The Effect of Night Duty of Pharmacists on Sleepiness and Concentration at Daytime

Hintergrund: In Deutschland ist seit Jahren ein Rückgang von Apotheken und Apothekern zu beobachten, der insbesondere ländliche Regionen trifft. Dies führt zu der Übernahme zusätzlicher Aufgaben und Dienstschichten durch den Apothekenleiter, was wiederum zu Schlafmangel und Überlastung führt. Das Ziel der vorliegenden Studie war es daher, anhand der Tagesschläfrigkeit und Konzentrationsfähigkeit von Apothekern nach einem Nachdienst die Auswirkungen dieser Entwicklung zu evaluieren. Methode: An der Studie nahmen 22 Apotheker und Apothekerinnen teil. Für jeden Teilnehmer wurde die Tagesschläfrigkeit und Konzentrationsfähigkeit nach einer Dienstnacht und nach einer Kontrollnacht ohne Dienst gemessen und verglichen. Die Aktivität während der Nacht wurde mittels Aktigraphie erfasst, die Tagesschläfrigkeit anhand der Epworth Schläfrigkeits-Skala (ESS) und der Karolinska Schläfrigkeits-Skala (KSS), und die Konzentrationsfähigkeit anhand des d2-R-Tests. Ergebnisse: Die aktimetrischen Daten unterschieden sich signifikant zwischen der Dients- und Kontrollnacht, mit einer kürzeren Schlafzeit, höherer Motilität und geringerer Schlafeffizienz in der Dienstnacht. Die Tagesschläfrigkeit nach einer Dienstnacht war gegenüber der Kontrollnacht erhöht: Auf der neunstufigen KSS erreichten die Teilnehmer nach der Kontrollnacht einen Durchschnittswert von 2,4, nach einer Dienstnacht einen Wert von 6,8. Der ESS-Wert nach der Kontrollnacht lag durchschnittlich bei 2,1 und somit im Normbereich, nach einer Dienstnacht bei 11,6 und außerhalb des Normbereichs. Auch die Konzentrationsfähigkeit war durch die Dienstnacht beeinträchtigt: Die Teilnehmer machten im Vergleich zur Kontrollnacht deutlich mehr Verwechslungsfehler im d2R-Test, erkannten weniger Zielobjekte und hatten eine doppelt so hohe Fehlerquote. Schlussfolgerungen: Die Ergebnisse dieser Pilotstudie demonstrieren, dass eine Nachtschicht zu Tagesschläfrigkeit von Apothekern beitragen und die Konzentration während der Tagesschicht herabsetzen kann. Dies weist auf einen Handlungsbedarf bezüglich der Arbeitssicherheit von Apothekern hin, um die Patientensicherheit zu gewährleisten und die Gesundheit des Apothekers im Arbeitsumfeld zu fördern.Background: A decline in pharmacies and pharmacists has been observed in Germany for years, affecting rural regions in particular. This leads to the pharmacy manager taking on additional tasks and duty shifts, which in turn causes sleep deprivation and burnout. Therefore, the aim of the present study was to evaluate the effects of this development on the basis of pharmacists' daytime sleepiness and ability to concentrate after a night shift. Methods: 22 male and female pharmacists participated in the study. For each participant, daytime sleepiness and concentration ability were measured after a night on duty and after a control night off duty. Activity during the night was assessed using actigraphy, daytime sleepiness using the Epworth Sleepiness Scale (ESS) and the Karolinska Sleepiness Scale (KSS), and concentration ability using the d2-R test. Results: Actimetric data differed significantly between the duty and control nights, with shorter sleep time, higher motility, and lower sleep efficiency on the duty night. Daytime sleepiness after a night shift was increased compared with the control night: On the nine-item KSS, participants scored an average of 2.4 after the control night and 6.8 after a night on duty. The ESS score averaged 2.1 after the control night, which was within the normal range, and 11.6 after a night on duty, which was outside the normal range. Concentration was also impaired by the night shift: Participants made significantly more confusion errors on the d2R test compared to the control night, recognized fewer targets, and the error rate was twice as high. Conclusions: The results of this pilot study demonstrate that a night shift can contribute to daytime sleepiness in pharmacists and decrease concentration during the day shift. This indicates a need for action regarding pharmacist work safety to promote the pharmacist’s health in the work environment and ensure patient safety

FE-Analysis of end-notched beams and tenon joints – J-Integral versus cohesive zone modelling

Improved wood-based materials, on the one hand, and computer-operated machinery, on the other, enable new types of timber-to-timber joints. Furthermore, new materials, such as laminated veneer lumber with cross-layers made of soft- or hardwood offer new possibilities regarding timber-to-timber connections like tenon and mortise. Experimental investigations have shown comparable failure mechanisms in mode I and mode II for tenon and multiple tenon joints, dovetail connections as well as for end-notched beams. In the field of fracture mechanics different concepts exists to describe the fracture behaviour such as the strain energy release rate, the stress intensity factors and the J-integral method for timber-to-timber joints. In this study the J-integral was determined around the crack tip in a finite element (FE) model in timber connections. The failure criterion was defined when the J-integral equals the energy release rate GcI+II in mixed mode of the timber material (Fig. 1a). A sensitivity analysis showed that the failure load Vc was not depending significantly on the initial crack length, the element size, the distance from the crack tip of the chosen contour Γ1 and the size of the chosen contour. In the next step, the model was validated on experimental test results of end-notched beams, tenon connections and multiple tenon connections (Fig. 1b). The experimental and numerical results showed very good accordance for different connection size and up to seven possible crack layers (Fig. 1c). Furthermore, a comparison between different fracture mechanic models with strain energy release rates and cohesive zones showed good performance of the new approach. Afterwards, the FE model using the J-integral failure criterion was used to perform a comprehensive study of geometrical parameters for end-notched beams and tenon connections. Finally, the dataset was used as a basis to develop a engineering model for three types of timber connections. The evaluation of the J-integral allows to determine the failure load due to crack initiation under a mixed mode loading in a linear elastic FE model with pre-defined cracks. The advantage of the J-integral method is the significant decrease of the computing time for extensive parameter studies. The model for end-notched beams, tenon joints and multiple tenon connections is insensitive to common variations of material properties as well as for the choice of the initial crack length. The application on timber structures under pure shear failure or tension failure perpendicular to the grain will be part of future research

DESIGN OF A USER CHARGE FOR HEAVY-DUTY VEHICLES ON GERMAN MOTORWAYS CONSIDERING THE OBJECTIVES OF EFFICIENCY, FAIRNESS AND ENVIRONMENTAL PROTECTION

The German government plans to introduce a kilometre charge on motorways for heavy duty vehicles "12t, beginning in the year 2003. According to an EU Directive the charge has to be orientated to the average infrastructure costs and can be differentiated according to the environmental performance (“EURO Standard”) of the vehicles. Based on the possible differentiation of the user charge this paper analyses the probable impacts on the transport market and on basic environmental indicators. Three scenarios are constructed: first, a modest user charge only on motorways; second, a higher user charge on the whole network of federal roads with a given level of service of the railways; and third, the previous scenario combined with an improved level of service of the railways. The result is that only in the case of the third scenario the hope of environmental policy is realistic that road transport can be reduced and environmental quality significantly improved through a road user charging scheme. Document type: Articl

The Effect of Night Duty of Pharmacists on Sleepiness and Concentration at Daytime

Background: The changing responsibilities of pharmacists contribute to a lack of qualified pharmacists to fill vacant positions, particularly in rural areas. Consequently, pharmacy managers cover various duties, including an increasing number of nights being on duty that can impair daytime concentration and performance. The objective of the study was to assess the effect of night duties on daytime sleepiness, sleep quality, and concentration abilities of pharmacists. Methods: 22 pharmacists, both sexes, aged 27 to 60 years, were recruited and their sleep time, sleep efficiency, and mobility (actigraphy) were assessed during a night on duty and a control night using an actimetry. Daytime sleepiness and concentration were assessed using standardized questionnaires (ESS, KSS, d2‐R). Results: Significant differences were observed between the night shift and control nights with respect to sleep time, sleep efficiency, and mobility. Daytime sleepiness was significantly increased after night shifts (ESS: 11.64 vs. 2.09; KSS: 6.77 vs. 2.41 after a night shift and control night, respectively; p < 0.001) and concentration diminished compared to control nights (d2‐R KL: 220.95 vs. 260.36 after a night shift and control night, respectively; p < 0.001). Conclusions: The results provide evidence that night duties lead to high daytime sleepiness in pharmacists, which in turn may negatively affect their ability to concentrate and their error rate. Existing regulations on emergency pharmacy services should be reconsidered regarding the safety of the pharmaceutical supply.Peer Reviewe

Получение желаемых передаточных функций импульсных систем автоматического управления

Рассмотрена задача получения желаемых передаточных функций импульсных систем автоматического управления. Предложен способ синтеза передаточных функций низкого порядка по прямым показателям качества, обеспечивающий конечное время переходного процесса

MITOCHONDRIENFUNKTIONSSTÖRUNGEN BEI MYOPATHIEN UND DEGENERATIVEN ZNS-ERKRANKUNGEN

Als im Jahre 1890 erstmals kleine Organellen in einer Zelle beschrieben wurden, die in Größe und Form den Bakterien sehr ähnlich waren, wußte man noch nichts von der Bedeutung dieser sogenannten Mitochondrien. Zunehmend aber wurde erkannt, daß die Mitochondrien für bestimmte Stoffwechselprozesse zuständig sind, insbesondere für solche der Energiebereitstellung. Die Mitochondrienforschung der letzten Jahre förderte dazu bisher völlig unbekannte Eigenschaften zutage, die die Mitochondrien interessant machen im Hinblick auf den Zelltod, für die Vererbungslehre, für die klinische Medizin oder auch für die Gerichtsmedizin. Daß die Mitochondrien bis heute aktueller Forschungsgegenstand sind, beweist eindrucksvoll die Märzausgabe 1999 der hochrangigen internationalen Fachzeitschrift „Science“ (Abb. 1), in der der mitochondrialen Forschung sogar ein Comeback bescheinigt wird

Edificio RW1 - Dusseldorf - Alemania Federal

This office building has 14 levels on the grade and a basement designed as a car park. The ground and first floors, which are larger in area, form a platform on which two twelve-storey towers are erected, with an irregular perimeter. In the architectural whole, the treatment of the façades stands out, in shiny aluminium plates, which, together with the accentuated movement of volumes and the slenderness of the construction —given by the relation established between the elongated narrow floors and the great height of the building — give the whole an attractive appearance, which can be seen from a great distance.Este edificio de oficinas se compone de catorce niveles sobre rasante y un sótano destinado a aparcamiento de automóviles. Las plantas baja y primera, de mayor extensión y superficie, conforman una plataforma sobre la que se elevan dos torres de doce plantas, de perímetro irregular. En el conjunto arquitectónico se destaca el tratamiento de las fachadas en placas de aluminio brillante, que con el pronunciado movimiento de volúmenes y la esbeltez de la construcción — dada por la relación establecida entre las plantas estrechas y alargadas y la gran altura de la edificación — otorgan al conjunto un atractivo aspecto, apreciable desde gran distancia

Spatial normalization for voxel-based lesion symptom mapping: impact of registration approaches

BackgroundVoxel-based lesion symptom mapping (VLSM) assesses the relation of lesion location at a voxel level with a specific clinical or functional outcome measure at a population level. Spatial normalization, that is, mapping the patient images into an atlas coordinate system, is an essential pre-processing step of VLSM. However, no consensus exists on the optimal registration approach to compute the transformation nor are downstream effects on VLSM statistics explored. In this work, we evaluate four registration approaches commonly used in VLSM pipelines: affine (AR), nonlinear (NLR), nonlinear with cost function masking (CFM), and enantiomorphic registration (ENR). The evaluation is based on a standard VLSM scenario: the analysis of statistical relations of brain voxels and regions in imaging data acquired early after stroke onset with follow-up modified Rankin Scale (mRS) values.Materials and methodsFluid-attenuated inversion recovery (FLAIR) MRI data from 122 acute ischemic stroke patients acquired between 2 and 3 days after stroke onset and corresponding lesion segmentations, and 30 days mRS values from a European multicenter stroke imaging study (I-KNOW) were available and used in this study. The relation of the voxel location with follow-up mRS was assessed by uni- as well as multi-variate statistical testing based on the lesion segmentations registered using the four different methods (AR, NLR, CFM, ENR; implementation based on the ANTs toolkit).ResultsThe brain areas evaluated as important for follow-up mRS were largely consistent across the registration approaches. However, NLR, CFM, and ENR led to distortions in the patient images after the corresponding nonlinear transformations were applied. In addition, local structures (for instance the lateral ventricles) and adjacent brain areas remained insufficiently aligned with corresponding atlas structures even after nonlinear registration.ConclusionsFor VLSM study designs and imaging data similar to the present work, an additional benefit of nonlinear registration variants for spatial normalization seems questionable. Related distortions in the normalized images lead to uncertainties in the VLSM analyses and may offset the theoretical benefits of nonlinear registration

Det digitale Danmark – et statistisk portræt

I denne artikel tegner vi et statistisk portræt af det digitale Danmark baseret på statistik fra Energistyrelsen, Eurostat og Danmarks Statistik. De nyeste tal fra Eurostat er fra 2019, mens tallene fra Danmarks Statistik er fra 2020. Der kan derfor være forskel i perioderne, der indgår i artiklen. I det første afsnit belyses den digitale infrastruktur, der er grundstenen for et velfungerende digitalt samfund. For at udnytte de muligheder, en solid digital infrastruktur med hurtige internetforbindelser giver, er det en forudsætning, at befolkningen har de nødvendige digitale færdigheder. Det ses der nærmere på i det andet afsnit. Artiklens sidste afsnit omhandler befolkningens digitale adfærd