Sleep and recovery in physicians on night call: a longitudinal field study

<p>Abstract</p> <p>Background</p> <p>It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call.</p> <p>Methods</p> <p>Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons.</p> <p>Results</p> <p>Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p < 0.001). Scores for mental fatigue and feeling well rested were poorer post-call, but returned to Sunday morning levels after two nights' sleep.</p> <p>Conclusions</p> <p>Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.</p

Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

<p>Abstract</p> <p>Background</p> <p>The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between <it>job satisfaction </it>and <it>motivation</it>. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance.</p> <p>Methods</p> <p>A previously developed and validated instrument addressing four work-related motivators (<it>job attributes, remuneration, co-workers and achievements</it>) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables.</p> <p>Results</p> <p>The survey revealed that <it>achievements </it>was ranked first among the four main motivators, followed by <it>remuneration</it>, <it>co-workers </it>and <it>job attributes</it>. The factor <it>remuneration </it>revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p < 0.005). The medical staff showed statistically significantly lower job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups.</p> <p>Conclusions</p> <p>The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.</p

Evaluating housing quality, health and safety using an Internet-based data collection and response system: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Typically housing and health surveys are not integrated together and therefore are not representative of population health or national housing stocks. In addition, the existing channels for distributing information about housing and health issues to the general public are limited. The aim of this study was to develop a data collection and response system that would allow us to assess the Finnish housing stock from the points of view of quality, health and safety, and also to provide a tool to distribute information about important housing health and safety issues.</p> <p>Methods</p> <p>The data collection and response system was tested with a sample of 3000 adults (one per household), who were randomly selected from the Finnish Population Register Centre. Spatial information about the exact location of the residences (i.e. coordinates) was included in the database inquiry. People could participate either by completing and returning a paper questionnaire or by completing the same questionnaire via the Internet. The respondents did not receive any compensation for their time in completing the questionnaire.</p> <p>Results</p> <p>This article describes the data collection and response system and presents the main results of the population-based testing of the system. A total of 1312 people (response rate 44%) answered the questionnaire, though only 80 answered via the Internet. A third of the respondents had indicated they wanted feedback. Albeit a majority (>90%) of the respondents reported being satisfied or quite satisfied with their residence, there were a number of prevalent housing issues identified that can be related to health and safety.</p> <p>Conclusions</p> <p>The collected database can be used to evaluate the quality of the housing stock in terms of occupant health and safety, and to model its association with occupant health and well-being. However, it must be noted that all the health outcomes gathered in this study are self-reported. A follow-up study is needed to evaluate whether the occupants acted on the feedback they received. Relying solely on an Internet-based questionnaire for collecting data would not appear to provide an adequate response rate for random population-based surveys at this point in time.</p

A change in the optical polarization associated with a gamma-ray flare in the blazar 3C 279

It is widely accepted that strong and variable radiation detected over all accessible energy bands in a number of active galaxies arises from a relativistic, Doppler-boosted jet pointing close to our line of sight. The size of the emitting zone and the location of this region relative to the central supermassive black hole are, however, poorly known, with estimates ranging from light-hours to a light-year or more. Here we report the coincidence of a gamma-ray flare with a dramatic change of optical polarization angle. This provides evidence for co-spatiality of optical and gamma-ray emission regions and indicates a highly ordered jet magnetic field. The results also require a non-axisymmetric structure of the emission zone, implying a curved trajectory for the emitting material within the jet, with the dissipation region located at a considerable distance from the black hole, at about 10^5 gravitational radii.Comment: Published in Nature issued on 18 February 2010. Corresponding authors: Masaaki Hayashida and Greg Madejsk

Which health professionals are most at risk for cardiovascular disease? Or do not be a manager

Objectives: Health care workers constitute a high-risk occupational category owing to the character of their work that includes high-risk environment, shift work and mental as well as physical stress. In occupational medicine, caring for their health condition should be a priority and include measures aimed at preventing cardiovascular diseases. The study aimed at determining the prevalence of cardiovascular disease (CVD) risk factors in employees of a large hospital and assessing their effect on the incidence of cardiovascular events. Materials and Methods: The group comprised 3124 employees with a mean age of 36.1 years (SD = 11.4), out of whom 562 were males (mean age of 37.1 years, range: 18-72; SD = 12.26) and 2562 were females (mean age of 35.9 years, range: 18-68; SD = 11.24). At their initial examination, the employees filled in a questionnaire on basic CVD risk factors (according to valid recommendations). This was supplemented with objective data to determine the risk of CVD using valid charts. From this group, a subset of persons at a high or intermediate risk was selected, comprising 247 individuals with a mean age of 54.1 years (SD = 5.73). After 5-9 years (mean 7.24±1.38 years), they either underwent another examination or their health status was ascertained by phone or in a computer database. The end point was the incidence of cardiovascular events (sudden death, acute myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, cardiac failure, stroke or transient ischemic attack). Results: The end point was noted in a total of 15 males (6.07%) and 6 females (2.42%), being statistically significantly present in managers (males p < 0.00007, females p < 0.00001), male physicians/surgeons (p < 0.025), tertiary-educated males (p < 0.0095), female smokers (p < 0.015), male ex-smokers (p < 0.007), overweight or obese males (p < 0.02) and those with the waist-to-hip ratio above 1.0 (p < 0.005). Conclusions: Cardiovascular events are most likely to occur in obese male physicians/surgeons holding managerial positions and in female managers

Detection of X-Ray Polarization from the Blazar 1ES 1959+650 with the Imaging X-Ray Polarimetry Explorer

Observations of linear polarization in the 2-8 keV energy range with the Imaging X-ray Polarimetry Explorer (IXPE) explore the magnetic field geometry and dynamics of the regions generating nonthermal radiation in relativistic jets of blazars. These jets, particularly in blazars whose spectral energy distribution peaks at X-ray energies, emit X-rays via synchrotron radiation from high-energy particles within the jet. IXPE observations of the X-ray-selected BL Lac-type blazar 1ES 1959+650 on 2022 May 3-4 showed a significant linear polarization degree of Πx = 8.0% ± 2.3% at an electric-vector position angle ψ x = 123° ± 8°. However, on 2022 June 9-12, only an upper limit of Πx ≤ 5.1% could be derived (at the 99% confidence level). The degree of optical polarization at that time, ΠO ∼ 5%, is comparable to the X-ray measurement. We investigate possible scenarios for these findings, including temporal and geometrical depolarization effects. Unlike some other X-ray-selected BL Lac objects, there is no significant chromatic dependence of the measured polarization in 1ES 1959+650, and its low X-ray polarization may be attributed to turbulence in the jet flow with dynamical timescales shorter than 1 day

X-Ray Polarization of the BL Lacertae Type Blazar 1ES 0229+200

We present polarization measurements in the 2-8 keV band from blazar 1ES 0229+200, the first extreme high synchrotron peaked source to be observed by the Imaging X-ray Polarimetry Explorer (IXPE). Combining two exposures separated by about two weeks, we find the degree of polarization to be ΠX = 17.9% ± 2.8% at an electric-vector position angle ψ X = 25.°0 ± 4.°6 using a spectro-polarimetric fit from joint IXPE and XMM-Newton observations. There is no evidence for the polarization degree or angle varying significantly with energy or time on both short timescales (hours) or longer timescales (days). The contemporaneous polarization degree at optical wavelengths was >7× lower, making 1ES 0229+200 the most strongly chromatic blazar yet observed. This high X-ray polarization compared to the optical provides further support that X-ray emission in high-peaked blazars originates in shock-accelerated, energy-stratified electron populations, but is in tension with many recent modeling efforts attempting to reproduce the spectral energy distribution of 1ES 0229+200, which attribute the extremely high energy synchrotron and Compton peaks to Fermi acceleration in the vicinity of strongly turbulent magnetic fields

The X-Ray Polarization View of Mrk 421 in an Average Flux State as Observed by the Imaging X-Ray Polarimetry Explorer

Particle acceleration mechanisms in supermassive black hole jets, such as shock acceleration, magnetic reconnection, and turbulence, are expected to have observable signatures in the multiwavelength polarization properties of blazars. The recent launch of the Imaging X-Ray Polarimetry Explorer (IXPE) enables us, for the first time, to use polarization in the X-ray band (2-8 keV) to probe the properties of the jet synchrotron emission in high-synchrotron-peaked BL Lac objects (HSPs). We report the discovery of X-ray linear polarization (degree pi(x) = 15% +/- 2% and electric vector position angle psi (x) = 35 degrees +/- 4 degrees) from the jet of the HSP Mrk 421 in an average X-ray flux state. At the same time, the degree of polarization at optical, infrared, and millimeter wavelengths was found to be lower by at least a factor of 3. During the IXPE pointing, the X-ray flux of the source increased by a factor of 2.2, while the polarization behavior was consistent with no variability. The higher level of pi(x) compared to longer wavelengths, and the absence of significant polarization variability, suggest a shock is the most likely X-ray emission site in the jet of Mrk 421 during the observation. The multiwavelength polarization properties are consistent with an energy-stratified electron population, where the particles emitting at longer wavelengths are located farther from the acceleration site, where they experience a more disordered magnetic field

IXPE observation of PKS 2155–304 reveals the most highly polarized blazar

We report the X-ray polarization properties of the high-synchrotron-peaked (HSP) blazar PKS 2155−304 based on observations with the Imaging X-ray Polarimetry Explorer (IXPE). We observed the source between Oct 27 and Nov 7, 2023. We also conducted an extensive contemporaneous multiwavelength (MW) campaign. We find that during the first half (T1) of the IXPE pointing, the source exhibited the highest X-ray polarization degree detected for an HSP blazar thus far, (30.7 ± 2.0)%; this dropped to (15.3 ± 2.1)% during the second half (T2). The X-ray polarization angle remained stable during the IXPE pointing at 129.4° ±1.8° and 125.4° ±3.9° during T1 and T2, respectively. Meanwhile, the optical polarization degree remained stable during the IXPE pointing, with average host-galaxy-corrected values of (4.3 ± 0.7)% and (3.8 ± 0.9)% during the T1 and T2, respectively. During the IXPE pointing, the optical polarization angle changed achromatically from ∼140° to ∼90° and back to ∼130°. Despite several attempts, we only detected (99.7% conf.) the radio polarization once (during T2, at 225.5 GHz): with degree (1.7 ± 0.4)% and angle 112.5° ±5.5°. The direction of the broad pc-scale jet is rather ambiguous and has been found to point to the east and south at different epochs; however, on larger scales (> 1.5 pc) the jet points toward the southeast (∼135°), similarly to all of the MW polarization angles. Moreover, the X-ray-to-optical polarization degree ratios of ∼7 and ∼4 during T1 and T2, respectively, are similar to previous IXPE results for several HSP blazars. These findings, combined with the lack of correlation of temporal variability between the MW polarization properties, agree with an energy-stratified shock-acceleration scenario in HSP blazars