Survey of shift and work tolerance of City of Houston emergency medical service personnel

This study of ambulance workers for the emergency medical services of the City of Houston studied the factors related to shiftwork tolerance and intolerance. The EMS personnel work a 24-hour shift with rotating days of the week. Workers are assigned to A, B, C, D shift, each of which rotate 24-hours on, 24-hours off, 24-hours on and 4 days off. One-hundred and seventy-six male EMTs, paramedics and chauffeurs from stations of varying levels of activity were surveyed. The sample group ranged in age from 20 to 45. The average tenure on the job was 8.2 years. Over 68% of the workers held a second job, the majority of which worked over 20 hours a week at the second position.^ The survey instrument was a 20-page questionnaire modeled after the Folkard Standardized Shiftwork Index. In addition to demographic data, the survey tool provided measurements of general job satisfaction, sleep quality, general health complaints, morningness/eveningness, cognitive and somatic anxiety, depression, and circadian types. The survey questionnaire included an EMS-specific scaler of stress.^ A conceptual model of Shiftwork Tolerance was presented to identify the key factors examined in the study. An extensive list of 265 variables was reduced to 36 key variables that related to: (1) shift schedule and demographic/lifestyle factors, (2) individual differences related to traits and characteristics, and (3) tolerance/intolerance effects. Using the general job satisfaction scaler as the key measurement of shift tolerance/intolerance, it was shown that a significant relationship existed between this dependent variable and stress, number of years working a 24-hour shift, sleep quality, languidness/vigorousness. The usual amount of sleep received during the shift, general health complaints and flexibility/rigidity (R$\sp2$ =.5073).^ The sample consisted of a majority of morningness-types or extreme-morningness types, few evening-types and no extreme-evening types, duplicating the findings of Motohashi's previous study of ambulance workers. The level of activity by station was not significant on any of the dependent variables examined. However, the shift worked had a relationship with sleep quality, despite the fact that all shifts work the same hours and participate in the same rotation schedule. ^

Workflow Interruptions and Failed Action Regulation in Surgery Personnel

Background Workflow interruptions during surgery may cause a threat to patient's safety. Workflow interruptions were tested to predict failure in action regulation that in turn predicts near-accidents in surgery and related health care. Methods One-hundred-and-thirty-three theater nurses and physicians from eight Swiss hospitals participated in a cross-sectional questionnaire survey. The study participation rate was 43%. Results Structural equation modeling confirmed an indirect path from workflow interruptions through cognitive failure in action regulation on near-accidents (p < 0.05). The indirect path was stronger for workflow interruptions by malfunctions and task organizational blockages compared with workflow interruptions that were caused by persons. The indirect path remained meaningful when individual differences in conscientiousness and compliance with safety regulations were controlled. Conclusion Task interruptions caused by malfunction and organizational constraints are likely to trigger errors in surgery. Work redesign is recommended to reduce workflow interruptions by malfunction and regulatory constraints.

La rupture saussurienne. L'espace du langage

Cet ouvrage propose une lecture radicalement nouvelle de la pensée saussurienne, fondée sur la reconnaissance de la distinction entre langue et idiome instaurée par la théorie saussurienne de la langue. Cette distinction, qui a été recouverte par l'ensemble de la linguistique postsaussurienne, ouvre l'espace du langage comme espace de théorisation. Une lecture qui donne lieu à une reconsidération des rapports entre linguistique et psychanalyse ainsi que de la question de la neurolinguistique.

Les Antilles et la représentation de l'espace transatlantique chez Maryse Condé

Si Maryse Condé, écrivain française originaire de la Guadeloupe, semble s’être sentie chez elle dans l’ensemble du monde atlantique (elle a résidé aux Antilles, en France, aux Etats-Unis, en Afrique), ainsi certaines de ses œuvres, alors même qu’elles prennent pour cadre de référence les Antilles, témoignent d’une rare capacité à s’approprier tout l’espace atlantique, que ce soit à travers les mouvements réels, libres ou forcés, des protagonistes ou au contraire par le biais de leurs souvenirs et rêveries. L’analyse des Derniers rois mages (1992), en particulier, nous permettra de dégager l’originalité de Maryse Condé en ce qui concerne la représentation de cet espace – espace non plus organisé en fonction des cartographies imaginaires figées fournies par l’impérialisme, la « négritude » ou la « créolité », mais traversé par une dynamique exploratoire, multifocale et non fusionnelle.

Exil, espace et frontières dans l'oeuvre de Milan Kundera

Milan Kundera emigrierte 1975 nach Frankreich. Der Zeitpunkt seiner Emigration trifft mit jenem zusammen, in dem sich in seiner Arbeit Überlegungen zu Exil, Grenzen und Raum entwickeln. In seinen politischen Schriften hebt er die Veränderung der europäischen Grenzen nach dem Zweiten Weltkrieg hervor sowie den Umstand, dass sich die Tschechoslowakei und Zentraleuropa in der Sowjetunion im „Exil“ befinden. In seinen Exilromanen bewegen sich die Figuren zwischen heimischem und exilischem Raum, und diese territoriale Grenzüberschreitung wird systematisch von einem metaphysischen Grenzübergang begleitet. Schliesslich zeigt Kundera in seinen Erwägungen zur Literatur, dass literarische Werke, um in ihrer ganzen Vielfalt berücksichtigt zu werden, in anderen Kulturräumen als ihrem eigenen zirkulieren müssen. Diese „Reise“ durch Kunderas Werk wird uns denn auch dazu bringen, über mögliche paradigmatische Figuren des zeitgenössischen Exils nachzudenken.

Introduction to disaster epidemiology for public health personnel

There has been a renewed interest in disaster epidemiology after the World Trade Center and Pentagon terrorist attacks of 2001, the devastation of Hurricane Katrina and the overwhelming loss of life that resulted from the tsunami that originated in the Indian Ocean and struck Indonesia and other adjacent countries on December 26, 2004. Institutions that have accepted the challenge of training the next generation of public health professionals as well as to continue the education of the dedicated professionals already serving in public health fields have a responsibility to train practitioners in the basic principles of disaster epidemiology as well as in practical applications of these principles. This culminating experience project involved developing an on-line course complete with the background information as well as relevant case studies that can be used as a curriculum for an introductory course in disaster epidemiology. ^

EXPOSURE OF PHARMACY PERSONNEL TO ANTINEOPLASTIC DRUGS

This dissertation consists of two parts: (1) Exposure of pharmacy personnel to antineoplastic drugs. The Salmonella reversion test was used to measure the mutagenic activities of urine concentrates from individuals preparing antineoplastic drugs for intravenous administration. Longitudinal studies were performed in which the total urine produced in 24-hour periods was collected, starting on a Sunday at 7 P.M. after a duty-free weekend and extending over an eight-day period. There was no detectable increase in mutagenic activity in the urine concentrates of three pharmacy administrators who had no contact with these drugs. All six individuals admixing drugs in open-faced, horizontal laminar flow hoods displayed a two-fold increase in mutagenesis by the fourth day with peak values of 2.7 to 24-fold occurring on days five and six, reduced values by day seven with a return to the spontaneous level by day eight. When four of the six positive individuals in the preceding experiment admixed comparable amounts of antineoplastic drugs in a closed-faced, vertical laminar flow hood, no increase in mutagenic activity was detected in their urine concentrates over the eight-day period. (2) Estimate of potential carcinogenic risks of antineoplastic drugs. Excision repair is the major repair system that is involved with the elimination of chemically induced DNA (deoxyribonucleic acid) lesions. This DNA excision repair capability increases in mammalian species with longer life span such as humans. In this study, the effect of functional DNA excision repair on the mutagenesis invoked by 17 antineoplastic drugs was determined by using a Salmonella/Microsome assay which was expanded to include some uvr('+) counterparts of the excisionless (uvrB) tester strains routinely employed. Although extrapolation cannot be made from bacteria to humans, one should be able to make a qualitative comparison as to which antineoplastic drugs are more potentially carcinogenic to humans based on the effects of excision repair on their mutagenesis in bacteria. The tested antineoplastic drugs were divided into three classes: those requiring excision repair for mutagenesis; those producing nonrepairable genetic damage; and those producing mostly repairable premutational DNA lesions. ^