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Kinds of Hours Terms modified by Hours Selected AbstractsEffect of Snow Cover Conditions on the Hydrologic Regime: Case Study in a Pluvial-Nival Watershed, Japan,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 4 2008Andrew C. Whitaker Abstract:, Hydrologic monitoring in a small forested and mountainous headwater basin in Niigata Prefecture has been undertaken since 2000. An important characteristic of the basin is that the hydrologic regime contains pluvial elements year-round, including rain-on-snow, in addition to spring snowmelt. We evaluated the effect of different snow cover conditions on the hydrologic regime by analyzing observed data in conjunction with model simulations of the snowpack. A degree-day snow model is presented and applied to the study basin to enable estimation of the basin average snow water equivalent using air temperature at three representative elevations. Analysis of hydrological time series data and master recession curves showed that flow during the snowmelt season was generated by a combination of ground water flow having a recession constant of 0.018/day and diurnal melt water flow having a recession constant of 0.015/hour. Daily flows during the winter/snowmelt season showed greater persistence than daily flows during the warm season. The seasonal water balance indicated that the ratio of runoff to precipitation during the cold season (December to May) was about 90% every year. Seasonal snowpack plays an important role in defining the hydrologic regime, with winter precipitation and snowmelt runoff contributing about 65% of the annual runoff. The timing of the snowmelt season, indicated by the date of occurrence of the first significant snowmelt event, was correlated with the occurrence of low flow events. Model simulations showed that basin average snow water equivalent reached a peak around mid-February to mid-March, although further validation of the model is required at high elevation sites. [source] Alleviation of Pulmonary Hypertension by Cardiac Resynchronization Therapy is Associated with Improvement in Central Sleep ApneaPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2008KAI-HANG YIU M.B.B.S. Background: Recent studies have demonstrated that cardiac resynchronization therapy (CRT) reduces sleep apnea in heart failure (HF); however, the mechanism of benefit remains unclear. Methods: Overnight polysomnography (PSG) was performed in consecutive HF patients who were scheduled for CRT implant. Patients with sleep apnea defined by an apnea-hypopnea index (AHI) of >10/hour were recruited and underwent echocardiogram examination at baseline and 3 months after CRT. Results: Among 37 HF patients screened, 20 patients (54%) had sleep apnea and 15 of them consented for the study. After 3 months of CRT, there was a significant improvement in New York Heart Association functional class (3.1 ± 0.1 vs 2.1 ± 0.1, P < 0.01), quality-of-life (QoL) score (62.9 ± 3.3 vs 56.1 ± 4.5, P = 0.02), left ventricular ejection fraction (LVEF, 28.8 ± 2.5% vs 38.1 ± 2.3%, P < 0.01), and reduction in pulmonary artery systolic pressure (PASP, 41.0 ± 2.7 vs 28.6 ± 2.2 mmHg; P < 0.01) compared with baseline. Repeated PSG after CRT demonstrated a reduction in the duration of arterial oxygen desaturation ,95% (251.2 ± 36.7 vs 141.0 ± 37.1 minutes), AHI (27.5 ± 4.7 vs 18.1 ± 3.0, P = 0.05), and number of central sleep apnea (CSA) (7.8 ± 2.6 vs 3.0 ± 1.3/hour, P = 0.03), but not number of obstructive sleep apnea (OSA, 8.6 ± 3.3 vs 7.2 ± 2.3/hour, P = 0.65) compared to baseline. Percentage change in PASP was significantly correlated with percentage changes in LVEF (r=,0.57, P = 0.04), AHI (r = 0.5, P = 0.05), and number of CSA episodes (r = 0.55, P = 0.02). Conclusions: The results demonstrated that CRT significantly reduces CSA in patients with HF. Importantly, we have noted a decrement of PASP correlated to drop in CSA which maybe one of the mechanisms explaining this observation. Future studies are required to confirm our finding and elucidate other possible mechanisms in this regard. [source] Surface Cooling for Rapid Induction of Mild Hypothermia After Cardiac Arrest: Design Determines EfficacyACADEMIC EMERGENCY MEDICINE, Issue 4 2010Thomas Uray MD Abstract Objectives:, Recently, a novel cooling pad was developed for rapid induction of mild hypothermia after cardiac arrest. The aim of this study was to evaluate the cooling efficacy of three different pad designs for in-hospital cooling. Methods:, Included in this prospective interventional study were patients with esophageal temperature (Tes) > 34°C on admission. The cooling pad consists of multiple cooling units, filled with a combination of graphite and water, which is precooled to ,18°C (design A) or to ,9°C (designs B and C) before use. The designs of the cooling pad differed in number, shape, and thickness of the cooling units, with weights of 9.7 kg (design A), 5.3 kg (design B), and 6.2 kg (design C). All three designs were tested in sequential order and were changed according to the results found in the previous trial. Cooling was started after admission until Tes = 34°C, when the cooling pad was removed. The target temperature of Tes = 32,34°C was maintained for 24 hours. Data are presented as medians and interquartile ranges (IQRs = 25%,75%) or proportions. Results:, Cooling rates were 3.4°C/hour (IQR = 2.5,3.7) with design A (n = 12), 2.8°C/hour (IQR = 1.6,3.3) with design B (n = 7), and 2.9°C/hour (IQR = 1.9,3.6) with design C (n = 10; p = 0.5). To reach 34°C, the cooling pad had to be exchanged with a new one due to melting and therefore depleting cooling capacity in three patients with design A, in five patients with design B, and in no patient with design C (p = 0.004). Conclusions:, With adequate design and storage temperature, the cooling pad proved to be efficient for rapid in-hospital cooling of patients resuscitated from cardiac arrest. ACADEMIC EMERGENCY MEDICINE 2010; 17:360,367 © 2010 by the Society for Academic Emergency Medicine [source] Increased Ventricular Ectopic Activity in Relation to C-Reactive Protein, and NT-Pro-Brain Natriuretic Peptide in Subjects With No Apparent Heart DiseasePACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2006AHMAD SAJADIEH M.D. Background: Subjects with frequent ventricular premature complexes (VPC) and no apparent heart disease make a heterogenic group with regard to prognosis. Some biomarkers have recently proved useful in risk stratification in different heart diseases. We examined prognostic impact of NT-Pro-brain natriuretic peptide (NT-Pro BNP), and C-reactive protein (CRP) in relation to frequent VPC in subjects with no apparent heart disease. Methods: Six hundred seventy-eight healthy subjects between 55 and 75 years of age with no history of cardiovascular disease were included in the study. All were tested with fasting laboratory testing and 48-hour ambulatory ECG monitoring. Frequent VPC was defined as VPC ,30/hour. Results: In 56 subjects (8%) with frequent VPC the prognosis was much poorer compared to those without frequent VPC (Hazard ratio and 95% CI: 2.3;1.2,4.4, P = 0.01), after adjustment for conventional risk factors. In subjects with frequent VPC increased levels of CRP (above 2.5 ,g/mL) was the only factor among the tested biomarkers, which was associated with a poor prognosis. Taking subjects without frequent VPC as reference, the hazard ratio and 95% CI for subjects with frequent VPC and increased CRP was 3.6;1.8,7.1, P = 0.0004, and for those with frequent VPC and normal CRP 0.8;0.2,3.5, P = 0.83, after correction for conventional risk factors. Conclusions: Among middle-aged and elderly subjects with no apparent heart disease and frequent VPCs, a CRP value ,2.5 ,g/mL is associated with a significantly higher risk of death and acute myocardial infarction. These subjects deserve primary prevention measures and further work up for structural heart disease. [source] Effects of glucose polymer with and without potassium and different diets on glycogen repletion after a treadmill exercise test in endurance horsesJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 11-12 2005T. M. Hess Glycogen repletion involves absorption of glucose and its uptake into the muscle cells through GLUT-4 transporters. In the muscle and adipose tissue GLUT,4 transporters facilitates the glucose transport in the presence of insulin and K+. Potassium supply has been shown to stimulate insulin secretion. This study tested the effects of a glucose polymer added with electrolytes containing potassium (GP+K) compared to a glucose polymer with electrolytes without potassium (GP-K) on glycogen repletion. Also it compared the effect of different diet adaptations on glycogen repletion. Six horses were fed a diet rich in sugar and starch (SS), and six horses a diet rich in fat and fibre (FF) for 6 months before the test. In a crossover designed study, 12 trained Arabian or Arabian cross horses were submitted to a glycogen depleting exercise test on the treadmill. After exercise stopped six horses were supplied with GP-K and six other horses supplied with GP+K, at a dose of 5 g/kg BW, and a rate of 1 g/kg BW/hour through naso-gastric gavage. Muscle biopsies were taken before, just after they stopped exercise, and 16 h after they had been supplied with glycogen replacing formulas, and analysed for muscle glycogen. Blood was taken before, after 3 h of exercise, after the stepwise exercise test, at 0, 1 and 4 h after exercise stopped and analysed for plasma glucose, insulin and [K+]. Muscle glycogen decreased from 516.41 ± 12.92 glucosyl units/kg dry weight muscle to 408.74 ± 12.92 glucosyl units/kg dry weight muscle (79%). Sixteen hours after the repletion protocol horses recovered their muscle glycogen to 458.53 ± 12.91 glucosyl units/kg dry weight muscle (89%). Plasma glucose had a glucose polymer by sampling effect (p = 0.013) and a feed by sampling effect (p = 0.022). Plasma glucose was higher in SS fed horses at 1 and 4 h after exercise. Plasma glucose was lower in GP+K supplied horses 4 h after exercise. Plasma insulin had a trend (p = 0.070) for a glucose polymer effect. No differences were found in muscle glycogen between the two GP treatments. Although the present results demonstrate that intensive nasogastric supplementation with glucose polymer can result in glycogen repletion approaching that following i.v. administration, the addition of potassium conferred no advantage. [source] WAGES, HOURS OF WORK AND JOB SATISFACTION OF RETIREMENT-AGE WORKERS,THE JAPANESE ECONOMIC REVIEW, Issue 2 2005ISAO OHASHI I analyse, theoretically and empirically, the effects of pension benefits, family conditions and the personal characteristics of older individuals on their labour supply, wages, hours worked and job satisfaction, in the framework of the Nash bargaining condition whereby an older worker and a firm bargain over employment conditions such as wages, hours of work and job investment. It is stressed that as workers become older they tend to give greater priority to the number of hours worked, work environment and type of job than to wages, and try to improve these through job investment, even at the cost of lower wages. [source] The early identification of dyslexia: Children with English as an additional languageDYSLEXIA, Issue 3 2004Jane M. Hutchinson Abstract It is generally accepted that dyslexia should be identified early for interventions to have maximum effect. However, when children speak English as an additional language (EAL), diagnosis is more complex and there is concern that these children tend to be under-identified. This paper reports a longitudinal study following the development of phonological awareness skills in relation to progress in learning to read with a cohort of British Asian children learning EAL and their monolingual peers. It also sought to determine the usefulness of a measure of phonological skills for the identification of dyslexic-type difficulties in children learning EAL. Analysis revealed that both cohorts achieved similar levels of reading accuracy in school Years 2, 4 and 6, with higher levels of reading comprehension for the monolingual children and faster reading fluency for children learning EAL in each school year. There was a similar pattern of relationships between the reading measures and measures of phonological awareness for both groups of children. However, monolingual children achieved higher levels of rhyme detection and alliteration fluency whilst the children learning EAL achieved faster number naming times. Overall, a phonological assessment battery was useful in identifying reading accuracy related difficulties in both groups of children. However, concerns are raised about the sensitivity of such measures following the introduction of the Literacy Hour. Copyright © 2004 John Wiley & Sons, Ltd. [source] Does the Model of Language in the National Literacy Strategy Create Failure for Pupils from Differing Language Backgrounds?ENGLISH IN EDUCATION, Issue 2 2002Pamela King Abstract The National Literacy Strategy (NLS) was introduced by the government in the wake of the hotly debated issue of falling educational standards in the UK. All schools were required to adopt the NLS Literacy Hour unless they could show their preferred programme would result in raised levels of achievement. My experience of delivering the Literacy Hour has been a process of adaptation to the needs of my pupils, who are drawn mainly from groups whose language backgrounds differ from that which is dominant in school. I have found that the requirements of NLS, together with many of the commercial resources used to teach it, are not appropriate for pupils from these groups and a question arose: is it the pupils who are in some way deficient or is it the approach and the resources being used? This article takes a case study of the use of a commercially produced resource to explore the model of language implicit in NLS, the kinds of resources it generates and the ways in which this creates failure in pupils from different language backgrounds. It then considers the New Literacy Studies and their implications for an alteration in our approach. [source] Writing Process and Progress: Where Do We Go from Here?ENGLISH IN EDUCATION, Issue 1 2001Mary Hilton Abstract This article examines the rationale behind the government's methods for raising standards in writing at Key Stage 2. Firstly there is a renewed drive to teach discrete units of sentence grammar. Secondly there is a fresh commitment to shared and guided writing. But, because it is envisaged that these teacher-led sessions will take up at least half of the Literacy Hour two or three times a week, both these aims will lead to a diminution of time for written composition by the children themselves. This is in accordance with new criticisms by NLS policy makers of the model of ,process' embedded in the National Curriculum, particularly the idea of creative pre-writing activities and sustained independent writing. The article goes on to argue that these new measures ignore research on the ways children learn to write and will not lead to a rise in standards. [source] Predictors of Survival 1 Hour After Implantation of an Intra-aortic Balloon Pump in Cardiac SurgeryJOURNAL OF CARDIAC SURGERY, Issue 1 2001Harald Hausmann M.D. From July 1996 to March 2000, 391 patients with intraoperative cardiac lowoutput syndrome who underwent surgery with heart-lung bypass and had an intre-aortic balloon pump (IABP) Implanted were analyzed in a prospective study. Of these 391 patients, 153 (39%) were operated on in an emergency situation, and 238 (61%) patients had elective surgeries. The perioperative mortality was 34% (133 patients). Clinical parameters were analyzed 1 hour after IABP support began. Statistical multivariate analysis showed that patients with an adrenaline requirement higher than 0.5 ,g/kg/min, a left mrial pressure higher then 15 mmHg, output of less than 100 mL/hour, and mixed venous saturation (SvO2) of less then 60% had poor outcomes. Using this data, we developed an IABP score to predict survival early after IABP implantation in cardiac surgery. We conclude that the success or failure of perioperative IABP support can be predicted early after implantation of the balloon pump. In patients with low-output syndrome despite IABP support, implantation of a vantricular assist system should be considered. [source] Accreditation and the Credit HourNEW DIRECTIONS FOR HIGHER EDUCATION, Issue 122 2003Jane V. Wellman Accreditation, the process of peer review to ensure the quality of a degree program, has depended on institutions measuring degree content in student credit hours. [source] Beyond the 50-Minute Hour: Increasing Control, Choice, and Connections in the Lives of Low-Income WomenAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2010Lisa A. Goodman Although poverty is associated with a range of mental health difficulties among women in this country, mainstream mental health interventions are not sufficient to meet the complex needs of poor women. This article argues that stress, powerlessness, and social isolation should become primary targets of our interventions, as they are key mediators of the relationship between poverty and emotional distress, particularly for women. Indeed, if ways are not found to address these conditions directly, by increasing women's control, choice, and connections, the capacity to improve the emotional well-being of impoverished women will remain limited at best. This is the first of 5 articles that comprise a special section of the American Journal of Orthopsychiatry, called "Beyond the 50-Minute Hour: Increasing Control, Choice, and Connections in the Lives of Low-Income Women." Together, these articles explore the nature and impact of a range of innovative mental health interventions that are grounded in a deep understanding of the experience of poverty. This introduction: (a) describes briefly how mainstream approaches fail to address the poverty-related mental health needs of low-income women; (b) illuminates the role of stress, powerlessness, and social isolation in women's lives; (c) highlights the ways in which the articles included in this special section address each of these by either adapting traditional mental health practices to attend to poverty's role in participants' lives or adapting community-based, social-justice-oriented interventions to attend to participants' mental health; and (d) discusses the research and evaluation implications of expanding mental health practices to meet the needs of low-income communities. [source] How inclusive is the Literacy Hour?BRITISH JOURNAL OF SPECIAL EDUCATION, Issue 3 2001Janice Wearmouth In this article, Janice Wearmouth and Janet Soler, both lecturers in the Faculty of Education and Language Studies at the Open University, explore the implications of recent Government initiatives for pupils who experience difficulties in literacy development. The authors focus, in particular, on their perceptions of the contradictions between the inclusive requirements of the National Curriculum and the prescriptive pedagogy of the National Literacy Strategy. The National Curriculum now requires teachers to respond to pupils' ,diverse learning needs'; the National Literacy Strategy is founded upon an expectation that all pupils in Key Stages 1 and 2 will be taught a daily Literacy Hour. This article explores the impact of these contrasting policies on classroom practice and concludes by drawing upon evidence of previously existing good practice in order to propose ways of resolving this dilemma. [source] An Evaluation of Flexible Workday Policies in Job Shops,DECISION SCIENCES, Issue 2 2002Kum-Khiong Yang ABSTRACT Job shops have long faced pressures for improvement in a challenging and volatile environment. Today's trends of global competition and shortening of product life cycles suggest that both the challenges and the intensity of market volatility will only increase. Consequently, the study of tactics for maximizing the flexibility and responsiveness of a job shop is important. Indeed, there is a significant body of literature that has produced guidelines on when and how to deploy tactics such as alternate routings for jobs and transfers of cross-trained workers between machines. In this paper we consider a different tactic by adjusting the length of workdays. Hours in excess of a 40-hour week are exchanged for compensatory time off at time and a half, and the total amount of accrued compensatory time is limited to no more than 160 hours in accordance with pending legislation. We propose several simple flexible workday policies that are based on an input/output control approach and investigate their performance in a simulated job shop. We find significant gains in performance over a fixed schedule of eight hours per day. Our results also provide insights into the selection of policy parameters. [source] Duty Hours in Emergency Medicine: Balancing Patient Safety, Resident Wellness, and the Resident Training Experience: A Consensus Response to the 2008 Institute of Medicine Resident Duty Hours RecommendationsACADEMIC EMERGENCY MEDICINE, Issue 9 2010Mary Jo Wagner MD Abstract Representatives of emergency medicine (EM) were asked to develop a consensus report that provided a review of the past and potential future effects of duty hour requirements for EM residency training. In addition to the restrictions made in 2003 by the Accreditation Council for Graduate Medical Education (ACGME), the potential effects of the 2008 Institute of Medicine (IOM) report on resident duty hours were postulated. The elements highlighted include patient safety, resident wellness, and the resident training experience. Many of the changes and recommendations did not affect EM as significantly as other specialties. Current training standards in EM have already emphasized patient safety by requiring continuous on-site supervision of residents. Resident fatigue has been addressed with restrictions of shift lengths and limitation of consecutive days worked. One recommendation from the IOM was a required 5-hour rest period for residents on call. Emergency department (ED) patient safety becomes an important concern with the decrease in the availability and in the patient load of a resident consultant that may result from this recommendation. Of greater concern is the already observed slower throughput time for admitted patients waiting for resident care, which will increase ED crowding and decrease patient safety in academic institutions. A balance between being overly prescriptive with duty hour restrictions and trying to improve resident wellness was recommended. Discussion is included regarding the appropriate length of EM training programs if clinical experiences were limited by new duty hour regulations. Finally, this report presents a review of the financing issues associated with any changes. ACADEMIC EMERGENCY MEDICINE 2010; 17:1004,1011 © 2010 by the Society for Academic Emergency Medicine [source] The effects of technology shocks on hours and output: a robustness analysisJOURNAL OF APPLIED ECONOMETRICS, Issue 5 2010Fabio Canova We analyze the effects of neutral and investment-specific technology shocks on hours and output. Long cycles in hours are removed in a variety of ways. Hours robustly fall in response to neutral shocks and robustly increase in response to investment-specific shocks. The percentage of the variance of hours (output) explained by neutral shocks is small (large); the opposite is true for investment-specific shocks. ,News shocks' are uncorrelated with the estimated technology shocks. Copyright © 2009 John Wiley & Sons, Ltd. [source] Sometimes Higher Heart Rate Variability Is Not Better Heart Rate Variability: Results of Graphical and Nonlinear AnalysesJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2005PHYLLIS K. STEIN Ph.D. Objective: To determine the prevalence and effect on traditional heart rate variability (HRV) indices of abnormal HRV patterns in the elderly. Methods: Hourly Poincaré plots and plots of spectral HRV from normal-to-normal interbeat intervals and hourly nonlinear HRV values were examined in a subset of 290 consecutive participants in the Cardiovascular Health Study. Only subjects in normal sinus rhythm with ,18 hours of usable data were included. Eligible subjects were 71 ± 5 years. During 7 years of follow-up, 21.7% had died. Hours were scored as normal (0), borderline (0.5), or abnormal (1) from a combination of plot appearance and HRV. Summed scores were normalized to 100% to create an abnormality score (ABN). Short-term HRV versus each 5th percentile of ABN was plotted and a cutpoint for markedly increased HRV identified. The t -tests compared HRV for subjects above and below this cutpoint. Cox regression evaluated the association of ABN and mortality. Results: Of 5,815 eligible hourly plots, 64.4% were normal, 14.5% borderline, and 21.1% abnormal. HR, SDNN, SDNNIDX, ln VLF and LF power, and power law slope did not differ by the cutpoint for increased short-term HRV, while SDANN and ln ULF power were significantly lower for those above the cutpoint. However, many HRV indices including LF/HF ratio and normalized LF and HF power were significantly different between groups (P < 0.001). Increased ABN was significantly associated with mortality (P = 0.019). Despite similar values for many HRV indices, being in the group above the cutpoint was significantly associated with mortality (P = 0.04). Conclusions: Abnormal HR patterns that elevate many HRV indices are prevalent among the elderly and associated with higher risk of mortality. Consideration of abnormal HRV may improve HRV-based risk stratification. [source] Pricing Behavior and the Response of Hours to Productivity ShocksJOURNAL OF MONEY, CREDIT AND BANKING, Issue 7 2007DOMENICO J. MARCHETTI pricing behavior; technology shocks; hours Recent contributions have suggested that technology shocks have a negative impact on hours, contrary to the prediction of standard flexible-price models of the business cycle. Some authors have interpreted this finding as evidence in favor of sticky-price models, while others have either extended flexible-price models or disputed the empirical finding itself. In this paper, we estimate a variety of alternative total factor productivity measures for a representative sample of Italian manufacturing firms and on average find a negative effect of productivity shocks on hours growth. More interestingly, using the reported frequency of price reviews, we show that the contractionary effect is stronger for firms with stickier prices and weaker or not significant for firms with more flexible prices. Price stickiness remains a crucial factor in shaping the response of hours after controlling for product storability or market power. [source] Non-stationary Hours in a DSGE ModelJOURNAL OF MONEY, CREDIT AND BANKING, Issue 6 2007YONGSUNG CHANG Bayesian econometrics; DSGE models; non-stationary hours The time series fit of dynamic stochastic general equilibrium (DSGE) models often suffers from restrictions on the long-run dynamics that are at odds with the data. Using Bayesian methods we estimate a stochastic growth model in which hours worked are stationary and a modified version with permanent labor supply shocks. If firms can freely adjust labor inputs, the data support the latter specification. Once we introduce frictions in terms of labor adjustment costs, the overall time series fit improves and the model specification in which labor supply shocks and hours worked are stationary is preferred. [source] International Experts' Perspectives on the State of the Nurse Staffing and Patient Outcomes LiteratureJOURNAL OF NURSING SCHOLARSHIP, Issue 4 2007Koen Van den Heede Purpose: To assess the key variables used in research on nurse staffing and patient outcomes from the perspective of an international panel. Design: A Delphi survey (November 2005-February 2006) of a purposively-selected expert panel from 10 countries consisting of 24 researchers specializing in nurse staffing and quality of health care and 8 nurse administrators. Methods: Each participant was sent by e-mail an up-to-date review of all evidence related to 39 patient-outcome, 14 nurse-staffing and 31 background variables and asked to rate the importance/usefulness of each variable for research on nurse staffing and patient outcomes. In two subsequent rounds the group median, mode, frequencies, and earlier responses were sent to each respondent. Findings: Twenty-nine participants responded to the first round (90.6%), of whom 28 (87.5%) responded to the second round. The Delphi panel generated 7 patient-outcome, 2 nurse-staffing and 12 background variables in the first round, not well-investigated in previous research, to be added to the list. At the end of the second round the predefined level of consensus (85%) was reached for 32 patient outcomes, 10 nurse staffing measures and 29 background variables. The highest consensus levels regarding measure sensitivity to nurse staffing were found for nurse perceived quality of care, patient satisfaction and pain, and the lowest for renal failure, cardiac failure, and central nervous system complications. Nursing Hours per Patient Day received the highest consensus score as a valid measure of the number of nursing staff. As a skill mix variable the proportion of RNs to total nursing staff achieved the highest consensus level. Both age and comorbidities were rated as important background variables by all the respondents. Conclusions: These results provide a snapshot of the state of the science on nurse-staffing and patient-outcomes research as of 2005. The results portray an area of nursing science in evolution and an understanding of the connections between human resource issues and healthcare quality based on both empirical findings and opinion. [source] Flexible work bundles and organizational competitiveness: a cross-national study of the European work contextJOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 8 2005Eleni T. Stavrou The present study explores the categorization of flexible work arrangements (FWAs) into bundles and their connection to organizational competitiveness in the European Union. The measures of competitiveness were performance, turnover, and absenteeism. Four moderators were used in the study, organization sector, industry sector, organization size, and organizational women-supportiveness. The analyses revealed four FWA Bundles, namely Non-Standard Work Patterns, Work Away from the Office, Non-Standard Work Hours and Work Outsourced. Non-Standard Work Patterns were found to be related to decreased turnover (in the private sector), while Work Away from the Office was related to improved performance and reduced absenteeism. Non-Standard Work Hours and Work Outsourced (within the public sector) were positively related to turnover, suggesting that these types are possibly not being used as true flexibility arrangements. Finally, post-hoc analysis revealed that Non-Standard Work Hours was related to increased performance only among Swedish organizations. Implications for management and future research are discussed. Copyright © 2005 John Wiley & Sons, Ltd. [source] Did the Tax Cuts Increase Hours of Work?KYKLOS INTERNATIONAL REVIEW OF SOCIAL SCIENCES, Issue 3 2000A Statistical Analysis of a Natural Experiment Effects on hours worked of cuts in the Swedish income taxes are analyzed using longtitudinal data that cover periods before and after a major tax reform in 1991. The results show that working males probably changed their hours very little as a result of reduced marginal tax rates, while women increased their hours in the order of 10 percent. One can thus conclude that the tax reforms increased gender inequality in workhours. Most of this effect comes directly from the tax changes and not through a change in the after tax net wage, a result that is not explained by a conventional myopic labor supply model with a static budget set. [source] Physicians' Labour Supply: The Wage Impact on Hours and Practice CombinationsLABOUR, Issue 4 2005Erik Magnus Sæther Increased wages is one instrument for boosting the hours provided by the personnel to the prioritized sub-markets. This study applies an econometric framework that allows for non-convex budget sets, non-linear labour supply curves and imperfect markets with institutional constraints. The labour supply decision is viewed as a choice from a set of discrete alternatives (job packages) in a structural labour supply model estimated on Norwegian micro data. An out-of-sample prediction is also presented and evaluated by means of a natural experiment. [source] Effect of the Amount of Hours Spent Studying on the Prevalence of Overactive Bladder in College WomenLUTS, Issue 2 2010Dong Gil SHIN Objectives: We conducted a questionnaire survey to access whether the amount of hours spent studying has an effect on the prevalence of OAB in college women. Methods: A total of 126 (63%; mean: 23.2 years) of 200 women participants completed the questionnaire. They were divided into two groups: group A (weekly studying hour >40 h) consisted of medical female students and group B (weekly studying hour <25 h) consisted of French literature woman students. The factors related to OAB were analyzed by the chi-squared test. Results: Of 126 respondents, the prevalence of OAB was prevalent in 38 (30.2%) women. There was significant difference in prevalence between the two groups: 7.0% for group A and 42.2% for group B. In group B, OAB prevalence was 66.7% for ,2 h, 41.2% for 2,,4 h, 46.5% for 4,,6 h, and >6 h was 23.5%. This survey showed that there is no relationship between the amount of hours spent studying and OAB. Conclusion: Although the amount of hours spent studying had no association with OAB in college women, OAB prevalence showed a decreasing pattern as the quantity of studying hour increases. Consequently, it is thought that the attitude toward study has more association with OAB than the quantity of studying hours. [source] Successful Cervical MR Scan in a Patient Several Hours after Pacemaker ImplantationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 10 2009DORITH GOLDSHER M.D. Recent data showed that patients with electrical implanted devices may under certain conditions be scanned safely by magnetic resonance imaging (MRI). The device must have been in place preferably for at least 4,8 weeks [Correction added after online publication 31-Aug-2009: number of weeks has been updated.] prior to MR imaging to allow healing and pacemaker pocket formation. We report on a patient with quadriplegia and suspected epidural hematoma referred for MR scan a day after he had a pacemaker implantation. The patient was also pacemaker-dependent. After considering the risk/benefit ratio in this patient, it was decided to perform the scan. The pacemaker was reprogrammed. MRI was performed under strict monitoring. A spinal cord contusion at the level of C1,3 was diagnosed. Based on the imaging findings no invasive procedure was done. Device interrogation found no change in sensing or pacing parameters or in the pacemaker's battery. At the end of the scan, the device was reprogrammed back to the initial settings. In this population, each scan should be discussed thoroughly and the risks to benefit ratio should be considered. Given appropriate precautions, in well-experienced imaging centers, MRI may be safely performed in patients with permanent cardiac electronic implantable devices. [source] Safety of Transesophageal Pacing for 24 Hours in a Canine ModelPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 7 2009D.A.C.V.I.M. Cardiology, HENRY W. GREEN III D.V.M. Background: Temporary epicardial pacing is often necessary following surgical correction of congenital heart disease. Epicardial pacing wires, while generally effective, can, however, become nonfunctional. Transesophageal atrial pacing (TEAP) can be a useful adjunct in this setting. The potential for esophageal damage with sustained TEAP is unknown. We assessed the safety of continuous (24 hours) TEAP by evaluating gross and histological changes to the esophagus in a canine model. Methods: Thirteen juvenile beagle dogs were fitted with a 4-Fr multipolar catheter placed transnasally into the esophagus to a level to sustain atrial capture. Pacing was established in nine dogs for 24 hours while four control dogs had catheters but no pacing stimulus applied. Paced dogs were divided into two groups: group A (n = 5) that were euthanized immediately and group B (n = 4) that were euthanized 7 days after the pacing period. Nonpaced dogs (group C, n = 4) were treated similar to group A. Gross and histological examination of the esophageal tissue was completed. Results: Gross and histological evidence of mild esophagitis was noted in dogs from groups A and C but not in dogs from group B. There was no evidence of esophageal stricture or fibrosis in any dog from any group. Conclusions: TEAP did not result in permanent esophageal changes after 24 hours of stimulation. Microscopic lesions of mild erosive esophagitis, seen after 24 hours of TEAP, were absent 7 days postpacing. Mechanical irritation from the catheter cannot be ruled out as a cause of these changes. [source] The Brief Pain Inventory and Its "Pain At Its Worst in the Last 24 Hours" Item: Clinical Trial Endpoint ConsiderationsPAIN MEDICINE, Issue 3 2010Thomas M. Atkinson PhD Abstract Context., In 2006, the United States Food and Drug Administration (FDA) released a draft Guidance for Industry on the use of patient-reported outcomes (PRO) Measures in Medical Product Development to Support Labeling Claims. This draft guidance outlines psychometric aspects that should be considered when designing a PRO measure, including conceptual framework, content validity, construct validity, reliability, and the ability to detect clinically meaningful score changes. When finalized, it may provide a blueprint for evaluations of PRO measures that can be considered by sponsors and investigators involved in PRO research and drug registration trials. Objective., In this review we examine the short form of the Brief Pain Inventory (BPI) and particularly the "pain at its worst in the last 24 hours" item in the context of the FDA draft guidance, to assess its utility in clinical trials that include pain as a PRO endpoint. Results and Conclusions., After a systematic evaluation of the psychometric aspects of the BPI, we conclude that the BPI and its "pain at its worst in the last 24 hours" item generically satisfy most key recommendations outlined in the draft guidance for assessing a pain-reduction treatment effect. Nonetheless, when the BPI is being considered for assessment of pain endpoints in a registration trial, sponsors and investigators should consult with the appropriate FDA division early during research design to discuss whether there is sufficient precedent to use the instrument in the population of interest or whether additional evaluations of measurement properties are advisable. [source] Effect of Different Concentrations of Ascorbic Acid on Motility, Membrane Integrity and Chromatin Status of Frozen-Thawed Canine Spermatozoa Within Six Hours of Storage at 37°CREPRODUCTION IN DOMESTIC ANIMALS, Issue 2009K Eulenberger Contents The aim of this study was to examine comprehensively the effect of ascorbic acid (Asc) on frozen-thawed canine semen. Pooled ejaculates (n = 10) were assessed for quality with a computer-assisted sperm analyser (CASA). After centrifugation, the semen was divided into four aliquots (A,D) of which three were diluted with Uppsala 1 extender (v/v) containing different concentrations of Asc (B: 6.8 mmol/l; C: 13 mmol/l; D: 27 mmol/l). One group without Asc served as control (A). Subsequently, dilution samples were treated and cryopreserved as described previously (Theriogenology 66, 2006, 173). After thawing, samples were stored at 37°C for 1, 3 and 6 h, then examined for quality (CASA, flow cytometry, sperm chromatin structure assay; SCSA). Staining for flow cytometry was performed with FITC-PNA and propidium iodide (Reproduction 128, 2004, 829). The SCSA was performed with both Tris-NACL-EDT buffer (TNE)- and Tris-fructose-citrate buffer (TFC). In the Asc-supplemented groups, percentages of progressively motile sperm (P) were significantly lower than in the control group (A 1 h: 56.6 ± 9.8, 6 h: 18 ± 4.5; B 1 h: 51.2 ± 11.8, 6 h: 13.6 ± 5; C 1 h: 41 ± 16.2, 6 h: 11.2 ± 6.1; D 1 h: 37 ± 15.2, 6 h: 8.6 ± 5; p < 0.01), whereas, the percentages of intact cells without acrosome reactions did not differ between groups (p > 0.05). Furthermore, there were no significant differences between TNE- and TFC-samples, for ,T, for SD of ,T or for comp ,T [comp ,T: TCF-A: 2.5 ± 1.7%, TNE-A: 3.4 ± 3.2%; TCF-D: 2.5 ± 2%, TNE-D: 3.3 ± 4.3%; p > 0.05]. However, samples diluted with both extenders correlated concerning ,T, but not comp ,T. We therefore recommend using TNE-buffer for SCSA with cryopreserved canine semen. In addition, the average ,T values did not differ significantly between the controls and all other groups (TNE-A: 380.2 ± 89.1; TNE-D: 338.1 ± 137.4; p > 0.05). It can be concluded that addition of Asc to cryoextender does not increase quality of frozen-thawed canine semen. [source] Price Competition, Business Hours and Shopping Time Flexibility,THE ECONOMIC JOURNAL, Issue 531 2008Oz Shy We analyse retail industries with two-stage competition in opening hours and prices. We explore the effects of consumers' shopping time flexibility by comparing bi-directional consumers with forward- or backward-oriented consumers, who can either postpone or advance their shopping, but not both. We demonstrate that retailers with longer opening hours charge higher prices and that opening hour differentiation softens price competition. We show that competition does not create incentives for retailers to expand their business hours beyond social optimum. In this respect our model does not justify restrictions on shopping hours. [source] Children and Women's Hours of Work,THE ECONOMIC JOURNAL, Issue 526 2008Gillian Paull The prevalence of women in part-time work continues to be a distinguishing feature of female employment in Britain. Using data from the BHPS, this article analyses the evolution of work hours for women and men during family formation and development. A substantial movement towards part-time work for women occurs with the first birth and continues steadily for ten years. The gender gap in hours subsequently diminishes but persists even after children have grown up. Births have little impact on men's hours, although there is some adjustment in the balance of work hours for couples following births and last school entry. [source] | ||||||||||||||||||||||||||||||||||||||||||||||