Influence of shift work on the physical work capacity of Tunisian nurses: a cross-sectional study in two university hospitals

Introduction: This study has been performed to determine the influence of rotating shift work on physical working capacity of Tunisian nurses and to design recommendations to managers so that they implement effective preventive measures. Methods: It is a cross-sectional design using a standardized questionnaire and many physical capacity tests on a representative sample of 1181 nurses and nursing assistants from two university hospital centers of the school of Medicine of Monastir located in the Tunisian Sahel. 293 participants have been recruited by stratified random sampling according to gender and departments. Maximum Grip strength, 30s sit-to-stand test, one leg test, Fingertip-to-Floor test, Saltsa test and peak expiratory flow were used to assess physical capacity. Work ability was assessed through the workability index.Results: Mental and physical loads were heavily perceived in shift healthcare workers (p=0.01; p=0.02). The maximum grip force was stronger in rotating shift work nurses (p=0.0001). Regarding to the seniority subgroups in each kind of work schedule, the Body Mass Index was increasing with seniority in both schedules. All the physical tests, were better in less-than-ten-year groups. Peak Flow and grip strength were significantly better in less-than-tenyear seniority in shift work group. Conclusion: There is a need to improve the design of the existing shift systems and to reduce as much as possible shift schedule as well as to avoid shift schedule for over-10-year-seniority nurses

Magnetic resonance texture parameters are associated with ablation efficiency in MR-guided high-intensity focussed ultrasound treatment of uterine fibroids

OBJECTIVES: The objective of this study is to assess the association between texture parameter analysis derived from T2-weighted images and efficiency of magnetic resonance-guided focussed ultrasound (MRgFUS) ablation for the treatment of uterine fibroids. MATERIALS AND METHODS: Fifty-five women treated by MRgFUS were included in this retrospective analysis. Texture parameters were calculated using three 2D regions of interest placed on three consecutive slices on the same sagittal 3D T2-weighted images obtained at the beginning of MRgFUS ablation. Using uni- and multi-variate linear regression, texture parameters, fibroids/muscular T2W ratio (T2Wr), Funaki type, and fibroid depth were correlated with ablation efficiency, defined as the ratio of non-perfused volume (NPV) on post-treatment contrast-enhanced MRI by total volume of treatment-cell sizes used. Inter-rater reproducibility for texture analysis was assessed using variation coefficients. RESULTS: The mean total treatment cell volume was 49.5 (±30) ml, corresponding to a mean NPV of 57.2 (±57) ml (28%). The mean ablation efficiency was 1.14 (±0.7), with a range of 0.03-3.6. In addition to fibroid/muscular T2Wr, seven of the 14 texture parameters were significantly correlated with ablation efficiency: mean signal intensity (p = .047); Skewness (p = .03); Kurtosis (p = .015); mean uniformity (p = .052); mean sum of square (p = .045); mean sum entropy (p = .021) and mean entropy (p = .051). In multivariate linear regression, fibroid/muscular T2Wr and sum of entropy were associated with ablation efficiency. The inter-rater coefficient of variation for sum entropy was 2.6%. CONCLUSIONS: Uterine fibroid texture parameters provide complementary information to T2Wr, and are associated with MRgFUS efficiency. Key points Mean sum entropy is negatively correlated with MRgFUS efficiency (ρ = -0.307, p = .021). Fibroids/muscular T2-weighted ratio and entropy are associated with MRgFUS efficiency. Texture parameters are better predictors of MRgFUS efficiency than Funaki type. Fibroid MR texture analysis can improve patient selection for MRgFUS