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Impact of work patterns on the health of Certified Registered Nurse Anesthetists Jessica M. Na, RN, BSN; Mariana C. Bordei, RN, BSN Wayne State University Introduction: The number of hours worked by health care providers has recently been under intense scrutiny. Substandard performance, medical errors, and detrimental effects on the provider's mental and physical health have been associated with extended work hours. The purpose of this survey research was to determine the prevalence of extended work schedules in anesthesia providers employed in a large suburban medical center and to evaluate the impact on the practitioner and his or her practice. Methods: After IRB approval was obtained, a survey piloted for content and context reliability ; was developed and administered to 300 CRNAs working for the Detroit Medical Center and affiliated sites. A cover letter accompanied the survey explaining the purpose of the research. The 42-item instrument required the respondents to provide demographic data and information regarding their typical work schedule. The questions that addressed the provider's mental, physical, and psychosocial health were rated using a Likert Scale. Results: The response rate was 46% N 139 ; . Thirty nine percent N 54 ; of the respondents reported working 41-48 hours per week. Thirty five percent of respondents N 49 ; reported working 6-10 hours of overtime per week. Increased work hours were positively correlated with caffeine consumption and BMI. The average BMI of respondents working less than 40 hours was 23, and for those working greater than 40 hours per week the average BMI was 27. Conclusions: Although this data revealed that the providers working more than 40 hours per week were heavier and consumed more caffeine, there were no differences in the respondents' perceptions of their physical and mental health. The health care providers working in excess of 40 hours per week did not experience more job related injuries. Future research may evaluate the impact of extended work hours on job performance and critical thinking skills.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians. 2003 American College of Physicians I-27, for example, anacin aspirin.
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Monitoring or analysis of humoral immune components in conventional body fluids, such as blood and urine, involves common methods. However, measurement of these factors in nonconventional biological fluids, such as cervical secretions, vaginal fluid, and saliva, is complex. The difficulties lie not only in the analysis of these mucosal fluids but also in obtaining reproducible and unaltered samples. The accuracy and consistency of the sampling procedures can ultimately affect experimental outcomes and quantitation of the individual components. Yet the assessment of such fluids is important because it gives insight into the local immune response, physiological modifications induced by infection, and potential drug profiles at the site of action 11, 12 ; . There are a number of different methods available for the collection of genital tract secretions, such as cervicovaginal washes, aspiration, and Wick absorption. Each technique has proven its utility but also has a downside. The washes yield a significant amount of material but combine vaginal and cervical secretions. These two secretions have different roles in the protection of the genital tract, and combining them prevents studies of each secretion. Aspiration works well for collection of cervical secretions at midcycle in women who are ovulating but yields little volume at other times in the cycle or when women are using oral contraceptives. Finally, the Wicks collect cervical and vaginal secretions individually but absorb a very small amount of material. The collection volume limits the and panadol!
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The authors extend special thanks to the Tuberculosis Elimination Staff at the Tarrant County Public Health Department for their support and encouragement during the writing process, especially Lee Sewell, BS, and Bev Seale, BSN, RN. The authors also thank Kathryn Halder, BS, at the University of North Texas Health Science Center at Fort Worth for her assistance in formatting the figures for publication, and Nancy Stroud, MA, for editing the document and acetaminophen, because caffeine.
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Following the presentations, the attendees discussed key questions and explored options to extend established research efforts into new interdisciplinary areas. Are mechanisms of tobacco-related carcinogenesis similar in all tobacco-related cancers? Are molecular alterations in NF-nB or signaling pathways in head and neck cancer also observed in bladder, pancreatic, kidney, and lung cancers? An integrated approach combining genomics, proteomics, and tissue microarrays would be best to address this question and could generate a uniform approach to prevent tobacco-related carcinogenesis. The participants agreed that a better understanding of the molecular basis for addiction is essential. Specifically, nicotinic receptors are neglected components of tobacco-related research. Although the complexity of these receptors and poor experimental tools have limited study of these receptors in the past, researchers can now profile these receptors, modify their function, and detect the presence or absence of specific.
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If you have inflammatory arthritis or are going through a periodic inflammatory phase of osteoarthritis, you'll need to be patient. It usually takes from two to four weeks at least before the anti-inflammatory medication starts relieving the real source of your pain: joint inflammation. For more severe forms of inflammatory arthritis, a disease-modifying drug may also be prescribed. Typically, these are slow-acting medications, taking anywhere from two to six months to achieve benefits. The best approach to reducing pain will incorporate a number of different strategies: medication, of course, but also a variety of non-medicinal management techniques to provide safe and effective pain relief. You'll need to discover what works for you, dovetailing different approaches to prolong pain relief. Ask your doctor for a referral to other health professionals, such as a physiotherapist, who can devise an individual exercise program for you that will help to prevent muscle wastage and reduce pain by strengthening, and increasing the joint's range of motion. Another pain management specialist available on referral is an occupational therapist OT ; . OTs can make or have custom splints and orthotic devices made to help keep affected joints properly aligned and protected from further injury. They're also an excellent resource for all kinds of other practical strategies for avoiding injury and reducing pain. The three major pain relievers - acetaminophen Tylenol, Panadol, Exdol, etc. ; , ASA Aspirin, Entrophen, Anacin, Novasen, etc. ; and ibuprofen Advil, MotrinIB, etc. ; - are all available without a prescription and are all about equally effective and.
Though there is certainly sufficient information at hand for many women to make an informed decision about hormone therapy, the entire question of HRT is undoubtedly not a closed matter. Further and different trials will no doubt be held; major pharmaceutical houses are likely hard at work to modulate current therapies or devise new ones. Whatever developments take place, you can be sure that the PBCC will keep you informed and arimidex and anacin, for example, analgesics.
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During the 2003 Benefit Update presentations, the "bene wrap" was introduced. The metaphor of a hot dog was used to describe the new Private HealthCare System PHCS ; . This is a "wrap-around" network that enhances the Medical Network of providers. PHCS network provides access for emergency medical care only as defined by the Summary Plan Description ; for EPO members who travel or for a student attending school outside of the service area. This benefit is accessible only when a Memorial Hospital Medical Network provider is not available for emergency services for EPO or EPO Mid-level In-network participants. PHCS network provides EPO Mid-level par ticipants an Out-of-network option to take advantage of discounted rates. This plan works like the previous Swing Plan in that participants can "swing" in-network and receive innetwork rates or "swing" out of network and pay the deductible and coinsurance up to the out-of-pocket maximum. CORE participants may also take advantage of the PHCS network. This network is nationwide with the office located in California. The hours of operation are Monday through Friday from 6: 30 a.m. to 5: 00 p.m. Pacific Standard Time. If you are planning to travel out of the Medical Network service area, you may want to call PHCS in advance to locate a provider. In the event of an emergency, when their office is closed, you will already have the information you need to obtain emergency services. 1 ; Call 800-678-7427. You will have to answer the customer service rep's questions: What is the name of the plan underwriter TPA: Ameriben Solutions Type of plan: Healthy Directions What type of provider they are looking for such as hospital, family practitioner, etc. ; Zip code of where they'd like the provider located 80902, etc. ; OR 2 ; Click onto their web site at phcs Enter how they would like to search for the provider Enter the address suggestion is to enter just the city, state and zip ; Choose a distance for the search in miles ; Choose a network - Healthy Directions Access Advantage Choose type of provider - such as hospital, family practitioner, etc.
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Overview: Welders can sustain injuries when small airborne particles of manganese in the welding fumes enter their noses or mouths, then enter the bloodstream and cross the blood-brain barrier. Once in the brain, manganese can affect parts of the brain that control muscle movement and other bodily functions, producing symptoms much like Parkinson's disease. The Welding Rods MDL has been assigned to the Northern District of Ohio, MDL-1535, The Hon. Kathleen O'Malley presiding. Plaintiffs allege that commercial manufacturers and sellers of welding rods were aware of these health dangers for many years and failed to provide adequate warnings. For more information, please visit the Plaintiffs' National Leadership Counsel website at: welding-rod-litigation . News: An Ohio jury has rejected the claims of Ernesto Solis, a 57-year old former welder, holding that the makers of welding rods were not liable for his health conditions. The jury was asked if the makers distributed welding rods with inadequate safety warnings and instructions, and ruled that they did not. The Solis case was the first of about 3, 800 MDL cases to go to trial; others may go to trial this fall. State court trials are scheduled for August 14 and October 2 in Arkansas. The Solis verdict follows a reported seven-figure settlement obtained by Plaintiff Charles Ruth, whose case was originally scheduled to be the first of the MDL cases to be tried. The Plaintiffs' Executive Committee of the MDL believes that in spite of the defense verdict, the Solis case firmly established the very real danger of manganese-laced welding fumes. Furthermore, Defendants were ordered toward the end of the case to produce thousands of pages of additional documents that Plaintiffs' counsel believe show the danger posed by welding fumes as well as a long-standing corporate cover-up to suppress the information. Strongest Cases: We are evaluating cases on behalf of welders who have suffered injuries due to manganese exposure, including those diagnosed with Parkinson's who may actually be suffering from manganism. We have filed one case in the MDL, and have obtained tolling agreements on all other cases, because nsaid.
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In 211 581 postmenopausal women, noted a small increase in ovarian cancer mortality with 10 or more years of oestrogen therapy Rodriguez et al. 2002 ; . Ovarian cancer death rates were: 64 and 38 per 10 000 women for baseline and former users of oestrogen therapy for 10 or more years respectively; and 26 per 10 000 women for never users. This study relied upon recall of prior HT use. Data were not available on type of HT use and only a small proportion of women had used HT for more than 10 years. Another cohort study, of 44 241 postmenopausal women, reported a slight increase in absolute risk of ovarian cancer in women using oestrogen therapy for 10 or more years compared with non-users, of 2 more cases per 10 000 woman years of HT use Lacey et al. 2002 ; . The increased risk was confined to women with a prior hysterectomy as these women were more likely to be prescribed longterm unopposed oestrogen therapy. However, the role of hysterectomy in the development of ovarian cancer in itself is unclear. In this study, results were presented as a cumulative of total person years of oestrogen use and were not stratified into the number of women in each group of long-term, short-term and non-users of oestrogen therapy. It also relied upon recall of prior HT use. Neither the oestrogen-only nor EP arms of the WHI study reported an increase in ovarian cancer risk vs placebo Writing Group for Women's Health initiative Investigators 2002, Anderson et al. 2004 ; . Coronary heart disease CHD ; The risk of acute coronary events for women increases exponentially with age and following the menopause. Women who have undergone a premature surgical menopause have double the risk of coronary artery disease compared with those who have undergone natural menopause Colditz et al. 1987 ; . However, the extent to which oestrogen insufficiency contributes to this increased risk is uncertain. The role of HT for the primary prevention of CHD is controversial; however, most would agree that HT has no role in secondary CHD prevention. Primary prevention There is strong epidemiological evidence that unopposed oestrogen may reduce CVD risk in menopausal women without established disease Colditz et al. 1987 ; . This appears to be attributable directly to plasma lipid changes, reduced low-density lipoprotein LDL ; and lipoprotein a ; and increased high-density lipoprotein Darling et al. 1997 ; as well as favourable effects of oestrogen on endothelial function Mendelsohn & Karas 1999 ; . Conversely, oral oestrogen increases serum levels of inflammatory markers that have been associated with CHD risk, an effect in part attenuated by oral progestin therapy Davison & Davis 2003 ; . In epidemiological research, concurrent progestin use does not appear to attenuate the beneficial effects of oestrogen on the cardiovascular system Grodstein et al. 1996.
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