Shedding Light on Junior Doctors’ Work Practices After Hours.

Shedding light on junior doctors’ work practices after hours.

Intern Med J. 2013 Jun 26;
Arabadzhiyska PN, Baysari MT, Walter S, Day RO, Westbrook JI

It is imperative to understand the current work practices of hospital personnel to inform efforts and secure resources towards the improvement of hospital systems. Research examining doctors’ work during night-shifts is limited.To describe and quantify the night-shift work-practices of junior doctors.An observational time and motion study was conducted. Eight resident doctors in four general wards were observed for 96 hours during night-shifts (Monday-Friday, 2200-0800).Doctors spent the highest proportion (28%; 95%CI 21-35) of their time performing social/personal tasks (e.g. sleeping, eating) and indirect care (24%; 95%CI 22-25) (e.g. reviewing notes, ordering tests). Work-related discussion comprised 15% (95%CI 13-17) and most took place at the beginning of the night. Medication-related tasks consumed a small proportion of time (4%; 95%CI 3-4) but attracted a higher level of multi-tasking and interruptions than most other tasks. On average, two hours of every shift were spent at a computer and 1.3 hours with patient notes. Doctors spent 72% of the night-shift alone, multi-tasked 6.4% of the time and were interrupted, on average, once every 46 minutes.This study provides new data about junior doctors’ work at night. Relative to doctors during the day, greater proportions of time were devoted to social/personal tasks including sleep and indirect care, but a similar proportion to direct care. Multi-tasking and interruptions were minimal. Computer activities were an integral part of work. Handovers were observed at the beginning but not the completion of the night-shift which may have implications for patient safety. HubMed – eating

The attachment system and physiology in adulthood: Normative processes, individual differences, and implications for health.

J Pers. 2013 Jun 25;
Robles TF, Kane HS

Attachment theory provides a conceptual framework for understanding intersections between personality and close relationships in adulthood. Moreover, attachment has implications for stress-related physiology and physical health. We review work on normative processes and individual differences in the attachment behavioral system, and their associations with biological mechanisms related to health outcomes. We highlight the need for more basic research on normative processes and physiology, and discuss our own research on individual differences in attachment and links with physiology. We then describe a novel perspective on attachment and physiology, wherein stress-related physiological changes may also be viewed as supporting the social-cognitive and emotion regulatory functions of the attachment system through providing additional energy to the brain, which has implications for eating behavior and health. We close by discussing our work on individual differences in attachment and restorative processes including sleep and skin repair, and by stressing the importance of developing biologically plausible models for describing how attachment may impact chronic illness. HubMed – eating

Medical Findings in Women with Anorexia Nervosa in a Korean Population.

Psychiatry Investig. 2013 Jun; 10(2): 101-107
Kim YR, Son MH, Nah JC, Park HA

Eating disorders are a common clinical problem among young women in Asian countries. The aim of this study is to determine the medical effects of anorexia nervosa (AN) in the Korean population.We comprehensively investigated medical complications including haemodynamic, haematologic, endocrine, and bone density abnormalities in 67 Korean women with AN, together with 194 healthy Korean women of comparable age with a cross-sectional design.In AN, 36.9% were anaemic, 50.8% were leukopenic, 35.5% were hypoproteinemic, 7.9% were hypokalemic, 9.5% had increased alanine aminotransferase, 6.3% were hyperbilirubinemia, 14.5% were hypercholesterolemia, 14.8% had decreased triiodothyronine. Osteopenia at any one site was identified in 43.3% and an additional 13.4% had osteoporosis. The lowest-ever body mass index was the main determinant of bone mineral density.Our data in Korean patients with AN show high frequencies of laboratory abnormalities for medical complications. This study emphasizes the importance of recognizing AN as a medical risk in young Korean women. HubMed – eating

[Dynamics and environmental load of food carbon consumption during urbanization: a case study of Xiamen City, China].

Huan Jing Ke Xue. 2013 Apr; 34(4): 1636-44
Yan Z, Cui SH, Li GL, Ren Y, Xu LL

With the rapid urbanization, city plays a more and more significant role in the carbon cycle of urban ecosystem. The contribution of household food carbon consumption to urban carbon cycle has become increasingly important, and has been the hot issues of the urban carbon cycle study. We analyzed the dynamics of the food carbon consumption in Xiamen City from 1988 to 2010, evaluated and forecasted the trends of food carbon consumption and its environmental load. The results showed that, from 1988 to 2010, per capita food consumption and per capita food carbon consumption declined by 6% and 25%, respectively. However, due to the rapid growth of population, the total food consumption and total food carbon consumption increased by 116% and 70%, respectively. The rising of total food carbon consumption led to the increasing environmental load of food carbon. The environmental load of food carbon increased from 98 800 t to 166 200 t, particularly there is a dramatic increase of carbon input into soil in recent years. From 2011 to 2024, total food carbon consumption and environmental load will continue to rise and then decline in 2025. Per capita food carbon consumption will decline continuously from 2011. The analysis of household food consumption showed that per household food carbon consumption was affected by household income, food cost and household persons. High food carbon consumption household usually had in average three persons eating at home, spent in average 3 125 yuan x month(-1) on food, the per household food carbon consumption was 1 134.91 kg,and the per capita food carbon consumption was 378.30 kg. Per capita food carbon consumption of high-consumption family was 4.84 times higher than that of low-consumption family. HubMed – eating