Free Weekend Research Articles

Social Jetlag and Cardiometabolic Risk in Preadolescent Children.

Objective: Childhood cardiometabolic disease risk (CMD) has been associated with short sleep duration. Its relationship with other aspects of sleep should also be considered, including social jetlag (SJL) which represents the difference between a person's social rhythms and circadian clock. This study investigated whether childhood CMD risk is associated with sleep duration, sleep disturbances, and SJL.Study Design: The observational study included 332 children aged 8–10 years (48.5% female). The three independent variables were sleep duration, sleep disturbances, and SJL. SJL was calculated as the variation in hours between the midpoint of sleep during free (weekend) days and work/school days. Eleven cardiometabolic biomarkers were measured, including central blood pressure, lipids, glycated hemoglobin, arterial wave reflection, and glucose. Underlying CMD risk factors were identified using factor analysis.Results: Four underlying CMD risk factors were identified using factor analysis: blood pressure, cholesterol, vascular health, and carbohydrate metabolism. Neither sleep disturbances nor sleep duration were significantly associated with any of the four CMD factors following adjustments to potential confounders. However, SJL was significantly linked to vascular health (p = 0.027) and cholesterol (p = 0.025).Conclusion: These findings suggest that SJL may be a significant and measurable public health target for offsetting negative CMD trajectories in children. Further studies are required to determine biological plausibility.

Differential Responses of Urinary Epinephrine and Norepinephrine to 24-h Shift-Work Stressor in Physicians.

Multiple stressors, including 24-h-shifts characterise the working environment of physicians, influencing well-being, health and performance. We aimed to evaluate the effect of the stressor 24-h-shift on the adrenal medullary and sympathoneural system in physicians with the hypothesis that shift work might have different impacts on both systems. Twenty-two physicians collected two 12-h-urine samples (“daytime” and “nighttime”) during a 24-h shift (“on-duty”) and on a free weekend (“off-duty”), respectively. Urinary excretion rates per m2 body surface area were assessed for the catecholamines epinephrine, norepinephrine and their respective free O-methylated metabolites metanephrine and normetanephrine by LC-MS/MS-analysis. The stressor provoked differential responses of epinephrine and norepinephrine. Epinephrine excretion rates showed significant increases from off to on duty. The largest proportional change (off-duty to on-duty) for epinephrine was observed for nighttime (205%), the increase for daytime was 84%. An increase in norepinephrine from off to on duty was only visible for nighttime collections. For the catecholamine metabolites, normetanephrine paralleled norepinephrine and exhibited an increase in excretion from off to on duty during nighttime collections of 53% whereas there was no change during daytime collections (3%). In conclusion: Whilst the 24-h-shift-work stressor in physicians activates the sympatho-adrenomedullary system, represented by epinephrine, the sympathoneural response through norepinephrine reflects mainly an ambulatory position during working hours.

Respiratory health and inflammatory markers - Exposure to respirable dust and quartz and chemical binders in Swedish iron foundries.

PurposeTo study the relationship between respirable dust, quartz and chemical binders in Swedish iron foundries and respiratory symptoms, lung function (as forced expiratory volume FEV1 and vital capacity FVC), fraction of exhaled nitric oxide (FENO) and levels of club cell secretory protein 16 (CC16) and CRP.MethodsPersonal sampling of respirable dust and quartz was performed for 85 subjects in three Swedish iron foundries. Full shift sampling and examination were performed on the second or third day of a working week after a work free weekend, with additional sampling on the fourth or fifth day. Logistic, linear and mixed model analyses were performed including, gender, age, smoking, infections, sampling day, body mass index (BMI) and chemical binders as covariates.ResultsThe adjusted average respirable quartz and dust concentrations were 0.038 and 0.66 mg/m3, respectively. Statistically significant increases in levels of CC16 were associated with exposure to chemical binders (p = 0.05; p = 0.01) in the regression analysis of quartz and respirable dust, respectively. Non-significant exposure-responses were identified for cumulative quartz and the symptoms asthma and breathlessness. For cumulative chemical years, non-significant exposure–response were observed for all but two symptoms. FENO also exhibited a non significant exposure-response for both quartz and respirable dust. No exposure-response was determined for FEV1 or FVC, CRP and respirable dust and quartz.ConclusionsOur findings suggest that early markers of pulmonary effect, such as increased levels of CC16 and FENO, are more strongly associated with chemical binder exposure than respirable quartz and dust in foundry environments.

High Glucocorticoid Response to 24-h-Shift Stressors in Male but Not in Female Physicians.

Physicians’ daily work is accompanied by emotional and physical stress, and 24-h shifts are considered to be a major stressor. Effects of stressors on the hypothalamic–pituitary–adrenal (HPA) axis can be evaluated by estimating the glucocorticoid excretion in urine samples. We characterized the impact of a 24-h working period on the urinary glucocorticoid excretion of physicians and focused on gender differences. 10 females and 12 male physicians collected 24-h urine samples during a 24-h shift (“on-duty”) and on a free weekend (“off-duty”) that were analyzed by gas chromatography–mass spectrometry. Urinary glucocorticoid excretion rates (GERs) were assessed by addition of the 24-h excretion rates per square meter body surface area for the seven major urinary cortisol and cortisone metabolites. Women showed generally lower glucorticoid excretion rates compared to men. Only male physicians had increased GERs on duty compared to off duty. As a measure of change between being on duty and off duty, the ratio GERs on duty/GERs off duty was significantly higher in males than in females. Thus, the 24-h shift stress factor generates diverging results between female and male subjects with activation of the HPA axis primarily in male physicians.

Prevalence of Suicidal Ideation and Its Association with Positive Affect in Working Women: A Day Reconstruction Study.

The suicide rate for females in China is the second highest worldwide, and China is the only country in the world in which the rate of suicides is higher for women than men. Affective instability has been shown to be a strong predictor of suicidal ideation, particularly among women. However, prior research has mainly focused on the impact of women's negative affect on suicidal ideation, ignoring the influence of positive affect on suicidal ideation. Studies have revealed that hopelessness, which is 1.3 times more important than depression for explaining suicidal ideation, is driven more by low levels of positive affect than by high levels of negative affect. Although positive affect has also been found to be related to suicidal ideation, and it demonstrates independent, beneficial effects on mental health, much remains to be learned about the association between positive affective instability and suicidal ideation. Therefore, we investigated the prevalence of suicidal ideation among Chinese working women and explored the differences between working women with and without suicidal ideation in the intensity and daily variability of positive affect. A total of 222 young working women of ages 22–36 years (M = 27.64, SD = 3.73) were recruited from a free weekend psychology lecture. The women subsequently completed a daily diary Day Reconstruction Method (DRM) as well as a suicidal ideation questionnaire. We used hierarchical linear modeling (HLM) to analyze the data, and the results showed that: (1) 10.81% of participates reported suicidal ideation, the intensity of positive affect (happiness, warmth/friendliness, interest and relaxation/calmness) was significantly lower for women with suicidal ideation compared to women without suicidal ideation; (2) differing diurnal patterns of positive emotions were observed between women with and without suicidal ideation; women with suicidal ideation demonstrated a significantly lower trend of growth and a higher volatility in happiness, warmth/friendliness, relaxation/calmness. Given that lower intensity of positive affect and greater affective instability significantly predicted suicidal ideation in Chinese women, researchers should pay more attention to the role of positive affect in female suicide prevention research and intervention efforts in the future.

Holiday travel, staycations, and subjective well-being

ABSTRACTThe tourism industry thrives on the notion that holiday travel improves well-being. However, scientific evidence that holiday travel is more beneficial than spending free time at home is lacking. Using the Effort-Recovery and the Limited Resources model as theoretical basis, this study investigates whether workers behave, think, and feel differently during travel than during leisure time spent at home. In a five-week longitudinal field study, we followed 24 workers during free evenings after work, a free weekend at home, and on a free weekend of domestic travel. Within-person differences were investigated between these three occasions in behavior, cognition, and emotions. During travel, employees slept more, engaged more in physical and social activities and less in obligatory activities than during free evenings after work. Hedonic well-being was higher and ruminative thinking lower during travel than during free evenings after work. Physical distance from home and work was related to engagement in resource-providing rather than resource-consuming activities and seems to translate into mental distance from everyday worries. Differences between holiday travel and weekends at home were small. Still, the findings suggest that travel may provide feelings of remoteness in places with novel and fascinating qualities, free of chores.

Bonnie and the Tall Ships: Kismet of a Free Weekend

Bonnie and the Tall Ships: Kismet of a Free Weekend

Hematopathology in the new decade: what to expect

At the beginning of a new decade, it is a good moment to reflect on the direction pathology, and especially hematopathology, is going. This is a risky business: you are probably all aware of the main problem foreseen for the twentieth century: an explosion of transportation (which indeed happened) resulting in the impossibility of removing the vast amount of horse manure from the streets in big cities…. At a speech celebrating 40 years of the Dutch pathology society in the 1970s, my promoter foresaw that clinical pathology would soon be fully based on enzyme histochemistry and electron microscopy; and how many have predicted that expression arrays would make pathologists an endangered species. We do see huge changes in our profession: a hematopathologist now uses, as a routine, histology, immunohistochemistry, and cytogenetic techniques. Often there is good access to clinical data through electronic patient records, so there is no need for complaining on lack of clinical data anymore. We are appreciated much better since our diagnosis is much more refined and also much more relevant to patients, thanks to better and variable treatment options. And we deliver faster: rapid tissue processing, speech recognition, and electronic transmission have made 1-day pathology feasible. What will happen next? Deep sequencing is now done in the research laboratories, and within 3–5 years, we will be able to have full knowledge of genetic changes in tumor and normal tissue of our patients. It is not easy to predict how this will affect our work, but it will be at least another tool; another layer of knowledge that pathologists can incorporate in their diagnosis. A large amount of biologicals is being tested in preclinical and early clinical studies, and we will see some patients that benefit, and others that do not. We need to develop tools to predict how a tumor responds to specific drugs, and use that knowledge as well. Within a few years we will all have slide scanners, and thus it does not matter anymore where we are when we make our diagnosis. Will we be carrying around I-Pads so that we can make a diagnosis even when we are enjoying a day at the beach? For sure, patients will ask for their tissues to be evaluated by specialized pathologists. In a nostalgic mood, I sometimes think back how things were 5 years ago: no Blackberry or I-phone, dictation on tapes, overnight tissue processing and another day before immuno came, bone-marrow biopsies in plastic after a week, airplanes that flew even when volcanoes were active, slide seminars with glass slides, poster areas that were bigger than commercial exhibitions, banks that were safe, pathologists who could work in peace in the cellar…. But soon my mobile rings, it is Friday morning, and a child with a fast-growing mass comes about: I am glad that I can tell the pediatric oncologist that when I get the biopsy in the morning I will be able to deliver a reliable diagnosis by the end of the afternoon, without stress and a free weekend coming up. Hematopathology is more interesting and more fun every year!

Toward a New Paradigm in Graduate Medical Education in the United States: Elimination of the 24-Hour Call

Sleep deprivation negatively affects resident performance, education, and safety. Concerns over these effects have prompted efforts to reduce resident hours. This article describes the design and implementation of a scheduling system with no continuous 24-hour calls. Aims included meeting Accreditation Council for Graduate Medical Education work hour requirements without increasing resident complement, maximizing continuity of learning and patient care, maintaining patient care quality, and acceptance by residents, faculty, and administration. Various coverage options were formulated and discussed. The final schedule was the product of consensus. After re-engineering the master rotation schedule, service-specific conversion of on-call schedules was initiated in July 2003 and completed in July 2004. Annual in-training and certifying examination performance, length of stay, patient mortalities, resident motor vehicle accidents/near misses, and resident satisfaction with the new scheduling system were tracked. Continuous 24-hour call has been eliminated from the program since July 2004, with the longest assigned shift being 14 hours. Residents have at least 1 free weekend per month, a 10-hour break between consecutive assigned duty hours, and a mandatory 4-hour "nap" break if assigned a night shift immediately following a day shift. Program-wide, duty hours average 66 hours per week for first-year residents, 63 hours per week for second-year residents, and 60 hours per week for third-year residents. Self-reported motor vehicle accidents and/or near misses of accidents significantly decreased (P < .001) and resident satisfaction increased (P = .42). The change was accomplished at no additional cost to the institution and with no adverse patient care or educational outcomes. Pediatric residency training with restriction to 14 consecutive duty hours is effective and well accepted by stakeholders. Five years later, the re-engineered schedule has become the new "normal" for our program.

Fiction: Off-label.

When the lights started blinking in the ballroom, quite a few of the regional neuroscience specialists looked rather sick. It was the usual collection of drug reps: the older ones were men; the “kids,” under 30, were of both sexes. We were trying to enjoy the croissants and the orange juice, but there was a growing apprehension. None of us wanted to attend an update on Yettol, our antiepilepsy drug, even as part of a free weekend at a Palm Beach hotel. We knew the drug was way behind in prescriptions for partial seizures: the latest figures showed it was last among ten anticonvulsants. So, what would the company tell us now? Unlike most of the reps, I chose a seat toward the front. I preferred to see the facial expressions and nuances of the speakers at close range. I sought hidden meanings in all things, possibly from having studied psychology and biology in college. The first speaker, Joseph Harnden, the pharmaceutical vice president, strode to the podium after an unnecessary introduction: everyone in the room had met him and had received his weekly e-mails for over a year. He always moved and talked in a hurried manner, but especially so today. Normally he would ceremoniously shed his sports jacket, but today he didn’t pause for that. He lowered the podium, leaned forward on his elbows, and began. “At Elite, we do believe it’s how you play the game that counts. We promote good health, and not profits; satisfaction, and not market shares. An educated, healthy, and satisfied consumer of our products is what we view as winning. When we launched Yettol, we knew there was a crying need for a drug to treat partial seizures, a need unfulfilled in a third of the world’s epileptic patients. Our company had …

The Heroic Tradition in Presidential Rhetoric

As I prepared this essay, my local cable company kindly provided me with a free weekend of Showtime and The Movie Channel. Happy to have any excuse to abandon the computer, I settled down to the longest movie I could find, a showing of the recent disaster epic Deep Impact. As many readers probably know, the film tells the story of an America facing an extinction level event—a big space rock is heading for Earth. What struck me about the film is its utter lack of evil. There are no bad people. Elijah Wood sacrifices his chance for safety to save the girl he loves. The astronauts, led by Robert Duvall, sacrifice themselves to save the world. The star reporter, played by Tea Leoni, sacrifices her chance for life to save a rival and her child. The American people as a whole sacrifice themselves to civility; as it seems the world is coming to an end, they do not rape, loot, or pillage. Most impressive is Morgan Freeman as the President of the United States. He tells the truth, he prays for the nation, and he renews our hope in a lovely speech at the end of the movie. A presidential speech ends this movie. Tellingly, there isn't even an explanation as to how or why a black man became president; in this America, he just is president. I decided that I could vote for Freeman—just as, in recent years, I have decided that I could vote for Kevin Klein (Dave), Michael Douglas (An American President), Bill Pullman (Independence Day), Harrison Ford (Air Force One) and Martin Sheen (West Wing). Now many who know me would probably suggest that my preferences have far more to do with the liberal cast I've assembled than with anything else. Yet there is something more going on here. Over the past decade an unusual number of movies and television episodes have portrayed the presidency. With the sole exceptions of the evil Gene Hackman and the weak Ronny Cox in Absolute Power and Murder at 1600, respectively, the president is a good guy—and even Cox turns out okay. Equally important for our purposes, rhetoric is at the center of most of these films; at critical moments, Klein addresses a joint session of Congress, Douglas speaks to the assembled press corps, Pullman inspires his pilots with what is, in effect, Henry Vs battle speech, and Sheen regularly gives inspirational talks to his staff and the country. West Wing, in fact, has become something of a cultural phenomenon—it's

: The Ascent of Babel: An Exploration of Language, Mind and Understanding by Gerry T.M. Altmann

Oxford University Press, 1997. £18.95 (xi + 253 pages)ISBN 0 19 852378 5If you want a quick tutorial on contemporary psycholinguistics, then this is the book to read. Gerry Altmann has produced an accessible, up-to-date, and entertaining treatment of what is only too often presented as a dull and impenetrable subject. In doing this, the book concentrates on the major theme of the subject, the problem of ambiguity.Psycholinguistics arose originally out of the formal linguistics of Chomsky in the 1960s, which was heavily dependent on the analogy between natural and artificial languages. However, it soon became apparent that natural, as opposed to artificial, languages suffer from a major mechanical flaw. They are inherently vague and ambiguous. Thus, real speech confounds non-human speech recognition systems because the same words, even when spoken by the same speaker under slightly different circumstances, are commonly associated with quite different patterns of sound. In a similar way, automatic parsers are confounded by the multitude of alternative possible interpretations for the same sentence in slightly different contexts. For example, Altmann illustrates at least 50 different interpretations for the written version of ‘Time flies like an arrow’ (e.g. think of fire flies that flash at regular intervals and like to settle on arrows, or imagine a zipper like a time-lock safe!). With the spoken version there turns out to be a further 60 interpretations (e.g. ‘Anne Arrow’ can be a name and ‘lichen’ a plant). The psycholinguistic puzzle is to explain how we manage to converse so easily and usually without the slightest awareness of these potential pitfalls.The book starts out with the problem of speech and how it could be acquired. The problem here is to explain how the newborn infant can even begin to make sense of a complex continuous speech stream. Altmann's approach is to consider the role of prosody and intonation and the contrast between a syllable-driven versus a phoneme-driven early learning mechanism. As with the rest of the book, he takes the reader through the main arguments and discusses the most important and interesting experiments relevant to each. This is all done in a readable and entertaining style that nevertheless does justice to the real complexities underlying the issues.The book goes on to consider core topics such as the organization of the mental lexicon, how we parse sentences, the psychological meaning of meaning, and how this might relate to discourse comprehension. Again, they are all handled in an entertaining and insightful way. I was particularly impressed with Altmann's skill in choosing examples and his use of different metaphors for the various processes being described. For instance, the example of how lexical ambiguity interacts with structural ambiguity that is alluded to above clearly illustrates the sophistication of the human sentence-processing system. And the combination-lock metaphor he uses as the key to the mental lexicon is both powerful and apposite in relation to the research findings.Beyond this the book covers many other topics often missing from the traditional texts of the 1970s and 80s. These include reading and language production as well as disorders of spoken and written language. Finally, Altmann attempts to pull everything together in the context of a neural-computational framework strongly influenced by the work of Jeffrey Elman.One of the strengths of the book is in this broad coverage. However, at only 233 pages of text the discussion is condensed and this inevitably leads to some weaknesses. For instance, there is sometimes a tendency for the text to skip from topic to topic without resolving the point at issue. Nevertheless, Altmann has done an excellent job of highlighting the key research questions in psycholinguistics and of illustrating some of the exciting experimental work that defines the subject today. So if you have a free weekend, it is certainly worth a read.

Validation of a Self‐Administered Questionnaire on Asthmatic Symptoms and Atopy in House Painters

Validation of a Self‐Administered Questionnaire on Asthmatic Symptoms and Atopy in House Painters: Gunilla Wieslander, et ai. Department of Occupational and Environmental Medicine, Uppsala University—The aim of this study was to validate questions on asthmatic symptoms and atopy among Swedish house painters. Clinical investigations were performed in 44 male painters, selected by stratified sampling from a larger group of 415 painters. Symptoms were recorded by means of a self‐administered questionnaire. Clinical examinations were performed after an exposure free weekend, and included dermal prick test to nine common allergens, dynamic spirometry, and methacholine challenge test (MCT). Atopy was defined as at least one positive skin prick test to common allergens. A forced expiratory volume in one second (FEVd below 80% of normal values were considered a sign of impaired lung function. A cumulative dose of methacholine below 8 mg causing a 20% decrease in FEVt (PD20) was considered a sign of bronchial hyperresponsiveness (BHR). Sensitivity and specificity for different questions was calculated. Most single airway symptom had a good sensitivity for severe BHR, defined as a PD2o below 0.5 mg of methacholine. For milder BHR, however, sensitivity was below 50% for most single symptoms, except the question on nonspecific hyperreactivity symptoms. By combining the symptoms to a symptom score predicable of BHR, a high sensitivity could be obtained for both mild BHR and severe BHR. Most single questions on respiratory symptoms had high specificity, but low sensitivity, as predictors of impaired FEV‐,. Sensitivity for impaired FEV‐, was improved by constructing another symptom score, predictable of FEVt. The assessment of a history of atopy by five questions on asthma, hay fever and eczema in childhood was significantly related to atopy verified by a positive dermal prick test (79% sensitivity and 75% specificity). There was also a significant relation between self‐reported hay fever and positive prick test to pollen extracts (52% sensitivity and 90% specificity). In conclusion, our questions on airway symptoms and atopy are related to clinical signs of BHR, impaired FEV1# and atopy respectively. By combining different symptoms to symptom scores, the problem with low sensitivity of single questions on airway symptoms and atopy can be reduced.

Transient increase in DNA strand breaks in car refinishing spray painters.

Genotoxic risk was evaluated for spray painters possibly exposed to polyester resins and acrylic enamel-based paints in automotive body repair shops. DNA (deoxyribonucleic acid) strand breaks and alkali-labile sites were measured in peripheral mononuclear blood cells ex vivo using the alkaline elution method. Samples of venous blood were taken on Monday after a free weekend and again on Friday from 38 male and 1 female spray painters and compared with the blood samples from 36 male and 3 female referents. The elution rate of each DNA sample was standardized by dividing it by the elution rate obtained from simultaneously sampled untreated Chinese hamster V79 cells. The spray painters showed a significantly (P < 0.001) higher mean level of strand breaks and alkali-labile sites in the Friday samples [2.05 (SE 0.17)] compared with the Monday samples [1.38 (SE 0.07)]. The Monday results of the spray painters were not distinguishable from the referents' [1.41 (SE 0.10)]. The increase in DNA damage was numerically higher, but only weakly significant (use of masks, P < 0.05) or nonsignificant (use of spray booths), when fewer safety provisions were taken. A significant increase in DNA strand breaks and alkali-labile sites was found in spray painters after a week's work. However, DNA damage seems to be reversible. The use of modern safety equipment seems to affect DNA damage only marginally. There is an urgent need to identify the genotoxic chemicals in the occupational environment of spray painters and to develop corresponding satisfactory safety measures.

Mutagenic activity and metabolites in the urine of workers exposed to trinitrotoluene (TNT).

Urine samples taken after work and after a free weekend from 50 workers employed in various activities in a chemical plant manufacturing explosives were analysed. On the basis of hygienic surveys, the subjects were divided into three categories of exposure to trinitrotoluene (TNT). The urine analyses consisted of gas chromatographic identification of TNT and its two metabolites, 4-ADNT and 2-ADNT, and a determination of the mutagenic activity. Two frame shift detector strains of Salmonella typhimurium were used, TA 98 and TA 98 NR, the latter being deficient in endogenous nitroreductase activity. On the basis of previous results on TNT mutagenicity, no exogeneous metabolic system was used to test the urine concentrates. Both tester strains showed that the mean urinary mutagenic activity was higher in the after work samples than in post weekend samples from the same subjects, showing that bacterial nitroreductase activity was not significantly responsible for the mutagenicity, although the response was higher with strain TA 98 than with TA 98 NR. The interindividual variation in urine mutagenicity was high, however, and the difference between the two sampling times was statistically significant (p less than 0.05) only for the high exposed group (workers in trotyl foundry and sieve house). Correlation between urinary mutagenicity and concentration of TNT in urine was poor; correlation was significant only with the urinary concentration of 4-ADNT. The correlation between urinary TNT and both metabolites was good (p less than 0.001). These results suggest that analysis of 4-ADNT in urine would be a sufficient biological measure for controlling exposure to TNT.