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https://www.readbyqxmd.com/read/27909158/off-site-emergency-planning-at-uk-nuclear-licensed-sites
#1
Paul Leonard, Gareth Thomas
Nuclear emergency planning arrangements in the UK are continually kept under review. This work proposes to outline how experience from nuclear exercises and undertaking emergency response duties can be based on radiological knowledge of specific sites and utilised in the future. In 2014, the UK regulator, the Office for Nuclear Regulation (ONR) revised their principles for the determination of off-site emergency planning areas around nuclear sites where predetermined countermeasures and other protection measures are applied to protect those people who may be affected by a radiation emergency...
December 1, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27900800/effects-of-partial-sleep-deprivation-on-reaction-time-in-anesthesiologists
#2
Haleh Saadat, Bruno Bissonnette, Dmitry Tumin, Vidya Raman, Julie Rice, N'Diris Barry, Joseph Tobias
BACKGROUND: Fatigue in anesthesiologists may have implications that extend beyond individual well-being. AIM: The aim of the present study was to evaluate the impact of sleep deprivation on the reaction time in anesthesiologists either after an overnight call or regular working hours. Moderation of this effect by coping strategies was observed. METHODS: Psychomotor vigilance test was used to assess reaction time in 23 anesthesiologists at two time-points: (i) on a regular non-call day and (ii) after a 17-h in-house call...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27893063/assessment-of-the-psychometric-properties-of-a-questionnaire-assessing-patient-reported-outcomes-with-laser-in-situ-keratomileusis-prowl
#3
Ron D Hays, Michelle E Tarver, Karen L Spritzer, Steve Reise, Gene Hilmantel, Elizabeth M Hofmeister, Keri Hammel, Jeanine May, Frederick Ferris, Malvina Eydelman
Importance: Patient-reported outcome (PRO) measures for laser in situ keratomileusis (LASIK) are needed. Objective: To develop PRO measures to assess satisfaction, eye-related symptoms, and their effect on functioning and well-being following LASIK based on patient and expert input. Design, Setting, and Participants: The Patient-Reported Outcomes With LASIK (PROWL) studies were prospective observational studies of patients undergoing LASIK surgery for myopia, hyperopia, or astigmatism...
November 23, 2016: JAMA Ophthalmology
https://www.readbyqxmd.com/read/27891413/cost-effective-recruitment-need-for-24x7-paediatricians-in-the-state-general-hospitals-in-relation-to-the-reduction-of-infant-mortality
#4
Ranjana Chatterjee, Sukanta Chatterjee
INTRODUCTION: According to World Health Organisation (WHO), improvement of hospital based care can have an impact of upto 30% in reducing Infant Mortality Rate (IMR), whereas, strengthening universal outreach and family-community based care is known to have a greater impact. The study intends to assess how far gaps in the public health facilities contribute towards infant mortality, as 2/3(rd) of infant mortality is due to suboptimum care seeking and weak health system. AIM: To identify cost-effectiveness of employment of additional paediatric manpower to provide round the clock skilled service to reduce IMR in the present state health facilities at the district general hospitals...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890143/what-work-schedule-characteristics-constitute-a-problem-to-the-individual-a-representative-study-of-swedish-shift-workers
#5
Torbjörn Åkerstedt, Göran Kecklund
The purpose was to investigate which detailed characteristics of shift schedules that are seen as problems to those exposed. A representative national sample of non-day workers (N = 2031) in Sweden was asked whether they had each of a number of particular work schedule characteristics and, if yes, to what extent this constituted a "big problem in life". It was also inquired whether the individual's work schedules had negative consequences for fatigue, sleep and social life. The characteristic with the highest percentage reporting a big problem was "short notice (<1 month) of a new work schedule" (30...
March 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/27884806/exploring-qualitative-perspectives-on-surgical-resident-training-well-being-and-patient-care
#6
Lindsey Kreutzer, Allison R Dahlke, Remi Love, Kristen A Ban, Anthony D Yang, Karl Y Bilimoria, Julie K Johnson
BACKGROUND: The Flexibility In duty hour Requirements for Surgical Trainees (FIRST) Trial found not difference in patient outcomes or resident wellbeing between more restrictive and flexible duty hour policies. Qualitative methods are appropriate for better understanding the experience and perceptions of those affected by duty hour regulations. We conducted a pilot qualitative study on how resident duty hour regulations are perceived by general surgery Program Directors (PDs), surgical residents and attending surgeons who participated in the FIRST Trial...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884805/utilization-and-underlying-reasons-of-duty-hour-flexibility-in-the-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial
#7
Karl Y Bilimoria, Christopher Quinn, Allison R Dahlke, Rachel R Kelz, Judy A Shea, Ravi Rajaram, Remi Love, Lindsey Kreutzer, Thomas Biester, Anthony D Yang, David B Hoyt, Frank R Lewis
BACKGROUND: The Flexibility in Duty-Hour Requirements for Surgical Trainees (FIRST) Trial randomized surgical residency programs to either standard duty-hour policies or flexible policies that eliminated caps on shift lengths and time off between shifts. Our objectives were to assess adherence to duty-hour requirements in the Standard Policy arm and examine how often and why duty-hour flexibility was used in the Flexible Policy arm. STUDY DESIGN: A total of 3,795 residents in the FIRST Trial completed a survey in January 2016 (response rate >95%) that asked how often and why they exceeded current standard duty hour limits in both study arms...
November 10, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884804/gender-based-differences-in-surgical-residents-perceptions-of-patient-safety-continuity-of-care-and-well-being-an-analysis-from-the-flexibility-in-duty-hour-requirements-for-surgical-trainees-first-trial
#8
Kristen A Ban, Jeanette W Chung, Richard S Matulewicz, Rachel R Kelz, Judy A Shea, Allison R Dahlke, Christopher Quinn, Anthony D Yang, Karl Y Bilimoria
BACKGROUND: Little is known about gender differences in residency training experiences and whether duty hour policies affect these differences. Using data from the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial, we (1) examined gender differences in surgical resident perceptions of patient safety, education, health/well-being, and job satisfaction and (2) assessed whether duty hour policies affected gender differences. STUDY DESIGN: We compared proportions of male and female residents expressing dissatisfaction or perceiving a negative effect of duty hours on aspects of residency training (patient safety, resident education, well-being, job satisfaction) overall and by postgraduate year (PGY)...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884803/association-between-resident-perceptions-of-patient-safety-and-duty-hour-violations
#9
Richard S Matulewicz, David D Odell, Jeanette W Chung, Kristen A Ban, Anthony D Yang, Karl Y Bilimoria
BACKGROUND: Residents are often required to balance whether to adhere to duty hour policies or violate them to care for patients and obtain educational experiences. Little is known about why residents violate duty hour policies and whether there is a relationship between how often residents violate duty hours and concerns about patient safety. Our objective was to assess the association between resident duty hour violations and resident concerns about patient safety. STUDY DESIGN: We analyzed survey data collected from surgery residents who completed the 2015 ABSITE, excluding those in the Flexible Policy arm of the FIRST Trial...
November 11, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884802/association-between-flexible-duty-hour-policies-and-general-surgery-resident-examination-performance-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#10
Eddie Blay, D Brock Hewitt, Jeanette W Chung, Thomas Biester, James F Fiore, Allison R Dahlke, Christopher M Quinn, Frank R Lewis, Karl Y Bilimoria
BACKGROUND: Concerns persist about the effect of current duty hour reforms on resident educational outcomes. We investigated whether a flexible, less-restrictive duty hour policy (Flexible Policy) was associated with differential general surgery examination performance compared to current Accreditation Council for Graduate Medical Education (ACGME) duty hour policy (Standard Policy). STUDY DESIGN: We obtained examination scores on the American Board of Surgery (ABS) In-Training Examination (ABSITE), Qualifying Examination (QE, written boards), and Certifying Examination (CE, oral boards) for residents in 117 general surgery residency programs that participated in the Flexibility In Duty Hour Requirements for Surgical Trainees (FIRST) Trial...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27884801/effect-of-flexible-duty-hour-policies-on-length-of-stay-for-complex-intra-abdominal-operations-a-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial-analysis
#11
Jonah J Stulberg, Emily Pavey, Mark E Cohen, Clifford Y Ko, David B Hoyt, Karl Y Bilimoria
BACKGROUND: Changes to resident duty hour policies in the Flexibility in Duty Hour Requirements for Surgical Trainees ("FIRST") Trial could impact hospitalized patients' length of stay (LOS) by altering care coordination. LOS may also serve as a reflection of all complications, particularly those not captured in the FIRST Trial (eg, pneumothorax from central line). Programs were randomized to either maintaining current ACGME duty hour policies ("Standard Arm") or more flexible policies waiving rules on maximum shift lengths and time off between shifts ("Flexible Arm")...
November 8, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27881531/burnout-prevalence-in-new-zealand-s-public-hospital-senior-medical-workforce-a-cross-sectional-mixed-methods-study
#12
Charlotte N L Chambers, Christopher M A Frampton, Murray Barclay, Martin McKee
OBJECTIVES: To explore the prevalence of, and associated factors contributing to burnout among senior doctors and dentists working in the New Zealand's public health system. DESIGN: Cross-sectional, mixed methods study. SETTING: New Zealand's 20 district health boards (DHBs). PARTICIPANTS: A total of 1487 of 3740 senior doctors and dentists who are members of the Association of Salaried Medical Specialists working in DHBs were recruited (response rate 40%)...
November 23, 2016: BMJ Open
https://www.readbyqxmd.com/read/27873408/number-needed-to-eat-pizza-and-resident-conference-attendance
#13
Michael J Cosimini, Liza Mackintosh, Todd P Chang
The didactic conference is a common part of the resident education curriculum. Given the demands of clinical responsibilities and restrictions on duty hours, maximising education is a challenge faced by all residency programmes. To date, little research exists with respect to how the provision of complimentary food affects physician and resident conference attendance. The objective of this study was to determine whether complimentary food improves resident arrival times and attendance at educational conferences and, furthermore, to test whether this provision is a potentially cost-effective tool for improving education...
December 2016: Medical Education
https://www.readbyqxmd.com/read/27847492/post-training-meditation-promotes-motor-memory-consolidation
#14
Maarten A Immink
Following training, motor memory consolidation is thought to involve either memory stabilization or off-line learning processes. The extent to which memory stabilization or off-line learning relies on post-training wakeful periods or sleep is not clear and thus, novel research approaches are needed to further explore the conditions that promote motor memory consolidation. The present experiment represents the first empirical test of meditation as potential facilitator of motor memory consolidation. Twelve adult residents of a yoga center with a mean of 9 years meditation experience were trained on a sequence key pressing task...
2016: Frontiers in Psychology
https://www.readbyqxmd.com/read/27833649/use-of-moulded-hearing-protectors-by-child-care-workers-an-interventional-pilot-study
#15
Peter Koch, Johanna Stranzinger, Jan Felix Kersten, Albert Nienhaus
BACKGROUND: Employees of a multi-site institution for children and adolescents started to wear moulded hearing protectors (MHPs) during working hours, as they were suffering from a high level of noise exposure. It was agreed with the institutional physician and the German Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) that this presented an opportunity to perform a scientific study to investigate potential beneficial effects on risk of burnout and subjective noise exposure at work when child care workers wear MHPs...
2016: Journal of Occupational Medicine and Toxicology
https://www.readbyqxmd.com/read/27825914/differences-in-resident-perceptions-by-postgraduate-year-of-duty-hour-policies-an-analysis-from-the-flexibility-in-duty-hour-requirement-for-surgical-trainees-first-trial
#16
Anthony D Yang, Jeanette W Chung, Allison R Dahlke, Thomas Biester, Christopher M Quinn, Richard S Matulewicz, David D Odell, Rachel R Kelz, Judy Shea, Frank Lewis, Karl Y Bilimoria
BACKGROUND: In the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial, there were several differences in residents' perceptions of aspects of their education, well-being, and patient care that differed between standard and flexible duty hour policies. Our objective was to assess whether these perceptions differed by level of training. STUDY DESIGN: A survey assessed residents participating in the FIRST Trial's perceptions of the effect of duty hour policies on aspects of patient safety, continuity of care, resident education, clinical training, and resident well-being...
November 4, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27825699/implementation-of-a-standardized-electronic-tool-improves-compliance-accuracy-and-efficiency-of-trainee-to-trainee-patient-care-handoffs-after-complex-general-surgical-oncology-procedures
#17
Callisia N Clarke, Sameer H Patel, Ryan W Day, Sobha George, Colin Sweeney, Georgina Avaloa Monetes De Oca, Mohamed Ait Aiss, Elizabeth G Grubbs, Brian K Bednarski, Jeffery E Lee, Diane C Bodurka, John M Skibber, Thomas A Aloia
BACKGROUND: Duty-hour regulations have increased the frequency of trainee-trainee patient handoffs. Each handoff creates a potential source for communication errors that can lead to near-miss and patient-harm events. We investigated the utility, efficacy, and trainee experience associated with implementation of a novel, standardized, electronic handoff system. METHODS: We conducted a prospective intervention study of trainee-trainee handoffs of inpatients undergoing complex general surgical oncology procedures at a large tertiary institution...
November 5, 2016: Surgery
https://www.readbyqxmd.com/read/27809403/effects-of-evaluator-s-fatigue-and-level-of-expertise-on-the-global-and-analytical-evaluation-of-preclinical-tooth-preparation
#18
Mohammad D Al Amri, Haneef R Sherfudhin, Syed R Habib
PURPOSE: To investigate the effects of evaluator fatigue and level of expertise on the grading of preclinical tooth crown preparations, by global and analytical methods of evaluation. MATERIALS AND METHODS: The study had a double-blind design. Two faculty members, each with more than 10 years of clinical and teaching experience, and two demonstrators with no teaching experience evaluated tooth preparations on maxillary central incisors and mandibular first molars...
November 3, 2016: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
https://www.readbyqxmd.com/read/27803179/physicians-attentional-performance-following-a-24-hour-observation-period-do-we-need-to-regulate-sleep-prior-to-work
#19
P Smyth, K Maximova, J D Jirsch
BACKGROUND: The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. METHODS: We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta...
November 1, 2016: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27788923/evaluating-handoffs-in-the-context-of-a-communication-framework
#20
Hani Hasan, Fadwa Ali, Paul Barker, Robert Treat, Jacob Peschman, Matthew Mohorek, Philip Redlich, Travis Webb
BACKGROUND: The implementation of mandated restrictions in resident duty hours has led to increased handoffs for patient care and thus more opportunities for errors during transitions of care. Much of the current handoff literature is empiric, with experts recommending the study of handoffs within an established framework. METHODS: A prospective, single-institution study was conducted evaluating the process of handoffs for the care of surgical patients in the context of a published communication framework...
October 24, 2016: Surgery
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