4 research outputs found
Self-reporting of internal medicine house staff work hours.
INTRODUCTION: The 80-hour workweek became a reality for residency programs nationwide on July 1, 2003. In this review of administrative data, we examine the self-reporting of work hours by a cohort of Internal Medicine residents. METHODS: Data was collected from 27 residents in training at Tripler Army Medical Center over a 4 month period from September 1 to December 31 2002. House staff reported their hours on a daily basis by responding to an email message, as well as on a monthly basis utilizing the Army's UCAPERs (Uniform Chart of Account Personnel System) mandatory monthly workload tracking system. Data from the two separate reporting systems was compared for accuracy, completeness and internal consistency. RESULTS: Compliance with daily reporting was variable (67-97% with overall compliance rate of 86%) but lower when compared with the mandatory military monthly reporting system (95-100%). There were large differences in reporting of average weekly work hours among individual residents when monthly reporting was compared to daily reporting of data with higher averages with monthly data reporting. Weekly totals averaged nearly 12 hours higher when reported monthly compared to reporting on a daily basis (p < 0.0001). A total of 18 residents reported that they worked more than 80 hours per week during one month using monthly data, while only 7 reported that they averaged more than 80 hours with the daily reporting data. When average weekly hours reported on a daily basis were compared with the total number of inpatient days worked over the four month period using a simple regression model, there was a significant relationship with average hours increasing with increasing number of inpatient days worked (adjusted R square = 0. 19, p = 0.01). CONCLUSIONS: Little internal consistency was found in the comparison of daily versus monthly work hour reporting, indicating that self-reporting may not provide accurate data. Complying with the 80-hour workweek is crucial for residency programs to maintain accreditation, and thus programs will need a way to accurately capture consistent resident work hour data. Further studies are indicated to determine the most accurate way of assessing house staff work hours
Do alexithymic individuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample
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Host factors are associated with vaginal microbiome structure in pregnancy in the ECHO Cohort Consortium
Using pooled vaginal microbiota data from pregnancy cohorts (N = 683 participants) in the Environmental influences on Child Health Outcomes (ECHO) Program, we analyzed 16S rRNA gene amplicon sequences to identify clinical and demographic host factors that associate with vaginal microbiota structure in pregnancy both within and across diverse cohorts. Using PERMANOVA models, we assessed factors associated with vaginal community structure in pregnancy, examined whether host factors were conserved across populations, and tested the independent and combined effects of host factors on vaginal community state types (CSTs) using multinomial logistic regression models. Demographic and social factors explained a larger amount of variation in the vaginal microbiome in pregnancy than clinical factors. After adjustment, lower education, rather than self-identified race, remained a robust predictor of L. iners dominant (CST III) and diverse (CST IV) (OR = 8.44, 95% CI = 4.06–17.6 and OR = 4.18, 95% CI = 1.88–9.26, respectively). In random forest models, we identified specific taxonomic features of host factors, particularly urogenital pathogens associated with pregnancy complications (Aerococcus christensenii and Gardnerella spp.) among other facultative anaerobes and key markers of community instability (L. iners). Sociodemographic factors were robustly associated with vaginal microbiota structure in pregnancy and should be considered as sources of variation in human microbiome studies