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https://www.readbyqxmd.com/read/28920706/do-night-and-around-the-clock-firefighters-shift-schedules-induce-deviation-in-tau-from-24-hours-of-systolic-and-diastolic-blood-pressure-circadian-rhythms
#1
Alain E Reinberg, Michael H Smolensky, Marc Riedel, Cedric Riedel, Eric Brousse, Yvan Touitou
Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A - 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B - 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C - 9 day shift (09:00-17:00h) FFs charged with administrative tasks...
September 18, 2017: Chronobiology International
https://www.readbyqxmd.com/read/28916237/ethics-and-palliative-care-in-the-perinatal-world
#2
REVIEW
Colleen M Marty, Brian S Carter
The perinatal world is unique in its dutiful consideration of two patients along the lines of decision-making and clinical management - the fetus and the pregnant woman. The potentiality of the fetus-newborn is intertwined with the absolute considerations for the woman as autonomous patient. From prenatal diagnostics, which may be quite extensive, to potential interventions prenatally, postnatal resuscitation, and neonatal management, the fetus and newborn may be anticipated to survive with or without special needs and technology, to have a questionable or guarded prognosis, or to live only minutes to hours...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28910472/a-descriptive-analysis-of-occupational-fatalities-due-to-felonious-assault-among-u-s-law-enforcement-officers-during-tactical-incidents-1996-2014
#3
Moriah S Thompson, Tyler M Hartman, Matthew D Sztajnkrycer
INTRODUCTION: Little is known about occupational fatalities among tactical officers. A greater understanding of such injuries is needed to improve officer safety. The purpose of this study was to provide a descriptive analysis of line-of-duty deaths secondary to felonious assault during tactical incidents. METHODS: Retrospective analysis was performed of open-source de-identified Federal Bureau of Investigation Uniform Crime Reporting Law Enforcement Officers Killed and Assaulted (LEOKA) data inclusive of the years 1996-2014...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28894913/european-otorhinolaryngology-training-programs-results-of-a-european-survey-about-training-satisfaction-work-environment-and-conditions-in-six-countries
#4
N Oker, Naif H Alotaibi, A C Reichelt, P Herman, M Bernal-Sprekelsen, Andreas E Albers
ORL-students and residents have an ongoing debate about the "best" programme in Europe. Aim of this study was to comparatively assess differences among programmes in training, satisfaction, quality of life (QoL) of residents and recent otorhinolaryngologist (ORL) specialists in France, Germany, Spain, Italy, Austria, and Belgium. A self-administered anonymous questionnaire, structured in ten sections including general information, provided guidance, working environment, training structure, teaching of medical students, publication work, QoL, and satisfaction with training, were emailed to residents and recent ORL specialists...
September 11, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28893812/impact-of-scribes-on-physician-satisfaction-patient-satisfaction-and-charting-efficiency-a-randomized-controlled-trial
#5
Risha Gidwani, Cathina Nguyen, Alexis Kofoed, Catherine Carragee, Tracy Rydel, Ian Nelligan, Amelia Sattler, Megan Mahoney, Steven Lin
PURPOSE: Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency. METHODS: We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 year...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28883024/hearing-threshold-shifts-among-military-pilots-of-the-israeli-air-force
#6
Liyona Kampel-Furman, Z Joachims, H Bar-Cohen, A Grossman, Y Frenkel-Nir, Y Shapira, E Alon, E Carmon, B Gordon
BACKGROUND: Military aviators are potentially at risk for developing noise-induced hearing loss. Whether ambient aircraft noise exposure causes hearing deficit beyond the changes attributed to natural ageing is debated. The aim of this research was to assess changes in hearing thresholds of Israeli Air Force (IAF) pilots over 20 years of military service and identify potential risk factors for hearing loss. METHODS: A retrospective cohort analysis was conducted of pure-tone air conduction audiograms of pilots, from their recruitment at 18 years of age until the last documented medical check-up...
September 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28873231/medical-innovation-in-a-children-s-hospital-diseases-desperate-grown-by-desperate-appliance-are-relieved-or-not-at-all
#7
Vic Larcher, Helen Turnham, Joe Brierley
A balance needs to be struck between facilitating compassionate access to innovative treatments for those in desperate need, and the duty to protect such vulnerable individuals from the harms of untested/unlicensed treatments. We introduced a principle-based framework (2009) to evaluate such requests and describe its application in the context of recently evolved UK, US and European regulatory processes. 24 referrals (20 individual; four group) were received by our quaternary children's hospital Clinical Ethics Committee (CEC) over the 5-year period (2011-16)...
September 5, 2017: Bioethics
https://www.readbyqxmd.com/read/28864400/effects-of-transcranial-direct-current-stimulation-on-neurosurgical-skill-acquisition-a-randomized-controlled-trial
#8
Patrick Ciechanski, Adam Cheng, Steven Lopushinsky, Kent Hecker, Liu Shi Gan, Stefan Lang, Kourosh Zareinia, Adam Kirton
BACKGROUND: Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery required extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure skill proficiency is met. Transcranial direct-current stimulation (tDCS) can enhance motor skill learning but is untested in surgical procedural training. We aimed to determine the effects of tDCS on simulation-based neurosurgical skill acquisition...
August 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28845054/duty-rosters-and-workloads-of-obstetricians-in-germany-results-of-a-germany-wide-survey
#9
Johannes Neimann, Julia Knabl, Julian Puppe, Christian Michael Bayer, Paul Gass, Lena Gabriel, Birgit Seelbach-Goebel, Johannes Lermann, Sarah Schott
BACKGROUND: Compiling a daily hospital roster which complies with existing laws and tariff regulations and meets the requirements for ongoing professional training while also taking the legal regulations on the health of employees into account makes planning the duty roster a challenge. The aim of this study was to obtain a realistic picture of existing duty roster systems and of the current workloads of obstetricians in Germany. METHOD: This online survey was sent to 2770 physicians training to become obstetricians or specializing in specific areas of obstetric care...
August 2017: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28842240/duty-hour-restrictions-revisited-second-year-of-the-first-trial
#10
John Paul G Kolcun, Karthik Madhavan, Michael Y Wang
No abstract text is available yet for this article.
August 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28833067/estimation-of-population-average-treatment-effects-in-the-first-trial-application-of-a-propensity-score-based-stratification-approach
#11
Jeanette W Chung, Karl Y Bilimoria, Jonah J Stulberg, Christopher M Quinn, Larry V Hedges
OBJECTIVE/STUDY QUESTION: To estimate and compare sample average treatment effects (SATE) and population average treatment effects (PATE) of a resident duty hour policy change on patient and resident outcomes using data from the Flexibility in Duty Hour Requirements for Surgical Trainees Trial ("FIRST Trial"). DATA SOURCES/STUDY SETTING: Secondary data from the National Surgical Quality Improvement Program and the FIRST Trial (2014-2015). STUDY DESIGN: The FIRST Trial was a cluster-randomized pragmatic noninferiority trial designed to evaluate the effects of a resident work hour policy change to permit greater flexibility in scheduling on patient and resident outcomes...
August 21, 2017: Health Services Research
https://www.readbyqxmd.com/read/28828300/generalizable-items-and-modular-structure-for-computerised-physician-staffing-calculation-on-intensive-care-units
#12
REVIEW
Manfred Weiss, Gernot Marx, Thomas Iber
Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks...
August 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28781132/-taking-training-to-the-next-level-the-american-college-of-surgeons-committee-on-residency-training-survey
#13
Richard B Damewood, Patrice Gabler Blair, Yoon Soo Park, Linda K Lupi, Rachel Williams Newman, Ajit K Sachdeva
OBJECTIVE: The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. DESIGN: Two surveys were developed, pilot tested, and administered to PDs following Institutional Review Board approval...
August 3, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28752744/trends-in-perception-of-psychosocial-school-environment-hbsc-study-2002-2014-in-the-czech-republic
#14
Jana Vašíčková, Tomáš Hollein, Erik Sigmund, Ferdinand Salonna, Zuzana Boberová
OBJECTIVE: School is a place where students spend most of their daytime hours. Previous studies indicate that the class climate significantly affects students in both positive and negative ways. The aim of our study is to describe the trends in the psychosocial school environment based on four surveyed years in the Czech Republic. METHODS: The trends in perception of school were assessed by the standardised self-reported HBSC questionnaire from data collected in 2002, 2006, 2010, and 2014...
July 2017: Central European Journal of Public Health
https://www.readbyqxmd.com/read/28751158/mentors-offering-maternal-support-reduces-prenatal-pregnancy-specific-anxiety-in-a-sample-of-military-women
#15
Karen L Weis, Regina P Lederman, Katherine C Walker, Wenyaw Chan
OBJECTIVE: To determine the efficacy of the Mentors Offering Maternal Support (MOMS) program to reduce pregnancy-specific anxiety and depression and build self-esteem and resilience in military women. DESIGN: Randomized controlled trial with repeated measures. SETTING: Large military community in Texas. PARTICIPANTS: Pregnant women (N = 246) in a military sample defined as active duty or spouse of military personnel...
July 24, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28746074/understanding-the-multidimensional-effects-of-resident-duty-hours-restrictions-a-thematic-analysis-of-published-viewpoints-in-surgery
#16
Katharine S Devitt, Michael J Kim, Lesley Gotlib Conn, Frances C Wright, Carol-Anne Moulton, Itay Keshet, Najma Ahmed
PURPOSE: Individuals representing various surgical disciplines have expressed concerns with the impact of resident duty hours (RDH) restrictions on resident education and patient outcomes. This thematic review of published viewpoints aimed to describe the effects of these restrictions in surgery. METHOD: The authors conducted a qualitative systematic review of non-research-based literature published between 2003 and 2015. Articles were included if they focused on the RDH restrictions in surgery and resident wellness, health promotion, resident safety, resident education and/or training, patient safety, medical errors, and/or heterogeneity regarding training or disciplines...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28742779/a-novel-method-of-evaluating-key-factors-for-success-in-a-multifaceted-critical-care-fellowship-using-data-envelopment-analysis
#17
Vikram Tiwari, Avinash B Kumar
BACKGROUND: The current system of summative multi-rater evaluations and standardized tests to determine readiness to graduate from critical care fellowships has limitations. We sought to pilot the use of data envelopment analysis (DEA) to assess what aspects of the fellowship program contribute the most to an individual fellow's success. DEA is a nonparametric, operations research technique that uses linear programming to determine the technical efficiency of an entity based on its relative usage of resources in producing the outcome...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28720087/resident-perceptions-of-the-impact-of-duty-hour-restrictions-on-resident-attending-interactions-an-exploratory-study
#18
Kristen A Gerjevic, Marcy E Rosenbaum, Manish Suneja
BACKGROUND: The institution of duty hour reforms by the Accreditation Council for Graduate Medical Education in 2003 has created a learning environment where residents are consistently looking for input from attending physicians with regards to balancing duty hour regulations and providing quality patient care. There is a paucity of literature regarding resident perceptions of attending physician actions or attitudes towards work hour restrictions. The purpose of this study was to identify attending physician behaviors that residents perceived as supportive or unsupportive of their compliance with duty hour regulations...
July 18, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28697744/e-learning-in-graduate-medical-education-survey-of-residency-program-directors
#19
Christopher M Wittich, Anoop Agrawal, David A Cook, Andrew J Halvorsen, Jayawant N Mandrekar, Saima Chaudhry, Denise M Dupras, Amy S Oxentenko, Thomas J Beckman
BACKGROUND: E-learning-the use of Internet technologies to enhance knowledge and performance-has become a widely accepted instructional approach. Little is known about the current use of e-learning in postgraduate medical education. To determine utilization of e-learning by United States internal medicine residency programs, program director (PD) perceptions of e-learning, and associations between e-learning use and residency program characteristics. METHODS: We conducted a national survey in collaboration with the Association of Program Directors in Internal Medicine of all United States internal medicine residency programs...
July 11, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28681057/comfort-and-exertion-while-using-filtering-facepiece-respirators-with-exhalation-valve-and-an-active-venting-system-among-male-military-personnel
#20
Melvin Seng, Liang En Wee, Xiahong Zhao, Alex R Cook, Sin Eng Chia, Vernon J Lee
INTRODUCTION: This study aimed to determine if disposable filtering facepiece respirators (FFRs), with exhalation valve (EV) and a novel active venting system (AVS), provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties. METHODS: We used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS...
July 6, 2017: Singapore Medical Journal
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