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At least 1,387 records · Page 77Linked to original sources
PubMed1994

Young hospital doctors after night duty: their task-specific cognitive status and emotional condition.

Sleep deprivation is an unpleasant burden of young hospital doctors during their medical training. It may disrupt the balance between coping strategies available to them and the professional demands encountered. Impaired medical care offered by sleep-deprived juniors may be a consequence. Valid research work on this subject is rare and surprisingly contradictory. Therefore, we evaluated the task-specific cognitive status and emotional condition of 40 young hospital doctors (27 men and 13 women, 29.9 +/- 2.9 years of age) at the University of Tuebingen, all of whom were in the beginning of their academic career. Subjects were tested twice acting as their own control, once at 8.00 am after a night off duty (OD) (at least 6 hours of uninterrupted sleep), and once at a similar time after a night on call (OC) being in the hospital for 24 hours. Standardized and reliable psychometric tests thought to represent daily routine medical function were performed. On-call activities were recorded by means of a sleep diary, whereas a questionnaire interrogated aspects of private and professional life. Neuropsychological function deteriorated significantly: number connection test (per cent of norms +/- SD, 103.2 +/- 9.8 OC vs 107.8 +/- 10.5 OD, F = 27.7, P < 0.001), things-to-do list (correct items +/- SD, 6.7 +/- 1.2 OC vs 7.4 +/- 1.5 OD, F = 12.7, P < 0.01), Vienna reaction timer (per cent of norms +/- SD, 95.6 +/- 9.0 OC vs 97.7 +/- 10.4 OD, F = 4.8, P < 0.05), Stroop test (T-values +/- SD, 59.7 +/- 6.3 OC vs 64.6 +/- 7.1 OD, F = 37.1, P < 0.001), ECG test (correct responses +/- SD, 38.3 +/- 7.3 OC vs 43.4 +/- 6.5 OD, F = 45.2, P < 0.001) and status of mood (T-value +/- SD, 60.3 +/- 9.0 OC vs 54.0 +/- 6.6 OD, F = 19.6, P < 0.001). Cognitive function and mood status of young hospital doctors after a night on call decrease considerably. In view of the special vulnerability of medical trainees to occupational stress all efforts are warranted to reduce sleep deprivation in the medical profession.

Adaptation, Psychological↗
PubMedDate not supplied

[Contribution of pilots to the folder of anxiety].

Anxiety crises sometimes exhibited inflight by professional pilots, mostly fighter pilots in our experience, do not qualify as psychiatric pathology. Here, it is to be understood as the study of mental disorders associated with the profession of pilot. Beyond circumstances or events implied in the onset of disorders, occupational psychopathology takes into account the background of the occupational motivation and the mental dynamics of adaptation to the job requirements.

Adaptation, Psychological↗
PubMed1987

Return to work among patients with small cell lung cancer.

Forty-four patients with small cell lung cancer (SCLC), who were working in some kind of profession when they were taken ill, were studied with regard to return to work during or after cancer treatment. All patients received combination chemotherapy without chest radiotherapy or prophylactic brain irradiation. Twelve patients, referred to as W, returned to work during some period (14-83 weeks) after commencement of treatment, and 32 did not (NW). The stage of the disease prior to treatment and the type of profession seemed to be major prognostic factors. Patients with limited disease or "light" occupations more often returned to work than did patients with extensive disease or "heavy" occupations (P = 0.027 and 0.037, respectively). Age, sex and performance status were less important factors. Long-term survival was not a necessary condition for return to work, and overall survival was not prolonged in W patients compared with NW patients. It is concluded that increased occupational activity is an important palliative gain from chemotherapy in SCLC, and that this gain is not confined to a specific subgroup of patients, but is most likely to occur in patients with limited disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2003

Managing the care of patients infected with bloodborne diseases.

BACKGROUND: The emergence of the bloodborne pathogens HIV, the cause of AIDS; hepatitis B virus, or HBV; and hepatitis C virus, or HCV, has been a milestone in the history of the dental profession. In the early 1980s, new cases of AIDS increased dramatically, and fear of acquiring this disease compelled clinicians to modify the delivery of medical and dental care to allay fears of transmission on the part of both patients and health care workers. Arguably, the AIDS pandemic has been the most significant factor in the evolution and delivery of modern medical and dental care in the last century. OVERVIEW: To help ally fears and remove barriers to caring for the HIV population, the Centers for Disease Control and Prevention, or CDC, introduced the concept of universal precautions in 1983. This was followed by the Occupational Safety and Health Administration's Bloodborne Pathogens Standard in 1991. Specific to the dental profession was the development of the principles of infection control in dentistry recommended by the CDC (1993); the American Dental Association (1995) and the Organization for Safety & Asepsis Procedures (1997). While initially difficult for some clinicians to acknowledge, these recommendations now are universally accepted throughout the profession, and provision of oral health care to patients infected with bloodborne disease is becoming commonplace. Compliance with recommended infection control practices remains an important component of dental practice. But it must be accompanied by an understanding of infectious and bloodborne diseases and the medical/dental management of the care of infected dental patients. CONCLUSIONS AND PRACTICE IMPLICATIONS: The emergence of the bloodborne pathogens and the increasing number of infected patients who seek oral health care compel clinicians to have a thorough knowledge about bloodborne diseases and the medical/dental management of the care of patients presenting with HIV, HBV or HCV infection.

Blood-Borne Pathogens↗