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Duty hours

Catherine de Blacam, Sean Tierney, Odhran Shelley
BACKGROUND: Surgical training requires exposure to clinical decision-making and operative experience in a supervised environment. It is recognised that learning ability is compromised when fatigued. The European Working Time Directive requires a decrease in working hours, but compliance reduces trainees' clinical exposure, which has profound implications for plastic surgery training. The aim of this study was to evaluate plastic surgery registrars' experience of an EWTD-compliant rota, and to examine its impact on patient care, education, and logbook activity...
October 20, 2016: Journal of Plastic Surgery and Hand Surgery
Michael J Rosenblum
No abstract text is available yet for this article.
October 19, 2016: Journal of General Internal Medicine
Eva Dye, Nancy Wells
BACKGROUND: Neonatal nurse practitioner (NNP) workload is not well studied, and metrics specific to NNP practice are lacking. Factors such as changes in resident duty hours, increasing neonatal intensive care unit admissions, and a shortage of NNPs contribute to NNP workload. Increased workload has been shown to be detrimental to providers and can affect quality of care. PURPOSE: This study quantified NNP workload using a subjective workload metric, the NASA Task Load Index, and a newly developed objective workload metric specific to NNP practice...
October 13, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
John Burger, Marc Capobianco, Robert Lovern, Ben Boche, Elliot Ross, Michael A Darracq, Robert McLay
BACKGROUND: Rates of completed suicide in the military have increased. Options are limited for acute relief of depression and suicidal ideation. Traditional treatments' effects take weeks to months. A novel, rapid, therapeutic target has emerged with the N-methyl-D-aspartate antagonist ketamine. Previous studies suggest that a single dose of intravenous (IV) ketamine rapidly alleviates depression and suicidality. METHODS: In this proof of concept study, an active duty convenience sample population presenting to the emergency department (ED) meeting criteria for inpatient psychiatric admission as a result of depression and suicidal thinking were randomized to receive either a subdissociative dose (0...
October 2016: Military Medicine
P Gal, T J Buist, J J J Smit, A Adiyaman, A R Ramdat Misier, P P H M Delnoy, A Elvan
INTRODUCTION: Pulmonary vein (PV) reconnection is frequently the cause of recurrence of atrial fibrillation (AF) after ablation. The second-generation gold multi-electrode ablation (Gold-MEA) catheter has a new design possibly resulting in improved lesion formation compared with its predecessor. We aimed to determine the association between effective radiofrequency applications with the Gold-MEA catheter and outcome after AF ablation. METHODS: 50 consecutive patients with paroxysmal AF underwent Gold-MEA (PVAC GOLD(TM), Medtronic Inc...
October 17, 2016: Netherlands Heart Journal
Kevin Riley, Jennifer Nazareno, Sterling Malish
INTRODUCTION: Live-in formal caregivers spend consecutive days in patients' homes, raising questions about their ability to secure adequate sleep while on duty. Few studies have examined sleeping conditions and outcomes for this growing workforce. METHODS: We collected weeklong sleep logs and interview data from 32 Filipino caregivers in Los Angeles who provide live-in services at least 3 consecutive days per week. RESULTS: Respondents recorded a total average of 6...
October 17, 2016: American Journal of Industrial Medicine
Christina A Minami, David D Odell, Karl Y Bilimoria
No abstract text is available yet for this article.
October 12, 2016: JAMA Surgery
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Rashid Haidarimoghadam, Reza Kazemi, Majid Motamedzadeh, Rostam Golmohamadi, Alireza Soltanian, Mohamad Reza Zoghipaydar
INTRODUCTION: The aim of this study was to evaluate the effects of consecutive night shifts (CNS) and shift length (SL) on cognitive performance and sleepiness. MATERIALS AND METHODS: This study evaluated the sleepiness and performance of 30 control rooms operators (CROs) working in a 7 nights, 7 days, 7 days off (7N7D7O) and 30 CROs working in a 4 nights, 7 days, 3 nights, 7 days off (4N7D3N7O) shift pattern in a petrochemical complex in the last night shift before swinging into the day shift...
October 4, 2016: International Journal of Occupational Safety and Ergonomics: JOSE
Henry Hoffmann, Daniel Oertli, Robert Mechera, Salome Dell-Kuster, Rachel Rosenthal, Richard Reznick, Hugh MacDonald
OBJECTIVE: Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming. DESIGN: This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR...
September 30, 2016: Journal of Surgical Education
Deepak Bhandari, John Russell Erskine Ruhl, Anthony John Murphy, Ernest McGahee, David Michael Chambers, Benjamin C Blount
Urinary diamines are biomarkers of diisocyanate exposure. Diisocyanates are considered as skin and respiratory sensitizers and are the most frequently reported cause of occupational asthma. Herein, we report on the development and validation of an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the measurement of five aromatic diamines, 4,4'-methylenedianiline (MDA), 2,4-toluenediamine (4TDA), 2,6-toluenediamine (6TDA), 1,5-naphthalenediamine (NDA), and p-phenylenediamine (PPDA) in human urine...
October 1, 2016: Analytical Chemistry
Phillip B Ham, Toby Anderton, Ryan Gallaher, Mike Hyrman, Erika Simmerman, Annamalai Ramanathan, David Fallaw, Steven Holsten, Charles Gordon Howell
Surgeons frequently report frustration and loss of efficiency with electronic medical record (EMR) systems. Together, surgery residents and a programmer at Augusta University created a rounds report (RR) summarizing 24 hours of vitals, intake/output, labs, and other values for each inpatient that were previously transcribed by hand. The objective of this study was to evaluate the RR's effect on surgery residents. Surgery residents were queried to assess the RR's impact. Outcome measures were time spent preparing for rounds, direct patient care time, educational activity time, rates of incorrect/incomplete data on rounds, and rate of duty hour violations...
September 2016: American Surgeon
John J Mercuri, Neil E Okey, Raj J Karia, Richard H Gross, Joseph D Zuckerman
INTRODUCTION: To date, no study has reported on the public's opinion of orthopaedic resident duty-hour requirements (DHR). METHODS: A survey was administered to people in orthopaedic waiting rooms and at three senior centers. Responses were analyzed to evaluate seven domains: knowledge of duty hours; opinions about duty hours; attitudes regarding shift work; patient safety concerns; and the effects of DHRs on continuity of care, on resident training, and on resident professionalism...
September 22, 2016: Journal of the American Academy of Orthopaedic Surgeons
Paul-Georges Reuter, Thibaut Desmettre, Sabine Guinemer, Olivier Ducros, Stéphane Begey, Agnès Ricard-Hibon, Laurianne Billier, Océane Grignon, Isabelle Megy-Michoux, Jean-Noël Latouff, Adeline Sourbes, Julien Latier, Isabelle Durand-Zaleski, Frédéric Lapostolle, Eric Vicaut, Frédéric Adnet
BACKGROUND: Telephone consultations in general practice are on the increase. However, data on their efficiency in terms of out-of-hours general practitioner (GP) workload, visits to hospital emergency departments (ED), cost, patient safety and satisfaction are relatively scant. The aim of this trial is to assess the effectiveness of telephone consultations provided by French emergency call centres in patients presenting with isolated fever or symptoms of gastroenteritis, mainly encountered diseases...
2016: Trials
Hibret Tilahun, Binyam Fekadu, Habtamu Abdisa, Maureen Canavan, Erika Linnander, Elizabeth H Bradley, Peter Berman
Ethiopia implemented an innovative community-based health program, called the health extension program, to enhance access to basic health promotion, disease prevention and selected curative services by establishing health posts in every village, also called kebeles, with average of 5000 people, staffed with two health extension workers (HEWs). This time and motion study was done to estimate the amount of time that HEWs spend on various work duties and to explore differences in urban compared with rural settings and among regions...
September 21, 2016: Health Policy and Planning
Issa Mirmehdi, Cindy-Marie O'Neal, Davis Moon, Heather MacNew, Christopher Senkowski
PURPOSE: With the implementation of strict 80-hour work week in general surgery training, serious questions have been raised concerning the quality of surgical education and the ability of newly trained general surgeons to independently operate. Programs that were randomized to the interventional arm of the Flexibility In duty-hour Requirements for Surgical Trainees (FIRST) Trial were able to decrease transitions and allow for better continuity by virtue of less constraints on duty-hour rules...
September 16, 2016: Journal of Surgical Education
Zheng-Li Wang, Li-Zhong Du, Yi-Yu Chen, Lu-Quan Li, Qi Lu, Ying Liu, Lu-Ying Cao, Yu He, Jia-Lin Yu
BACKGROUND: Critical value reporting has been widely adopted by hospitals throughout the world, but there were few reports about neonatal critical values. This study aimed to analyze characteristics of the neonatal critical values considered at our center and to provide information on improving neonatal intensive care. METHODS: A retrospective study of critical values at a newborn tertiary center in China was conducted to assess neonatal critical values according to test, distribution, reporting time, patient outcome and the impact to the therapy...
September 20, 2016: World Journal of Pediatrics: WJP
Cátia Reis, Catarina Mestre, Helena Canhão, David Gradwell, Teresa Paiva
BACKGROUND: Sleep and fatigue management is one of the main challenges in airline operations scheduling. Our aim was to compare the differences regarding fatigue, sleep, and labor specificities between the two most common types of flight, short/medium haul (SM-H) and long haul (L-H), in a large sample of airline pilots. METHODS: A self-report questionnaire was developed, composed of socio-economic and labor questions, and psychological assessment scales for fatigue and sleep...
September 2016: Aerospace Medicine and Human Performance
Osamu Nomura, Hiroki Mishina, Yoshinori Kobayashi, Akira Ishiguro, Hirokazu Sakai, Hiroyuki Kato
Duty hour regulations have been placed in residency programs to address mental health concerns and to improve wellness. Here, we elucidate the prevalence of depressive symptoms after implementing an overnight call shift system and the factors associated with burnout or depression among residents.A sequential exploratory mixed methods study was conducted in a tertiary care pediatric and perinatal hospital in Tokyo, Japan. A total of 41 pediatric residents participated in the cross-sectional survey. We determined and compared the prevalence of depressive symptoms and the number of actual working hours before and after implementing the shift system...
September 2016: Medicine (Baltimore)
Megan H Halliday, Andrew J Bouland, Benjamin J Lawner, Angela C Comer, Daniel C Ramos, Mark Fletcher
INTRODUCTION: A lack of coordination between emergency medical services (EMS), emergency departments (ED) and systemwide management has contributed to extended ambulance at-hospital times at local EDs. In an effort to improve communication within the local EMS system, the Baltimore City Fire Department (BCFD) placed a medical duty officer (MDO) in the fire communications bureau. It was hypothesized that any real-time intervention suggested by the MDO would be manifested in a decrease in the EMS at-hospital time...
September 2016: Western Journal of Emergency Medicine
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