often limited by the lifetime of their batteries. For devices that have multiple batteries or that have the option to connect an extra battery, battery scheduling, thereby exploiting the recovery properties of the batteries, can help to extend the system lifetime. Due to

  10. Lifetime improvement by battery scheduling

    NARCIS (Netherlands)

    Jongerden, M.R.; Haverkort, Boudewijn R.H.M.

    The use of mobile devices is often limited by the lifetime of its battery. For devices that have multiple batteries or that have the option to connect an extra battery, battery scheduling, thereby exploiting the recovery properties of the batteries, can help to extend the system lifetime. Due to the

  11. How useful are preemptive schedules?

    NARCIS (Netherlands)

    Brucker, P.; Heitmann, S.; Hurink, J.L.

    2001-01-01

    Machine scheduling admits two options to process jobs. In a preemptive mode processing may be interrupted and resumed later even on a different machine. In a nonpreemptive mode interruptions are not allowed. Usually, the possibility to preempt jobs leads to better performance values. However, also

  12. Interaction in activity location scheduling

    NARCIS (Netherlands)

    Tabak, V.; Vries, de B.; Dijkstra, J.; Jessurun, A.J.

    2006-01-01

    In this paper we discuss the interaction in activity location scheduling which is the main subject of an ongoing research project called "User Simulation of Space Utilization". The aim of this research project is to develop an overall model for the simulation of human movement and utilization of

  13. Scheduling with target start times

    NARCIS (Netherlands)

    Hoogeveen, J.A.; Velde, van de S.L.; Klein Haneveld, W.K.; Vrieze, O.J.; Kallenberg, L.C.M.

    1997-01-01

    We address the single-machine problem of scheduling n independent jobs subject to target start times. Target start times are essentially release times that may be violated at a certain cost. The goal is to minimize an objective function that is composed of total completion time and maximum

  14. Stochastic scheduling on unrelated machines

    NARCIS (Netherlands)

    Skutella, Martin; Sviridenko, Maxim; Uetz, Marc Jochen

    2013-01-01

    Two important characteristics encountered in many real-world scheduling problems are heterogeneous machines/processors and a certain degree of uncertainty about the actual sizes of jobs. The first characteristic entails machine dependent processing times of jobs and is captured by the classical

  15. Scheduling periodic tasks with slack

    NARCIS (Netherlands)

    Korst, J.H.M.; Aarts, E.H.L.; Lenstra, J.K.

    1997-01-01

    We consider the problem of nonpreemptively scheduling periodic tasks on a minimum number of identical processors, assuming that some slack is allowed in the time between successive executions of a periodic task. We prove that the problem is NP-hard in the strong sense. Necessary and sufficient

  16. Toward Realistic Acquisition Schedule Estimates

    Science.gov (United States)

    2016-04-30

    replace earlier versions of the F/A-18. Joint and International Nature At the time of JSF conception, there was a clear preference at the highest levels...ALPHABET SOUP ” (Aboulafia, 2015) OF STUDIES AND CONCEPTS • … MERGED INTO JAST • … WHICH EVOLVED TO JSF • WELL-KNOWN COST AND SCHEDULE

  17. Analyzing NPS Scheduling Using OSIRIS

    Science.gov (United States)

    1993-03-01

    School TEACHER SCHEDULE BLOCKS REPORT Date: 2/19/93 Period Name ID Term Days 1234 Adragna , Joe 170401 1 F xx Agrawal, Brij 120101 1 F xx Almquist...LOAD REPORT Date: 3/18/93 Total Max Consec Total Teacher ID Term Classes Classes Stud Adragna , Joe 170401 1 1 1 3 Agrawal, Brij 120101 1 2 2 98 Aiello

  18. Who benefits from family support? Work schedule and family differences.

    Science.gov (United States)

    Jennings, Kristen S; Sinclair, Robert R; Mohr, Cynthia D

    2016-01-01

    Prior research has demonstrated the benefits of family-supportive organization perceptions (FSOP) for reducing stress, increasing satisfaction, and increasing worker commitment; however, less research has studied health outcomes or possible differences in the effects of FSOP based on worker characteristics. The present study examined relationships between FSOP and health outcomes, as well as how those relationships may depend on work schedule and family differences. Using a sample of 330 acute care nurses, the findings indicated that FSOP predicted several health and well-being outcomes obtained 9 months later. Further, the relationships between FSOP and the outcome variables depended on some work schedule and family differences. In terms of family differences, FSOP was most strongly related to life satisfaction for those who cared for dependent adults. The relationship between FSOP and health outcomes of depression, musculoskeletal pain, and physical health symptoms were generally significant for workers with dependent children, but not significant for workers with no children. Regarding schedule differences, the relationship between FSOP and life satisfaction was significant for those on nonstandard (evening/night) shifts but not significant for standard day shift workers; however, there were no differences in FSOP relationships by number of hours worked per week. The findings demonstrate that FSOP may benefit some employees more than others. Such differences need to be incorporated into both future work-family theory development and into efforts to document the effectiveness of family-supportive policies, programs, and practices. (c) 2016 APA, all rights reserved).

  19. Decomposing changes in life expectancy: Compression versus shifting mortality

    Directory of Open Access Journals (Sweden)

    Marie-Pier Bergeron-Boucher

    2015-09-01

    Full Text Available Background: In most developed countries, mortality reductions in the first half of the 20th century were highly associated with changes in lifespan disparities. In the second half of the 20th century, changes in mortality are best described by a shift in the mortality schedule, with lifespan variability remaining nearly constant. These successive mortality dynamics are known as compression and shifting mortality, respectively. Objective: To understand the effect of compression and shifting dynamics on mortality changes, we quantify the gains in life expectancy due to changes in lifespan variability and changes in the mortality schedule, respectively. Methods: We introduce a decomposition method using newly developed parametric expressions of the force of mortality that include the modal age at death as one of their parameters. Our approach allows us to differentiate between the two underlying processes in mortality and their dynamics. Results: An application of our methodology to the mortality of Swedish females shows that, since the mid-1960s, shifts in the mortality schedule were responsible for more than 70Š of the increase in life expectancy. Conclusions: The decomposition method allows differentiation between both underlying mortality processes and their respective impact on life expectancy, and also determines when and how one process has replaced the other.

  20. Mechanical spectral shift reactor

    International Nuclear Information System (INIS)

    Sherwood, D.G.; Wilson, J.F.; Salton, R.B.; Fensterer, H.F.

    1981-01-01

    A mechanical spectral shift reactor comprises apparatus for inserting and withdrawing water displacer elements from the reactor core for selectively changing the water-moderator volume in the core thereby changing the reactivity of the core. The apparatus includes drivemechanisms for moving the displacer elements relative to the core and guide mechanisms for guiding the displayer rods through the reactor vessel

  1. Mechanical spectral shift reactor

    International Nuclear Information System (INIS)

    Sherwood, D.G.; Wilson, J.F.; Salton, R.B.; Fensterer, H.F.

    1982-01-01

    A mechanical spectral shift reactor comprises apparatus for inserting and withdrawing water displacer elements from the reactor core for selectively changing the water-moderator volume in the core thereby changing the reactivity of the core. The apparatus includes drive mechanisms for moving the displacer elements relative to the core and guide mechanisms for guiding the displacer rods through the reactor vessel. (author)

  2. Washington's marine oil spill compensation schedule - simplified resource damage assessment

    International Nuclear Information System (INIS)

    Geselbracht, L.; Logan, R.

    1993-01-01

    The Washington State Preassessment Screening and Oil Spill Compensation Schedule Rule (Chapter 173-183 Washington Administrative Code), which simplifies natural resource damage assessment for many oil spill cases, became effective in May 1992. The approach described in the rule incorporates a number of preconstructed rankings that rate environmental sensitivity and the propensity of spilled oil to cause environmental harm. The rule also provides guidance regarding how damages calculated under the schedule should be reduced to take into account actions taken by the responsible party that reduce environmental injury. To apply the compensation schedule to marine estuarine spills, the resource trustees need only collect a limited amount of information such as type of product spilled, number of gallons spilled, compensation schedule subregions the spill entered, season of greatest spill impact, percent coverage of habitats affected by the spill, and actions taken by the responsible party. The result of adding a simplified tool to the existing assortment of damage assessment approaches is that resource trustees will now be able to assess damages for most oil spill cases and shift more effort than was possible in the past to resource restoration

  3. Development of Watch Schedule Using Rules Approach

    Science.gov (United States)

    Jurkevicius, Darius; Vasilecas, Olegas

    The software for schedule creation and optimization solves a difficult, important and practical problem. The proposed solution is an online employee portal where administrator users can create and manage watch schedules and employee requests. Each employee can login with his/her own account and see his/her assignments, manage requests, etc. Employees set as administrators can perform the employee scheduling online, manage requests, etc. This scheduling software allows users not only to see the initial and optimized watch schedule in a simple and understandable form, but also to create special rules and criteria and input their business. The system using rules automatically will generate watch schedule.

  4. Project management with dynamic scheduling baseline scheduling, risk analysis and project control

    CERN Document Server

    Vanhoucke, Mario

    2013-01-01

    The topic of this book is known as dynamic scheduling, and is used to refer to three dimensions of project management and scheduling: the construction of a baseline schedule and the analysis of a project schedule's risk as preparation of the project control phase during project progress. This dynamic scheduling point of view implicitly assumes that the usability of a project's baseline schedule is rather limited and only acts as a point of reference in the project life cycle.

  5. Backfilling with Fairness and Slack for Parallel Job Scheduling

    Energy Technology Data Exchange (ETDEWEB)

    Sodan, Angela C; Wei Jin, E-mail: acsodan@uwindsor.ca [University of Windsor, Computer Science, Windsor, Ontario (Canada)

    2010-11-01

    Parallel job scheduling typically combines a basic policy like FCFS with backfilling, i.e. moving jobs to an earlier than their regular scheduling position if they do not delay the jobs ahead in the queue according to the rules of the backfilling approach applied. Commonly used are conservative and easy backfilling which either have worse response times but better predictability or better response times and poor predictability. The paper proposes a relaxation of conservative backfilling by permitting to shift jobs within certain constraints to backfill more jobs and reduce fragmentation and subsequently obtain better response times. At the same time, deviation from fairness is kept low and predictability remains high. The results of the experimentation evaluation show that the goals are met, with response-time performance lying as expected between conservative and easy backfilling.

  6. Field Engineers' Scheduling at Oil Rigs: a Case Study

    Directory of Open Access Journals (Sweden)

    Y. S. Usmani

    2012-02-01

    Full Text Available Oil exploration and production operations face a number of challenges. Professional planners have to design solutions for various practical problems or issues. However, the time consumed is often very extensive because of the large number of possible solutions. Further, the matter of choosing the best solution remains. The present paper investigates a problem related to leading companies in the energy and chemical manufacturing sector of the oil and gas industry. Each company’s field engineers are expensive and valuable assets. Therefore, an optimized roster is rather important. In the present paper, the objective is to design a field engineers’ schedule which would be both feasible and satisfying towards the various demands of rigs, with minimum operational cost to the company. An efficient and quick optimization technique is presented to schedule the shifts of field engineers.

  7. Backfilling with Fairness and Slack for Parallel Job Scheduling

    International Nuclear Information System (INIS)

    Sodan, Angela C; Wei Jin

    2010-01-01

    Parallel job scheduling typically combines a basic policy like FCFS with backfilling, i.e. moving jobs to an earlier than their regular scheduling position if they do not delay the jobs ahead in the queue according to the rules of the backfilling approach applied. Commonly used are conservative and easy backfilling which either have worse response times but better predictability or better response times and poor predictability. The paper proposes a relaxation of conservative backfilling by permitting to shift jobs within certain constraints to backfill more jobs and reduce fragmentation and subsequently obtain better response times. At the same time, deviation from fairness is kept low and predictability remains high. The results of the experimentation evaluation show that the goals are met, with response-time performance lying as expected between conservative and easy backfilling.

  8. [Sleep disorders among physicians on shift work].

    Science.gov (United States)

    Schlafer, O; Wenzel, V; Högl, B

    2014-11-01

    Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be

  9. The Vessel Schedule Recovery Problem

    DEFF Research Database (Denmark)

    Brouer, Berit Dangaard; Plum, Christian Edinger Munk; Vaaben, Bo

    Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker cons...... consumption and the impact on the remaining network and the customer service level. The model is applied to 4 real cases from Maersk Line. Solutions are comparable or superior to those chosen by operations managers. Cost savings of up to 58% may be achieved.......Maritime transportation is the backbone of world trade and is accountable for around 3% of the worlds CO2 emissions. We present the Vessel Schedule Recovery Problem (VSRP) to evaluate a given disruption scenario and to select a recovery action balancing the trade off between increased bunker...

  10. CMS Planning and Scheduling System

    CERN Document Server

    Kotamaki, M

    1998-01-01

    The paper describes the procedures and the system to build and maintain the schedules needed to manage time, resources, and progress of the CMS project. The system is based on the decomposition of the project into work packages, which can be each considered as a complete project with its own structure. The system promotes the distribution of the decision making and responsibilities to lower levels in the organisation by providing a state-of-the-art system to formalise the external commitments of the work packages without limiting their ability to modify their internal schedules to best meet their commitments. The system lets the project management focus on the interfaces between the work packages and alerts the management immediately if a conflict arises. The proposed system simplifies the planning and management process and eliminates the need for a large, centralised project management system.

  11. 75 FR 42831 - Proposed Collection; Comment Request for Form 1065, Schedule C, Schedule D, Schedule K-1...

    Science.gov (United States)

    2010-07-22

    .../or continuing information collections, as required by the Paperwork Reduction Act of 1995, Public Law... Income, Credits, Deductions and Other Items), Schedule L (Balance Sheets per Books), Schedule M-1 (Reconciliation of Income (Loss) per Books With Income (Loss) per Return)), Schedule M-2 (Analysis of Partners...

  12. Nurse perceptions of workplace environment: differences across shifts.

    Science.gov (United States)

    Teclaw, Robert; Osatuke, Katerine

    2015-11-01

    To evaluate whether nurse work shift affected workplace perceptions. Although the importance of work schedule in shaping work attitudes, generally (and specifically for nurses) is well accepted, much work remains in characterising how and why nurses' perceptions might differ across shifts. Using an exploratory study of observational data, we examined whether shift influenced non-supervisory nurses' job perceptions in the Veterans Health Administration All Employee Survey (n = 14057; years 2008, 2010, 2012). The size of differences in item means (95% C.I.) across shifts was evaluated graphically. Using ordinal logistic regression, we accounted for the ordinal outcome variables and controlled for the demographic and survey year effects. Nurses' perceptions of workplace climate differed across shifts. Items with the greatest differences, consistent across years and analytic methods, involved supervisors and fairness. Night and weekend shift nurse ratings were more negative than for weekday shift nurses. Off-shift nurses are less satisfied with work/life balance, their supervisors and especially fairness. Overall satisfaction and turnover intention are not affected to the same extent. These results indicate several specific areas that nurse managers can address through workforce support and communication. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

  13. Preemptive scheduling in overloaded systems

    Czech Academy of Sciences Publication Activity Database

    Chrobak, M.; Epstein, L.; Noga, J.; Sgall, Jiří; van Stee, R.; Tichý, Tomáš; Vakhania, N.

    2003-01-01

    Roč. 67, č. 1 (2003), s. 183-197 ISSN 0022-0000 R&D Projects: GA ČR GA201/01/1195; GA MŠk ME 476; GA AV ČR IAA1019901; GA MŠk LN00A056 Institutional research plan: CEZ:AV0Z1019905; CEZ:AV0Z1019905 Keywords : scheduling * online algorithms * benefit Subject RIV: BA - General Mathematics Impact factor: 0.795, year: 2003

  14. WCET Analysis for Preemptive Scheduling

    OpenAIRE

    Altmeyer, Sebastian; Gebhard, Gernot

    2008-01-01

    Hard real-time systems induce strict constraints on the timing of the task set. Validation of these timing constraints is thus a major challenge during the design of such a system. Whereas the derivation of timing guarantees must already be considered complex if tasks are running to completion, it gets even more complex if tasks are scheduled preemptively -- especially due to caches, deployed to improve the average performance. In this paper we propose a new method to compu...

  15. Scheduling Maintenance Jobs in Networks

    OpenAIRE

    Abed, Fidaa; Chen, Lin; Disser, Yann; Groß, Martin; Megow, Nicole; Meißner, Julie; Richter, Alexander T.; Rischke, Roman

    2017-01-01

    We investigate the problem of scheduling the maintenance of edges in a network, motivated by the goal of minimizing outages in transportation or telecommunication networks. We focus on maintaining connectivity between two nodes over time; for the special case of path networks, this is related to the problem of minimizing the busy time of machines. We show that the problem can be solved in polynomial time in arbitrary networks if preemption is allowed. If preemption is restricted to integral t...

  16. Environmental surveillance master sampling schedule

    International Nuclear Information System (INIS)

    Bisping, L.E.

    1995-02-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program

  17. Broadcast scheduling for mobile advertising

    OpenAIRE

    De Reyck, B.; Degraeve, Z.

    2003-01-01

    We describe a broadcast scheduling system developed for a precision marketing firm specialized in location-sensitive permission-based mobile advertising using SMS (Short Message Service) text messaging. Text messages containing advertisements were sent to registered customers when they were shopping in one of two shopping centers in the vicinity of London. The ads typically contained a limited-time promotional offer. The company's problem was deciding which ads to send out to which customers ...

  18. Schedule of the nuclear program

    International Nuclear Information System (INIS)

    Heigl, F.

    1977-01-01

    The lecure tries to explain the main phases which must be passed to establish nuclear power plants, the feasibility phase, preconstruction and construction phase. Each phase consists of a lot of activities which are commented. Further the lecture tries to give some ideas of durances and dependence between the phases or activities to get a complete time schedule of the realization of a nuclear power project. (HP) [de

  19. Environmental surveillance master sampling schedule

    Energy Technology Data Exchange (ETDEWEB)

    Bisping, L.E.

    1995-02-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the U.S. Department of Energy (DOE). This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring onsite drinking water falls outside the scope of the SESP. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control, and reporting. The ground-water sampling schedule identifies ground-water sampling .events used by PNL for environmental surveillance of the Hanford Site. Sampling is indicated as annual, semi-annual, quarterly, or monthly in the sampling schedule. Some samples are collected and analyzed as part of ground-water monitoring and characterization programs at Hanford (e.g. Resources Conservation and Recovery Act (RCRA), Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), or Operational). The number of samples planned by other programs are identified in the sampling schedule by a number in the analysis column and a project designation in the Cosample column. Well sampling events may be merged to avoid redundancy in cases where sampling is planned by both-environmental surveillance and another program.

  20. Environmental surveillance master sampling schedule

    Energy Technology Data Exchange (ETDEWEB)

    Bisping, L.E.

    1993-01-01

    Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest Laboratory (PNL) for the US Department of Energy (DOE). Samples are routinely collected and analyzed to determine the quality of air, surface water, ground water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. This document contains the planned schedule for routine sample collection for the Surface Environmental Surveillance Project (SESP) and Drinking Water Project, and Ground-Water Surveillance Project.

  1. Guidelines of Decommissioning Schedule Establishment

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jae Yong; Yun, Taesik; Kim, Younggook; Kim, Hee-Geun [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    Decommissioning has recently become an issue highlighted in Korea due to the Permanent Shutdown (PS) of Kori-1 plant. Since Korea Hydro and Nuclear Power (KHNP) Company decided the PS of Kori-1 instead of further continued operation, Kori-1 will be the first decommissioning plant of the commercial reactors in Korea. Korean regulatory authority demands Initial Decommissioning Plan (IDP) for all the plants in operation and under construction. In addition, decommissioning should be considered for the completion of the life cycle of NPPs. To date, Korea has no experience regarding decommissioning of the commercial reactor and a lot of uncertainties will be expected due to its site-specific factors. However, optimized decommissioning process schedule must be indispensable in the safety and economic efficiency of the project. Differed from USA, Korea has no experience and know-hows of the operation and site management for decommissioning. Hence, in Korea, establishment of decommissioning schedule has to give more weight to safety than precedent cases. More economical and rational schedule will be composed by collecting and analyzing the experience data and site-specific data and information as the decommissioning progresses. In a long-range outlook, KHNP having capability of NPP decommissioning will try to decommissioning business in Korea and foreign countries.

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  3. The association between rotating shift work and increased occupational stress in nurses.

    Science.gov (United States)

    Lin, Pei-Chen; Chen, Chung-Hey; Pan, Shung-Mei; Chen, Yao-Mei; Pan, Chih-Hong; Hung, Hsin-Chia; Wu, Ming-Tsang

    2015-01-01

    The aim of this study was to investigate whether rotating shift work increases occupational stress in nurses. This study measured shift work scheduling and occupational stress by using the Effort-Reward Imbalance model with self-reported questionnaires in a sample of 654 female nurses. Overcommitment risk was higher in nurses who worked rotating shifts than in those who worked day/non-night shifts (OR, 2.16; 95% CI, 1.03-4.66). However, an effort/reward imbalance was not directly associated with work schedules (OR, 1.88; 95% CI, 0.87-4.35). Among nurses working rotation rotating shifts, those who had 2 days off after their most recent night shifts showed an alleviated risk of overcommitment (OR, 0.52; 95% CI, 0.32-0.82), but those who had worked for at least one series of 7 consecutive work days per month had an increased risk of effort/reward imbalance (OR, 2.75; 95% CI, 1.69-4.48). Additionally, those who had little or no participation in planning working hours and shift scheduling and worked overtime at least three times per week during the preceding 2 months tended to have high stress. The nurses who worked rotating shifts tended to experience work-related stress, but their stress levels improved if they had at least 2 days off after their most recent night shift and if they were not scheduled to work 7 consecutive days. These empirical data can be used to optimize work schedules for nurses to alleviate work stress.

  4. Sustainable employability in shiftwork: related to types of work schedule rather than age.

    Science.gov (United States)

    Peters, Velibor; Engels, Josephine A; de Rijk, Angelique E; Nijhuis, Frans J N

    2015-10-01

    There is scarce research on age and sustainable employability of nurses working in various types of work schedules. Earlier research showed that nurses working in work schedules differ regarding age. Different operationalisations of age might explain variations in sustainable employability. Therefore, the aim of this study was to investigate how nurses working in various types of work schedule differ regarding sustainable employability, and the role that age plays in these differences. Age was defined as chronological age, organisational age, life-span age, and functional age. Questionnaires were distributed to 974 Dutch nurses in residential elder care (response rate 51 %) with questions about the type of work schedule, aspects of sustainable employability, various operationalisations of age, and registered sickness absence data were used. Nurses working in various types of work schedules differed regarding aspects of sustainable employability, also when operationalisations of age were added. The 'life-span age' was directly related to aspects of sustainable employability. Statistically, work ability and job satisfaction were only explained by varying operationalisations of age. Nurses' sustainable employability appeared to be mainly related to differences between the types of work schedule rather than age. Fixed early shifts are characterised by the most positive aspects of sustainable employability, and three rotating schedules score worst. To improve sustainable employability, organisations should implement a system in which nurses with different types of work schedule are monitored in combination with their life-span perspective.

  5. A IEEE 802.11e HCCA Scheduler with a Reclaiming Mechanism for Multimedia Applications

    Directory of Open Access Journals (Sweden)

    Anna Lina Ruscelli

    2014-01-01

    Full Text Available The QoS offered by the IEEE 802.11e reference scheduler is satisfactory in the case of Constant Bit Rate traffic streams, but not yet in the case of Variable Bit Rate traffic streams, whose variations stress its scheduling behavior. Despite the numerous proposed alternative schedulers with QoS, multimedia applications are looking for refined methods suitable to ensure service differentiation and dynamic update of protocol parameters. In this paper a scheduling algorithm, Unused Time Shifting Scheduler (UTSS, is deeply analyzed. It is designed to cooperate with a HCCA centralized real-time scheduler through the integration of a bandwidth reclaiming scheme, suitable to recover nonexhausted transmission time and assign that to the next polled stations. UTSS dynamically computes with an O(1 complexity transmission time providing an instantaneous resource overprovisioning. The theoretical analysis and the simulation results highlight that this injection of resources does not affect the admission control nor the centralized scheduler but is suitable to improve the performance of the centralized scheduler in terms of mean access delay, transmission queues length, bursts of traffic management, and packets drop rate. These positive effects are more relevant for highly variable bit rate traffic.

  6. Robust and Flexible Scheduling with Evolutionary Computation

    DEFF Research Database (Denmark)

    Jensen, Mikkel T.

    Over the last ten years, there have been numerous applications of evolutionary algorithms to a variety of scheduling problems. Like most other research on heuristic scheduling, the primary aim of the research has been on deterministic formulations of the problems. This is in contrast to real world...... scheduling problems which are usually not deterministic. Usually at the time the schedule is made some information about the problem and processing environment is available, but this information is uncertain and likely to change during schedule execution. Changes frequently encountered in scheduling...... environments include machine breakdowns, uncertain processing times, workers getting sick, materials being delayed and the appearance of new jobs. These possible environmental changes mean that a schedule which was optimal for the information available at the time of scheduling can end up being highly...

  7. Pittsburgh International Airport - Scheduled Passenger Traffic

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Here you can find Pittsburgh International Airport’s Monthly Scheduled Traffic Reports. Each of these reports contain a year-over-year (YOY) analysis of scheduled...

  8. DME Prosthetics Orthotics, and Supplies Fee Schedule

    Data.gov (United States)

    U.S. Department of Health & Human Services — Durable Medical Equipment, Prosthetics-Orthotics, and Supplies Fee Schedule. The list contains the fee schedule amounts, floors, and ceilings for all procedure codes...

  9. GSA eLibrary Schedules and Contracts

    Data.gov (United States)

    General Services Administration — GSA eLibrary (formerly Schedules e-Library) is the online source for the latest contract award information for: GSA Schedules; Department of Veterans Affairs (VA)...

  10. Interactive Anticipatory Scheduling for Two Military Applications

    National Research Council Canada - National Science Library

    Howe, Adele

    2003-01-01

    ...; these models partially explain what makes some job shop scheduling problems difficult. For the second, several algorithms for Air Force Satellite Control Network scheduling have been compared on historical and recent data...

  11. How should periods without social interaction be scheduled? Children's preference for practical schedules of positive reinforcement.

    Science.gov (United States)

    Luczynski, Kevin C; Hanley, Gregory P

    2014-01-01

    Several studies have shown that children prefer contingent reinforcement (CR) rather than yoked noncontingent reinforcement (NCR) when continuous reinforcement is programmed in the CR schedule. Preference has not, however, been evaluated for practical schedules that involve CR. In Study 1, we assessed 5 children's preference for obtaining social interaction via a multiple schedule (periods of fixed-ratio 1 reinforcement alternating with periods of extinction), a briefly signaled delayed reinforcement schedule, and an NCR schedule. The multiple schedule promoted the most efficient level of responding. In general, children chose to experience the multiple schedule and avoided the delay and NCR schedules, indicating that they preferred multiple schedules as the means to arrange practical schedules of social interaction. In Study 2, we evaluated potential controlling variables that influenced 1 child's preference for the multiple schedule and found that the strong positive contingency was the primary variable. © Society for the Experimental Analysis of Behavior.

  12. Mechanical spectral shift reactor

    International Nuclear Information System (INIS)

    Wilson, J.F.; Sherwood, D.G.

    1982-01-01

    A mechanical spectral shift reactor comprises a reactive core having fuel assemblies accommodating both water displacer elements and neutron absorbing control rods for selectively changing the volume of water-moderator in the core. The fuel assemblies with displacer and control rods are arranged in alternating fashion so that one displacer element drive mechanism may move displacer elements in more than one fuel assembly without interfering with the movement of control rods of a corresponding control rod drive mechanisms. (author)

  13. Rest requirements and rest management of personnel in shift work

    Energy Technology Data Exchange (ETDEWEB)

    Hammell, B.D. [PDG Environmental, Melbourne, FL (United States); Scheuerle, A. [Univ. of Texas, Houston, TX (United States)

    1995-12-31

    A difficulty-weighted shift assignment scheme is proposed for use in prolonged and strenuous field operations such as emergency response, site testing, and short term hazardous waste remediation projects. The purpose of the work rotation plan is to increase productivity, safety, and moral of workers. Job weighting is accomplished by assigning adjustments to the mental and physical intensity of the task, the protective equipment worn, and the climatic conditions. The plan is based on medical studies of sleep deprivation, the effects of rest adjustments, and programs to reduce sleep deprivation and normalize shift schedules.

  14. Network scheduling at Belene NPP construction site

    International Nuclear Information System (INIS)

    Matveev, A.

    2010-01-01

    Four types of schedules differing in the level of their detail are singled out to enhance the efficiency of Belene NPP Project implementation planning and monitoring: Level 1 Schedule–Summary Integrated Overall Time Schedule (SIOTS) is an appendix to EPC Contract. The main purpose of SIOTS is the large scale presentation of the current information on the Project implementation. Level 2 Schedule–Integrated Overall Time Schedule (IOTS)is the contract schedule for the Contractor (ASE JSC) and their subcontractors.The principal purpose of IOTS is the work progress planning and monitoring, the analysis of the effect of activities implementation upon the progress of the Project as a whole. IOTS is the reporting schedule at the Employer –Contractor level. Level 3 Schedules, Detail Time Schedules(DTS) are developed by those who actually perform the work and are agreed upon with Atomstroyexport JSC.The main purpose of DTS is the detail planning of Atomstroyexport subcontractor's activities. DTSare the reporting schedules at the level of Contractor-Subcontractor. Level 4 Schedules are the High Detail Time Schedules (HDTS), which are the day-to-day plans of work implementation and are developed, as a rule, for a week's time period.Each lower level time schedule details the activities of the higher level time schedule

  15. An improved scheduling algorithm for linear networks

    KAUST Repository

    Bader, Ahmed; Alouini, Mohamed-Slim; Ayadi, Yassin

    2017-01-01

    In accordance with the present disclosure, embodiments of an exemplary scheduling controller module or device implement an improved scheduling process such that the targeted reduction in schedule length can be achieve while incurring minimal energy penalty by allowing for a large rate (or duration) selection alphabet.

  16. 40 CFR 141.702 - Sampling schedules.

    Science.gov (United States)

    2010-07-01

    ... serving at least 10,000 people must submit their sampling schedule for the initial round of source water... submitting the sampling schedule that EPA approves. (3) Systems serving fewer than 10,000 people must submit... analytical result for a scheduled sampling date due to equipment failure, loss of or damage to the sample...

  17. An improved scheduling algorithm for linear networks

    KAUST Repository

    Bader, Ahmed

    2017-02-09

    In accordance with the present disclosure, embodiments of an exemplary scheduling controller module or device implement an improved scheduling process such that the targeted reduction in schedule length can be achieve while incurring minimal energy penalty by allowing for a large rate (or duration) selection alphabet.

  18. 77 FR 41258 - FOIA Fee Schedule Update

    Science.gov (United States)

    2012-07-13

    ... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Establishment of FOIA Fee Schedule. SUMMARY: The Defense Nuclear Facilities Safety Board is publishing its Freedom of Information Act (FOIA) Fee Schedule Update pursuant to...

  19. 76 FR 43819 - FOIA Fee Schedule Update

    Science.gov (United States)

    2011-07-22

    ... DEFENSE NUCLEAR FACILITIES SAFETY BOARD 10 CFR Part 1703 FOIA Fee Schedule Update AGENCY: Defense Nuclear Facilities Safety Board. ACTION: Establishment of FOIA Fee Schedule. SUMMARY: The Defense Nuclear Facilities Safety Board is publishing its Freedom of Information Act (FOIA) Fee Schedule Update pursuant to...

  20. 75 FR 7411 - Schedule of Water Charges

    Science.gov (United States)

    2010-02-19

    ... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Schedule of Water Charges AGENCY: Delaware River... Administrative Manual--Part III--Basin Regulations--Water Supply Charges to revise the schedule of water charges... commenter and the subject line ``Schedule of Water Charges.'' FOR FURTHER INFORMATION, CONTACT: Please...

  1. Mechanisms for scheduling games with selfish players

    NARCIS (Netherlands)

    Hoeksma, R.P.

    2015-01-01

    Many challenges in operations research involve optimization. In particular, scheduling treats the optimal planning of tasks. This thesis focuses on machine scheduling models, where a number of tasks, called jobs, need to be scheduled on one or more machines. The outcome is determined by which job is

  2. Split-shift work in relation to stress, health and psychosocial work factors among bus drivers.

    Science.gov (United States)

    Ihlström, Jonas; Kecklund, Göran; Anund, Anna

    2017-01-01

    Shift work has been associated with poor health, sleep and fatigue problems and low satisfaction with working hours. However, one type of shift working, namely split shifts, have received little attention. This study examined stress, health and psychosocial aspects of split-shift schedules among bus drivers in urban transport. A questionnaire was distributed to drivers working more than 70% of full time which 235 drivers in total answered. In general, drivers working split-shift schedules (n = 146) did not differ from drivers not working such shifts (n = 83) as regards any of the outcome variables that were studied. However, when individual perceptions towards split-shift schedules were taken into account, a different picture appeared. Bus drivers who reported problems working split shifts (36%) reported poorer health, higher perceived stress, working hours interfering with social life, lower sleep quality, more persistent fatigue and lower general work satisfaction than those who did not view split shifts as a problem. Moreover, drivers who reported problems with split shifts also perceived lower possibilities to influence working hours, indicating lower work time control. This study indicates that split shifts were not associated with increased stress, poorer health and adverse psychosocial work factors for the entire study sample. However, the results showed that individual differences were important and approximately one third of the drivers reported problems with split shifts, which in turn was associated with stress, poor health and negative psychosocial work conditions. More research is needed to understand the individual and organizational determinants of tolerance to split shifts.

  3. Abstract flexibility description for virtual power plant scheduling

    OpenAIRE

    Fröhling, Judith

    2017-01-01

    In the ongoing paradigm shift of the energy market from big power plants to more and more small and decentralized power plants, virtual power plants (VPPs) play an important role. VPPs bundle the capacities of the small and decentralized resources (DER). Planing of VPP operation, that is also called scheduling, relies on the flexibilities of controllable DER in the VPP, e.g., combined heat and power plants (CHPs), heat pumps and batteries. The aim of this thesis is the development of an abstr...

  4. Scheduling Data Access in Smart Grid Networks Utilizing Context Information

    DEFF Research Database (Denmark)

    Findrik, Mislav; Grønbæk, Jesper; Olsen, Rasmus Løvenstein

    2014-01-01

    Current electrical grid is facing increased penetration of intermittent energy resources, in particular wind and solar energy. Fast variability of the power supply due to renewable energy resources can be balanced out using different energy storage systems or shifting the loads. Efficiently...... managing this fast flexibility requires two-way data exchange between a controller and sensors/meters via communication networks. In this paper we investigated scheduling of data collection utilizing meta-data from sensors that are describing dynamics of information. We show the applicability...

  5. Students' educational experiences and interaction with residents on night shifts.

    Science.gov (United States)

    Schiller, Jocelyn; Sokoloff, Max; Tendhar, Chosang; Schmidt, John; Christner, Jennifer

    2017-08-01

    The purpose of this mixed-methods study was to investigate whether increased night shifts for students on paediatric rotations had any negative impact on their overall quality of educational experiences in light of the implementation of duty-hour restrictions. Both quantitative and qualitative data were collected from 30 students on paediatric rotations during the academic year 2011/12. Students completed two questionnaires, one in response to their experiences during the day shifts and another in response to their experiences during the night shifts. Only 25 cases were retained for the final analyses. The non-parametric Wilcoxon signed-rank test was used to analyse the quantitative data, and constant comparative thematic analyses, as described by Creswell, were used to analyse the qualitative data. [Do] increased nights shifts for students … [have] any negative impact on their overall quality of educational experiences[?] RESULTS: The results indicated that students' perceived quality of experiences during the night shifts was greater, compared with their day shifts. Students reported having more time to socialise during the night shifts. They further reported that informal ways of learning, such as impromptu teaching and spontaneous discussions on clinical problems, were more beneficial, and these often occurred in abundance during the night shifts as opposed to the scheduled didactic teaching sessions that occur during the day shifts. This study documented many unanticipated benefits of night shifts. The feeling of cohesiveness of the night team deserves further exploration, as this can be linked to better performance outcomes. More consideration should be given to implementing night shifts as a regular feature of clerkships. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  6. Nurse Scheduling by Cooperative GA with Effective Mutation Operator

    Science.gov (United States)

    Ohki, Makoto

    In this paper, we propose an effective mutation operators for Cooperative Genetic Algorithm (CGA) to be applied to a practical Nurse Scheduling Problem (NSP). The nurse scheduling is a very difficult task, because NSP is a complex combinatorial optimizing problem for which many requirements must be considered. In real hospitals, the schedule changes frequently. The changes of the shift schedule yields various problems, for example, a fall in the nursing level. We describe a technique of the reoptimization of the nurse schedule in response to a change. The conventional CGA is superior in ability for local search by means of its crossover operator, but often stagnates at the unfavorable situation because it is inferior to ability for global search. When the optimization stagnates for long generation cycle, a searching point, population in this case, would be caught in a wide local minimum area. To escape such local minimum area, small change in a population should be required. Based on such consideration, we propose a mutation operator activated depending on the optimization speed. When the optimization stagnates, in other words, when the optimization speed decreases, the mutation yields small changes in the population. Then the population is able to escape from a local minimum area by means of the mutation. However, this mutation operator requires two well-defined parameters. This means that user have to consider the value of these parameters carefully. To solve this problem, we propose a periodic mutation operator which has only one parameter to define itself. This simplified mutation operator is effective over a wide range of the parameter value.

  7. Optimal Residential Load Scheduling Under Utility and Rooftop Photovoltaic Units

    Directory of Open Access Journals (Sweden)

    Ghulam Hafeez

    2018-03-01

    Full Text Available With the rapid advancement in technology, electrical energy consumption is increasing rapidly. Especially, in the residential sector, more than 80% of electrical energy is being consumed because of consumer negligence. This brings the challenging task of maintaining the balance between the demand and supply of electric power. In this paper, we focus on the problem of load balancing via load scheduling under utility and rooftop photovoltaic (PV units to reduce electricity cost and peak to average ratio (PAR in demand-side management. For this purpose, we adopted genetic algorithm (GA, binary particle swarm optimization (BPSO, wind-driven optimization (WDO, and our proposed genetic WDO (GWDO algorithm, which is a hybrid of GA and WDO, to schedule the household load. For energy cost estimation, combined real-time pricing (RTP and inclined block rate (IBR were used. The proposed algorithm shifts load from peak consumption hours to off-peak hours based on combined pricing scheme and generation from rooftop PV units. Simulation results validate our proposed GWDO algorithm in terms of electricity cost and PAR reduction while considering all three scenarios which we have considered in this work: (1 load scheduling without renewable energy sources (RESs and energy storage system (ESS, (2 load scheduling with RESs, and (3 load scheduling with RESs and ESS. Furthermore, our proposed scheme reduced electricity cost and PAR by 22.5% and 29.1% in scenario 1, 47.7% and 30% in scenario 2, and 49.2% and 35.4% in scenario 3, respectively, as compared to unscheduled electricity consumption.

  8. The nurse scheduling problem: a goal programming and nonlinear optimization approaches

    Science.gov (United States)

    Hakim, L.; Bakhtiar, T.; Jaharuddin

    2017-01-01

    Nurses scheduling is an activity of allocating nurses to conduct a set of tasks at certain room at a hospital or health centre within a certain period. One of obstacles in the nurse scheduling is the lack of resources in order to fulfil the needs of the hospital. Nurse scheduling which is undertaken manually will be at risk of not fulfilling some nursing rules set by the hospital. Therefore, this study aimed to perform scheduling models that satisfy all the specific rules set by the management of Bogor State Hospital. We have developed three models to overcome the scheduling needs. Model 1 is designed to schedule nurses who are solely assigned to a certain inpatient unit and Model 2 is constructed to manage nurses who are assigned to an inpatient room as well as at Polyclinic room as conjunct nurses. As the assignment of nurses on each shift is uneven, then we propose Model 3 to minimize the variance of the workload in order to achieve equitable assignment on every shift. The first two models are formulated in goal programming framework, while the last model is in nonlinear optimization form.

  9. Flexible Work Schedules: What Are We Trading off To Get Them?

    Science.gov (United States)

    Golden, Lonnie

    2001-01-01

    Flexible work schedules have more than doubled since 1985, but workers sometimes must be willing to increase their hours, work evening shifts, or switch to part-time status, self-employment, or certain occupations to get flexibility. Flexibility was less likely for nonwhite, female, unmarried, and less-educated workers. (Contains 38 notes and…

  10. Evidence for positive, but not negative, behavioral contrast with wheel-running reinforcement on multiple variable-ratio schedules.

    Science.gov (United States)

    Belke, Terry W; Pierce, W David

    2016-12-01

    Rats responded on a multiple variable-ratio (VR) 10 VR 10 schedule of reinforcement in which lever pressing was reinforced by the opportunity to run in a wheel for 30s in both the changed (manipulated) and unchanged components. To generate positive contrast, the schedule of reinforcement in the changed component was shifted to extinction; to generate negative contrast, the schedule was shifted to VR 3. With the shift to extinction in the changed component, wheel-running and local lever-pressing rates increased in the unchanged component, a result supporting positive contrast; however, the shift to a VR 3 schedule in the changed component showed no evidence of negative contrast in the unaltered setting, only wheel running decreased in the unchanged component. Changes in wheel-running rates across components were consistent in showing a compensation effect, depending on whether the schedule manipulation increased or decreased opportunities for wheel running in the changed component. These findings are the first to demonstrate positive behavioral contrast on a multiple schedule with wheel running as reinforcement in both components. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety.

    Science.gov (United States)

    Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M

    2012-01-01

    12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift in order to reduce their work/home conflicts, however, at the expense of the patient's safety, as well as their own health and safety. Therefore, it is important to develop measures, such as extended child care, association of nurses to the elaboration of their rota, 9- or 10-hour shifts in the afternoon, allowing naps during night shifts, and reduction of changing shifts with short notice. Work schedules must be organized in order to allow time for shift handover, social support and team building.

  12. It Is Not Just about the Schedule: Key Factors in Effective Reference Desk Scheduling and Management

    Science.gov (United States)

    Sciammarella, Susan; Fernandes, Maria Isabel; McKay, Devin

    2008-01-01

    Reference desk scheduling is one of the most challenging tasks in the organizational structure of an academic library. The ability to turn this challenge into a workable and effective function lies with the scheduler and indirectly the cooperation of all librarians scheduled for reference desk service. It is the scheduler's sensitivity to such…

  13. Cure Schedule for Stycast 2651/Catalyst 9.

    Energy Technology Data Exchange (ETDEWEB)

    Kropka, Jamie Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); McCoy, John D. [New Mexico Inst. of Mining and Technology, Socorro, NM (United States)

    2017-11-01

    The Emerson & Cuming technical data sheet (TDS) for Stycast 2651/Catalyst 9 lists three alternate cure schedules for the material, each of which would result in a different state of reaction and different material properties. Here, a cure schedule that attains full reaction of the material is defined. The use of this cure schedule will eliminate variance in material properties due to changes in the cure state of the material, and the cure schedule will serve as the method to make material prior to characterizing properties. The following recommendation uses one of the schedules within the TDS and adds a “post cure” to obtain full reaction.

  14. Mechanical spectral shift reactor

    International Nuclear Information System (INIS)

    Doshi, P.K.; George, R.A.; Dollard, W.J.

    1982-01-01

    A mechanical spectral shift arrangement for controlling a nuclear reactor includes a plurality of reactor coolant di