Duty hours

BACKGROUND: Police Tactical Groups (PTGs) are specialist police units tasked with rigorous physical and psychosocial duties. Consequently, selection courses (SCs) for service in these units must also be rigorous. Given the intensity of SCs, holistic monitoring for potential overstress may be beneficial. Heart Rate Variability (HRV) is one holistic stress measure that can be obtained in austere environments. OBJECTIVE: The purpose of this study was to profile HRV during a PTG SC...

BACKGROUND AND OBJECTIVES: Neurosurgery residency involves a complex structure with multiple hospitals, services, and clinic days, leading to challenges in creating equitable call schedules. Manually prepared scheduling systems are prone to biases, error, and perceived unfairness. To address these issues, we developed an automated scheduling system (Automated Optimization of Neurosurgery Scheduling System [AONSS]) to reduce biases, accommodate resident requests, and optimize call variation, ultimately enhancing the educational experience by promoting diverse junior-senior-attending relationships...

INTRODUCTION: If left untreated, burn injuries can deepen or progress in depth within the first 72 hours after injury as a result of increased wound inflammation, subsequently worsening healing outcomes. This can be especially detrimental to warfighters who are constrained to resource-limited environments with delayed evacuation times to higher roles of care and more effective treatment. Preventing this burn progression at the point of injury has the potential to improve healing outcomes but requires a field-deployable therapy and delivery system...

BACKGROUND: The COVID-19 pandemic brought unprecedented upheaval for healthcare systems globally. Rapid changes in the way nurses were asked to work brought about many challenges, especially with the requirement for nurses to move into intensive care and high dependency areas to deliver care for the increasing number of critically ill patients. AIM: The purpose of this evaluation was to assess the impact of these changes on nurses who were redeployed during the first acute phase of the pandemic and explore factors associated with burnout...

OBJECTIVES: Immediate postnatal care is a critical intervention to reduce maternal and neonatal morbidity and mortality; however, many women and newborns receive inadequate postnatal care timely and effectively during the first 24 hours following childbirth. Therefore, this study aimed to assess the immediate postnatal care guidelines implementation and its associated factors among healthcare providers in the East Shewa zone public health facilities, Oromia, Ethiopia. DESIGN: Facility-based cross-sectional study was conducted from 13 September 2022 to 28 October 2022...

BACKGROUND: The emergence of the COVID-19 pandemic led to an increased demand for hospital beds, which in turn led to unique changes to both the organisation and delivery of patient care, including the adoption of adaptive models of care. Our objective was to understand staff perspectives on adaptive models of care employed in intensive care units (ICUs) during the pandemic. METHODS: We interviewed 77 participants representing direct care staff (registered nurses) and members of the nursing management team (nurse managers, clinical educators and nurse practitioners) from 12 different ICUs...

Lead contamination in soil has emerged as a significant environmental concern. Recently, pulse electrochemical treatment (PECT) has garnered substantial attention as an effective method for mitigating lead ions in low-permeability soils. However, the impact of varying pulse time gradients, ranging from seconds to hours, under the same pulse duty cycle on lead removal efficiency (LRE) and energy consumption in PECT has not been thoroughly investigated. In this study, a novel, modified PECT method is proposed, which couples PECT with a permeable reaction barrier (PRB) and adds acetic acid to the catholyte...

INTRODUCTION: The escalation of violence against doctors, a global concern, is also evident in India. In recent years, there has been a noticeable increase in the instances of violence against doctors in Kerala, a state situated in the southern part of India. This study examines the prevalence and types of violence against doctors in Kerala, considering factors, such as gender, workplace, designation, timing, and those involved. METHODOLOGY: This cross-sectional study involved modern medicine doctors holding a minimum degree in Bachelor of Medicine and Bachelor of Surgery (MBBS), practicing in Kerala...

BACKGROUND: While fatigue is an inevitable aspect of performing surgical procedures, lack of consensus remains on its effect on surgical performance. The aim of this systematic review was to assess the effect of non-muscular fatigue on surgical outcome. METHODS: MEDLINE and Embase were searched up to 17 January 2023. Studies on students, learning, duty-hour restrictions, muscle fatigue, non-surgical or subjective outcome, the weekend effect, or time of admission were excluded...

BACKGROUND: Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call. METHODS: We conducted a two group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021...

PURPOSE: Sleep is a modifiable factor affecting chronic diseases and conditions in the Active-Duty (AD) United States (US) military population. This study assesses the impact of reported sleep health behaviors and sleep profiles on reported multimorbidity in active-duty service members (ADSMs). PARTICIPANTS AND METHODS: The study used a military representative sample of 17,166 active duty SMs from the 2018 Department of Defense Health Related Behaviors Survey (HRBS) to explore sleep patterns and profiles, and medical conditions...

INTRODUCTION: An enriching learning environment is integral to resident wellness and education. Integrated vascular (VS) and general surgery (GS) residents share 18 months of core general surgery rotations during the post graduate year (PGY) 1-3 years; differences in their experiences may help identify practical levers for change. METHODS: We used a convergent mixed-methods design. Cross-sectional surveys were administered after the 2020 ABSITE and VSITE, assessing eight domains of the learning environment and resident wellness...

INTRODUCTION: The United States Navy (USN) developed and refined standardized oxygen treatment tables for diving injuries, but USN tables may not address all situations of spinal decompression sickness (DCS). We describe a detailed recompression treatment regimen that deviated from standard USN protocol for an active-duty USN diver with a severe, delayed presentation of spinal cord DCS. CASE REPORT: A USN diver surfaced from his second of three dives on a standard Navy 'no-Decompression' Air SCUBA dive (Max depth 101 fsw utilizing a Navy Dive Computer) and developed mid-thoracic back pain, intense nausea, paresthesias of bilateral feet, and penile erection...

OBJECTIVE: The aim of this study was to examine the impact of pharmacy automation on the workload and satisfaction of pharmacists and pharmacy assistants in an inpatient setting. METHODS: This was an observational, cross-sectional survey using a convenience sampling method conducted at the University Malaya Medical Centre (UMMC) In-Patient Pharmacy. A validated online questionnaire assessed user satisfaction and task duration. RESULTS: A total of 21 pharmacists and 18 pharmacy assistants participated in the survey...

INTRODUCTION: Long duty times are common in the aviation industry, especially with the introduction of ultra long range flights (ULR). This article aims to compare the subjective fatigue assessment and concentration ability of flight crews with objective concentration and alertness tests during (U)LR-flights. METHOD: The study examined different (U)LR-flights. Before, during and after the flights subjective fatigue and concentration ability of the flight crew was examined with visual analog scale and objective attention and concentration ability with the FAIR-2 test respectively the 3-min Psychomotor Vigilance Test...

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Introduction Pain management is a crucial aspect of patients' perioperative journey and a fundamental duty of every anesthetist. Throughout anesthesia training, there is an emphasis on the management of critical incidents, several of which surround pain management. With changes to the anesthesia curriculum over recent years, variable exposure to training opportunities, and a reduction in clinical hours during training, many trainees report feeling underprepared for their future roles as consultants. However, pain management remains a small fragment of the core anesthesia curriculum with no pain-focused simulation courses currently available across the UK...

With the continuous promotion of urbanization in China, the economic level of small and medium-sized cities has been further improved. The transportation industry is crucial in promoting urban-rural integration and construction. Still, motor vehicle emissions also bring air pollution problems to cities, with heavy-duty diesel vehicle emissions severely impacting the urban environment. This study used a bottom-up approach to analyze the spatial emission characteristics of heavy-duty diesel vehicles under different road types in Kunming, a typical medium-sized city in China...

OBJECTIVES: Mathematical models of human neurobehavioral performance that include the effects of acute and chronic sleep restriction can be key tools in assessment and comparison of work schedules, allowing quantitative predictions of performance when empirical assessment is impractical. METHODS: Using such a model, we tested the hypothesis that resident physicians working an extended duration work roster, including 24-28 hours of continuous duty and up to 88 hours per week averaged over 4weeks, would have worse predicted performance than resident physicians working a rapidly cycling work roster intervention designed to reduce the duration of extended shifts...

PURPOSE: India has the highest burden of preterm/low birth weight newborns. To tackle this, Kangaroo Mother Care (KMC) needs to be scaled up. We did a quality improvement (QI) study to increase KMC coverage to 80% and its utilization to at least 4 h/infant/day. METHODS: This study was conducted at a stepdown ward (KMC ward) of a tertiary care teaching institute over a period of four months. All babies with birth weight <2.5 kg were eligible. The QI team included faculty in-charge, one senior resident and three senior staff nurses...