Accessibility and demand at an Emergency Care Unit: the user's perspective

AIM: To analyze the search for Emergency Care (EC) in the Western Health District of Ribeirão Preto (São Paulo), in order to identify the reasons why users turn to these services in situations that are not characterized as urgencies and emergencies. METHODS: A qualitative and descriptive study was undertaken. A guiding script was applied to 23 EC users, addressing questions related to health service accessibility and welcoming, problem solving, reason to visit the EC and care comprehensiveness. RESULTS: The subjects reported that, at the Primary Health Care services, receiving care and scheduling consultations took a long time and that the opening hours of these services coincide with their work hours. At the EC service, access to technologies and medicines was easier. CONCLUSION: Primary health care services have been unable to turn into the entry door to the health system, being replaced by emergency services, putting a significant strain on these services' capacity.

Prevalence of burnout among surgical residents and surgeons in Switzerland

Burnout is a pathologic reaction in response to long-term work-related stress. The aim of this study was 2-fold: first, to assess the prevalence and degree of burnout among surgical residents and surgeons in Switzerland and, second, to identify predictors of burnout in the surgical community. Four hundred five of 618 anonymous questionnaires (65.5%) were returned. Among respondents, 3.7% and 35.1% showed high and moderate degrees of burnout, respectively. Respondents with high and moderate degrees of burnout had higher summary scores of perceived stress (P < .001). In multiple logistic regression analysis, the strongest predictors of burnout were poor interaction with nurses, disturbances due to telephone consultations, and high overall workload. To reduce burnout, new work models should be sought, in addition to decreasing work intensity and workload rather than restricting work hours alone.

Resident work hour restrictions do not improve patient safety in surgery: a critical appraisal based on 7 years of experience in Switzerland

In 2005 the Swiss government implemented new work-hour limitations for all residency programs in Switzerland, including a 50-hour weekly limit. The reduction in the working hours of doctors in training implicate an increase in their rest time and suggest an amelioration of doctors' clinical performance and consequently in patients' outcomes and safety - which was not detectable in a preliminary study at a large referral center in Switzerland. It remains elusive why work-hour restrictions did not improve patient safety. We are well advised to thoroughly examine and eliminate the known adverse effects of reduced work-hours to improve our patients' safety.

Morbidity in surgery: impact of the 50-hour work-week limitation in Switzerland

Work-hour regulations for residency programmes in Switzerland, including a 50-hour weekly limit, were set in on 1 January 2005. Patient safety was one of the major arguments for the implementation. As the effect of the restriction of residency work hours on patient care in Switzerland has not yet been evaluated on objective data, the aim of the present study was to assess its impact by comparing the patients' morbidity and mortality before (2001-2004) and after (2005-2008) the implementation.

Wellness and Obesity: Implications for Health Care Costs Among Restaurant Managers

Overeating, inadequate exercise, work-related stress, and long working hours are accepted issues among restaurant managers. The underlying question was whether such life styles affect employers' health care cost and restaurant managers' health and ability to cope with imposed business requirements. The author discusses strategies to help employers reduce health care costs, increase employee productivity, and improve job satisfaction.

Animal Farm, Baby Boom and Crackberry Addicts

[Excerpt] In this chapter, we draw from both popular media and research support, along with anecdotal examples drawn from conversations accumulated as part of our own prior studies. Our goal is to present reminders that working hours are a personal life choice, even with external demands, but a choice that is influenced by elements of the individual’s working situation. The implications of a choice for long working hours are shown through use of two past “hard working” icons from popular media, one from the 1940s and one from the 1980s. Discussion continues into current time with an overview highlighting advances in technology that provide expanded work opportunities but, also, exacerbate tendencies toward work addiction.

Avaliação do impacto de poluentes estrogénicos em peixes

Dissertação de Mestrado, Biologia Marinha, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Prevalencia y factores asociados al síndrome de agotamiento profesional en residentes de diferentes especialidades médicas : una revisión de la literatura de los últimos 15 años

El Síndrome de Agotamiento Profesional (SAP), es común en los trabajadores de la salud, particularmente en los expuestos a altos niveles de estrés en el trabajo e incluye el agotamiento emocional, despersonalización y baja realización personal. Se considera que los médicos residentes presentan una mayor prevalencia del síndrome que los médicos debido a que se encuentran en entrenamiento, período en el cual están sometidos a alta carga laboral debido a las largas horas de trabajo, horarios irregulares, privación de sueño, intensas demandas emocionales, así como la presión de dominar un gran conocimiento clínico. Objetivo. Determinar la prevalencia del Síndrome de Agotamiento Profesional o Burnout en la población de médicos residentes. Metodología. Se realizó una búsqueda de artículos en la base de datos electrónica Pubmed, seleccionando aquellos publicados entre los años 2001 al 2016, tanto en idioma inglés como en español, a texto completo y enfocados en estudios en médicos residentes. Resultados. Los hallazgos sugieren que el Síndrome de Agotamiento Profesional o Burnout es altamente prevalente, que varía de acuerdo a la residencia que se esté realizando, encontrando un promedio del 50% con un rango de 27% a 75% entre las diferentes especialidades de la población estudiada y, en consecuencia, puede constituir un problema de salud que amerita atención en cada Institución, esto a pesar de que la prevalencia pueda variar de un lugar a otro y en las diferentes especialidades. Conclusiones. El SAP o Burnout constituye un problema de salud entre la población de médicos residentes, lo que sugiere la conveniencia de diseñar medidas para su prevención como informar en la inducción al programa de residencia sobre el riesgo de la aparición del síndrome y sus síntomas, consultar tempranamente ante signos de alarma, adecuar el sistema de vigilancia epidemiológica para que incluya esta condición específica y ajustar o disminuir la carga laboral entre otras.

Rostering ambulance services

This paper developed a model for rostering ambulance crew in order to maximise the coverage throughout a planning horizon and minimise the number of ambulance crew. Rostering Ambulance Services is a complex task, which considers a large number of conflicting rules related to various aspects such as limits on the number of consecutive work hours, the number of shifts worked by each ambulance staff and restrictions on the type of shifts assigned. The two-stage models are developed using nonlinear integer programming technique to determine the following sub-problems: the shift start times; the number of staff required to work for each shift; and a balanced schedule of ambulance staff. At the first stage, the first two sub-problems have been solved. At the second stage, the third sub-problem has been solved using the first stage outputs. Computational experiments with real data are conducted and the results of the models are presented.

Eat, drink and be civil : sociability and the cafe

The article investigates the ascendency of the cafe in the current period of urbanism. I suggest that “going for a coffee” is less about coffee and more about how we connect with others in a mobile world, when flexible work hours are increasingly the norm and more people are living alone than any other period in history. The café also plays a role in the development of civil discourse and civility, and plays an important role in the development of cosmopolitan civil societies.

Strategies for rapid congestion recovery using ramp metering

This research investigated strategies for motorway congestion management from a different angle: that is, how to quickly recover motorway from congestion at the end of peak hours, given congestion cannot be eliminated due to excessive demand during the long peak hours nowadays. The project developed a zone recovery strategy using ramp metering for rapid congestion recovery, and a serious of traffic simulation investigations were included to evaluate the developed strategy. The results, from both microscopic and macroscopic simulation, demonstrated the effectiveness of the zone recovery strategy.

A ramp metering strategy for rapid congestion recovery

Recurrent congestion caused by high commuter traffic is an irritation to motorway users. Ramp metering (RM) is the most effective motorway control means (M Papageorgiou & Kotsialos, 2002) for significantly reducing motorway congestion. However, given field constraints (e.g. limited ramp space and maximum ramp waiting time), RM cannot eliminate recurrent congestion during the increased long peak hours. This paper, therefore, focuses on rapid congestion recovery to further improve RM systems: that is, to quickly clear congestion in recovery periods. The feasibility of using RM for recovery is analyzed, and a zone recovery strategy (ZRS) for RM is proposed. Note that this study assumes no incident and demand management involved, i.e. no re-routing behavior and strategy considered. This strategy is modeled, calibrated and tested in the northbound model of the Pacific Motorway, Brisbane, Australia in a micro-simulation environment for recurrent congestion scenario, and evaluation results have justified its effectiveness.

The National Road Safety Partnership Program providing a pathway for any business/organisation to create a positive road safety culture

The National Road Safety Partnership Program (NRSPP) is an industry-led collaborative network which aims to support Australian businesses in developing a positive road safety culture. It aims to help businesses to protect their employees and the public, not only during work hours, but also when their staff are ‘off-duty’. How do we engage and help an organisation minimise work-related vehicle crashes and their consequences both internally, and within the broader community? The first step is helping an organisation to understand the true cost of its road incidents. Larger organisations often wear the costs without knowing the true impact to their bottom line. All they perceive is the change in insurance or vehicle repairs. Understanding the true cost should help mobilise a business’s leadership to do more. The next step is ensuring the business undertakes an informed, structured, evidence-based pathway which will guide them around the costly pitfalls. A pathway based around the safe system approach with buy-in at the top which brings the workforce along. The final step, benchmarking, allows the organisation to measure and track its change. This symposium will explore the pathway steps for organisations using NRSPP resources to become engaged in road safety. The 'Total Cost of Risk' calculator has been developed by Zurich, tested in Europe by Nestle and modified by NRSPP for Australia. This provides the first crucial step. The next step is a structured approach through the Workplace Road Safety Guide using experts and industry to discuss the preferred safe system approach which can then link into the national Benchmarking Project. The outputs from the symposium can help frame a pathway for organisations to follow through the NRSPP website.

Publishing in the Networked World: Transforming the Nature of Communication, 14th International Conference on Electronic Publishing 16-18 June 2010, Helsinki, Finland

The title of the 14th International Conference on Electronic Publishing (ELPUB), “Publishing in the networked world: Transforming the nature of communication”, is a timely one. Scholarly communication and scientific publishing has recently been undergoing subtle changes. Published papers are no longer fixed physical objects, as they once were. The “convergence” of information, communication, publishing and web technologies along with the emergence of Web 2.0 and social networks has completely transformed scholarly communication and scientific papers turned to living and changing entities in the online world. The themes (electronic publishing and social networks; scholarly publishing models; and technological convergence) selected for the conference are meant to address the issues involved in this transformation process. We are pleased to present the proceedings book with more than 30 papers and short communications addressing these issues. What you hold in your hands is a by-product and the culmination of almost a Year long work of many people including conference organizers, authors, reviewers, editors and print and online publishers. The ELPUB 2010 conference was organized and hosted by the Hanken School of Economics in Helsinki, Finland. Professors Turid Hedlund of Hanken School of Economics and Yaşar Tonta of Hacettepe University Department of Information Management (Ankara, Turkey) served as General Chair and Program Chair, respectively. We received more than 50 submissions from several countries. All submissions were peer-reviewed by members of an international Program Committee whose contributions proved most valuable and appreciated. The 14th ELPUB conference carries on the tradition of previous conferences held in the United Kingdom (1997 and 2001), Hungary (1998), Sweden (1999), Russia (2000), the Czech Republic (2002), Portugal (2003), Brazil (2004), Belgium (2005), Bulgaria (2006), Austria (2007), Canada (2008) and Italy (2009). The ELPUB Digital Library, http://elpub.scix.net serves as archive for the papers presented at the ELPUB conferences through the years. The 15th ELPUB conference will be organized by the Department of Information Management of Hacettepe University and will take place in Ankara, Turkey, from 14-16 June 2011. (Details can be found at the ELPUB web site as the conference date nears by.) We thank Marcus Sandberg and Hannu Sääskilahti for copyediting, Library Director Tua Hindersson – Söderholm for accepting to publish the online as well as the print version of the proceedings. Thanks also to Patrik Welling for maintaining the conference web site and Tanja Dahlgren for administrative support. We warmly acknowledge the support in organizing the conference to colleagues at Hanken School of Economics and our sponsors.

Study on flow characteristics of solid/liquid system in lysozyme crystal growth

During the process of lysozyme protein crystallization with batch method, the macroscopic flow field of solid/liquid system was observed by particle image velocimetry (PIV). Furthermore, a normal growth rate of (110) face and local flow field around a single protein crystal were obtained by a long work distance microscope. The experimental results showed that the average velocity, the maximal velocity of macroscopic solid/liquid system and the velocity of local flow field around single protein crystal were fluctuant. The effective boundary layer thickness delta(eff), the concentration at the interface Q and the characteristic velocity V were calculated using a convection-diffusion model. The results showed that the growth of lysozyme crystal in this experiment was dominated by interfacial kinetics rather than bulk transport, and the function of buoyancy-driven flow in bulk transport was small, however, the effect of bulk transport in crystal growth had a tendency to increase with the increase of lysozyme concentration. The calculated results, also showed that the order of magnitude of shear force was about 10(-21) N, which was much less than the bond force between the lysozyme molecules. Therefore the shear force induced by buoyancy-driven flows cannot remove the protein molecules from the interface of crystal.