Regular Working Day Research Articles

CENTRAL AORTIC PRESSURE (CAP) MEASURED IN THE OFFICE WITH SPHYGMOCOR AND DURING 24 HOURS (MOBIL-O-GRAPH AND ARTERIOGRAPH) AND HYPERTENSION MEDIATED ORGAN DAMAGE (HMOD) IN YOUNG PAT

Objective: Central aortic pressure (CAP) is a parameter of central hemodynamics. It can be measured in the office with SphygmoCor, and during 24-hours with Mobil-O-Graph and Arteriograph. Debate is going on whether CAP is more associated with HMOD than brachial blood pressure. The aim of our study is to analyse assocation of office CAP and 24-hour CAP with HMOD in patients with stage 1 hypertension. Design and method: This study included 154 patients with the primary hypertension (69.5% women, mean age 38.5). In all of them we collected various clincial data and antroplogical paramaters. CAP was measured in the office (SphygmoCor) and during regular working days (24h ABPM systems: Mobil-o-Graph and Arteriograph). Results: The increased office CAP was associated with five indicators of HMOD: decrease in eGFR, increase in 24 hours albuminuria, thickness of the intima and carotid media (cIMT), NT pro-BNP, left ventricular hypertrophy- ECG Cornell criteria (LVH). Elevated 24-hour (Mobi-O-Graph) systolic CAP was associated with increased cITM and decreased EF. Higher values of diastolic CAP (Mobi-O-Graph) were accompanied by a greater possibility of LVH. An increase in 24 hours systolic CAP (Arteriograph) was followed with an increase in the cITM. An increase in 24 hours diastolic CAP(Arteriograph) was followed with a decrease in eGFR. Conclusions: CAP could be considered as a indicator of HMOD and total cardiovascular risk especially in young patients, but large longitudinal studies are need in order to confirm this. CAP measured with SphymoCor can be considered a better predictor of HMOD compared to CAP measured over 24 hours. Further investigation is needed to determine clinical value of both office and 24 hours CAP.

Sleep and stress at work and in the family among young people

Objective: to investigate the relationship between the quality and duration of sleep and stress at work and at home in people aged 25–44 years living in Novosibirsk.Material and methods. The study of a representative cohort of people aged 25–44 years was conducted in 2013–2016 in one of the districts of Novosibirsk (budget topic No. AAAA-A17-117112850280-2). A total of 975 individuals were examined (427 men, mean age – 34±0.4 years, response rate – 71%; 548 women, mean age – 35±0.4 years, response rate – 72%). The general examination was conducted according to the standard methods of the WHO program “MONICA-psychosocial (MOPSY)”. The standard Jenkins questionnaire was used to assess the quality and duration of sleep. Scales to assess stress at home (scale “Knowledge and attitude towards one’s own health”) and at work (Karazek scale) were included in the standard questionnaire.Results. Men aged 25 to 44 with sleep disorders were more likely to report that they “dislike their work” (52.2%) and that their attitude towards work is “average” (50.7%). It is rare for both men (46.8%) and women (56.6%) to relax and have rest after a normal working day. Women with sleep problems (56.5 %) stated that they are unable to rest adequately at home. Both men and women with sleep disorders confirmed that there had been serious conflicts in the family in the last 12 months: “several” times" (57.1 % and 55.8 % respectively) or “often” (53.3 % and 68.4 % respectively). Women with a sleep duration of 5–6 hours stated that they “never” (36.4 %) or “rarely” (36.8 %) manage to relax and recover after a regular working day; for 33.3 %, responsibilities at work have “increased”; 37.2 % have started to do extra work.Conclusion. A correlation was found between sleep disturbances and their duration and stress both at work and at home.

Comparison of effects of modafinil and caffeine on fatigue-vulnerable and fatigue-resistant aircrew after a limited period of sleep deprivation.

Introduction: Literature suggests pilots experience fatigue differently. So-called fatigue-resistant or -vulnerable individuals might also respond differently to countermeasures or stimulants. This study, which is part of a larger randomized controlled clinical trial, aims to investigate the effect of caffeine and modafinil on fatigue-resistant and -vulnerable pilots. Methods: This study included 32 healthy employees of the Royal Netherlands Air Force, who completed three test days, separated by at least 7days. After a regular work day, the subjects were randomly administered either 300mg caffeine, 200mg modafinil or placebo at midnight. Hereafter the subjects performed the psychomotor vigilance test (PVT), vigilance and tracking test (VigTrack) and Stanford sleepiness scale (SSS) six times until 8 a.m. the next day. Subjects were ranked on the average number of lapses on the PVT during the placebo night and divided into three groups: fatigue-vulnerable (FVUL), -intermediate (FINT) and -resistant (FRES), with 11, 10 and 11 subjects in each group, respectively. Area under the curve (AUC) of the PVT, VigTrack and SSS during the test nights were calculated, which were used in univariate factorial analysis of variance (ANOVA). Tukey's HSD post hoc tests were used to differentiate between the groups. Results: A significant effect of treatment was found in the ANOVA of both PVT parameters, VigTrack mean reaction time and SSS. There was a statistically significant effect of fatigue group on all PVT parameters and VigTrack mean percentage omissions, where FINT and FRES scored better than FVUL. There was a significant interaction effect between treatment and fatigue group for PVT number of lapses. This is congruent for the AUC analyses in which for all parameters (except for the SSS) the performance of the FVUL group was consistently worse than that of the FINT and FRES groups. Discussion: This study demonstrates that the performance of individuals with different fatigue tolerances are differently affected by simulants after a limited period of sleep deprivation. The classification of fatigue tolerance through PVT lapses when sleep deprived seems to be able to predict this.

Primary care gatekeeping during the COVID-19 pandemic: a survey of 1234 Norwegian regular GPs.

In the Nordic healthcare systems, GPs regulate access to secondary health services as gatekeepers. Limited knowledge exists about the gatekeeper role of GPs during public health crises seen from the perspective of GPs. To document GPs' gatekeeper role and organisational changes during the initial COVID-19 lockdown in Norway. A cross-sectional online survey was addressed to all regular Norwegian GPs (n = 4858) during pandemic lockdown in spring 2020. Each GP documented how patients with potential COVID-19 disease were triaged and handled during a full regular workday. The survey also covered workload, organisational changes, and views on advice given by the authorities. A total of 1234 (25.4%) of Norway's GPs participated. Together, they documented nearly 18 000 consultations, of which 65% were performed digitally (video, text, and telephone). Suspected COVID-19 symptoms were reported in 11% of the consultations. Nearly all these patients were managed in primary care, either in regular GP offices (55.7%) or GP-run municipal respiratory clinics (40.7%), while 3.7% (n = 73) were admitted to hospitals. The GPs proactively contacted an average of 0.8 at-risk patients per day. While 84% were satisfied with the information provided by the medical authorities, only 20% were able to reorganise their practice in accordance with national recommendations. During the early stage of the COVID-19 pandemic in Norway, the vast majority of patients with COVID-19-suspected symptoms were handled in primary care. This is likely to have protected secondary health services from potentially detrimental exposure to contagion and breakdown of capacity limits.

POOR AGREEMENT BETWEEN CAROTID-FEMORAL PULSE WAVE VELOCITY (C-F PWV) AND 24 HOUR PWV DETERMINED WITH TWO DIFFERENT METHODS

Objective: The gold standard of arterial stiffness determination is measurement of the carotide-femoral pulse wave velocity (cf-PWV). It was suggested that 24 hour measurement might give addition or more insights in the estimation of the global cardiovascular (CV) risk Our aim was to analyze association/concordance between cf-PWV values (SphygmoCor) with the values obtained with 24h measurments (Mobil-o-Graph and Arteriograph). Design and method: This study included 154 patients with the primary hypertension (women 69.5%, mean age 38.5). In all of them we collected various clinical and laboratory data and antroplogical paramaters. Parameters of arterial stiffness were measured with the SphygmoCor and 24h using Mobil-o-Graph and Arteriograph devices during the regular working day. Concordance correlation coefficient (CCC) was calculated. the Bland Altman method was used to estimate the deviation of methods Limits of agreement (LoA) are defined as the mean difference ± 1.96 SD difference. Results: Statistically significant correlation was observed between cf-PWV and data obtained with Arteriograph: 24h, day, night; and Mobilograph: 24h, day and night (r = 0.500, p < 0.001; r = 0.485, p < 0.001; r = 0.519, p < 0.001); r = 0.697, p < 0.001, r = 0.691, p < 0.001) r = 0.665, p < 0.001, respectively). cf-PWV shared 25% and 49% of the variance (R2) with the Arteriograph and Mobilograph, respectively. CCC was weak for both methods, Arteriograph and Mobilograph (CCC 0.49 95%CI 0.36-0.60; 0.50 95% CI 0.41-0.58, respectively). Large difference was observed for both methods, being larher for Arteriograph than with Mobilograph (-0.31 m/s (LoA -4.8 to 4.8) ; 1.6 m/s (LoA -1.69 to 4.89, respectively). Conclusions: In the group of young treated hypertensive patients with mild CV risk we found week agreement between cf-PWV and 24h PWV data. Better concordance was found between cf-PWV and Mobilograph than with Arteriograph. It could be concluded that cf-PWV and 24h PWV could not be used intercheangable. More results are needed to answer whether 24 h PWV has the same clinical value as cf-PWV

Impact of national holidays and weekends on incidence of acute type A aortic dissection repair

Previous studies have demonstrated that environmental and temporal factors may affect the incidence of acute type A aortic dissection (ATAAD). Here, we aimed to investigate the hypothesis that national holidays and weekends influence the incidence of surgery for ATAAD. For the period 1st of January 2005 until 31st of December 2019, we investigated a hypothesised effect of (country-specific) national holidays and weekends on the frequency of 2995 surgical repairs for ATAAD at 10 Nordic cities included in the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) collaboration. Compared to other days, the number of ATAAD repairs were 29% (RR 0.71; 95% CI 0.54–0.94) lower on national holidays and 26% (RR 0.74; 95% CI 0.68–0.82) lower on weekends. As day of week patterns of symptom duration were assessed and the primary analyses were adjusted for period of year, our findings suggest that the reduced surgical incidence on national holidays and weekends does not seem to correspond to seasonal effects or surgery being delayed and performed on regular working days.

Effects of prolonged working hours on heart rate variability in internal medicine physicians

Prior studies have utilized heart rate variability (HRV) as the assessment tools for psychological and physiological stress during 24-h shift. However, data regarding effects of prolonged working hours > 24 h on HRV are limited. We aimed to compare between pre- and post-call HRV among physicians who worked 24 plus 8 h. The study included 60 physicians in the internal medicine training. All subjects underwent Holter ECG monitoring for HRV assessment. We compared between HRV of an 8-h regular workday (8am to 4 pm) before on-call duty (pre-call HRV) and an 8-h workday after 24-h on-call duty (post-call HRV). The mean age was 26 ± 2.5 years. Mean total sleep time during on-call duty was 238.9 ± 88.3 min. In overall population, the time-domain and frequency-domain HRV parameters were not different between pre- and post-call day. However, the physicians reported their sleep time in the 1st quartile (< 180 min) had significant increase in SDNN, pNN50, high frequency (HF), and decrease in low/high frequency ratio (LF/HF). In contrast, the physicians reported their sleep time in the 4th quartile (> 307.5 min) had significant decrease in pNN50, LF, HF, and increase in heart rate. Multiple linear regression revealed total sleep time as an independent factor associated with pre- and post-call HRV alterations. More sleep during on call (> 5 h) was associated with HRV pattern suggesting both increased sympathetic activity and reduced parasympathetic activity, while less sleep (< 3 h) during on call was associated with post-call parasympathetic rebound HRV pattern.

The Effect of Sleep Quality and Mental Fatigue on the Learning Rate of Shift Workers with Fast Shift Work Rotation.

Modern industrial societies are always prone to errors and accidents due to complex devices, multitasking, and shift work jobs. Therefore, behavioral tests in learning and memory are necessary to evaluate employees' perceptions to examine the brain's information processing and the physiological and psychological aspects of memory disorders. In this study, the effect of fast shift rotation, sleep quality, and mental fatigue on individuals' learning and memory was investigated using a maze device. Participants were divided into two groups (regular daytime workers and shift workers). The quality of sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the rate of mental fatigue was evaluated using a checklist published by the Japan Industrial Safety and Health Association. Learning time and the number of learning errors at the beginning and end of the morning shifts and night shifts had a significant relationship (P value <0.0001). However, there was no meaningful relationship between sleep quality and time and the number of learning errors in day workers and shift workers. The results indicated that although shift workers experience rapid shift rotation, they are still exposed to this circadian sleep change's side effects such as general physical fatigue, sensory-neurological fatigue, poor perceived sleep quality, daily dysfunction, difficulty in learning, and memory. They show a significant difference compared to people working on a regular workday.

A Case for Academic Teleradiology.

A Case for Academic Teleradiology.

Cesarean delivery availability in Iowa was not constrained by anesthesia workforce limitations: Retrospective cohort study of inpatient surgery case counts

BackgroundOur goal was to assess whether anesthesia workforce limited surgical obstetrical care in the rural US state of Iowa. All Iowa hospitals with obstetrics have anesthesia practitioners (i.e., constraints would be functional, not related to having no anesthesia coverage). Our hypothesis #1 was that scheduling for cesarean delivery would functionally be separate from other inpatient operating room scheduling. Our hypothesis #2 was absence of systematic differences among hospitals in their distributions of cesarean deliveries between weekends and regular workdays. MethodsThe retrospective cohort study included all inpatient surgical cases at hospitals with cesarean births in the state of Iowa October 2015 through June 2021. There were analyzed 112 hospitals × 2100 days × 2 numbers, counts of cesarean deliveries and counts of all other surgical cases. ResultsThe incremental risk ratio between daily cesarean deliveries and other inpatient surgical cases was 1.00 per cesarean delivery (99% confidence interval 0.99 to 1.01). Thus, doing another cesarean delivery was not associated with either a proportional reduction (ratio <1) or increase (ratio >1) in other cases performed on the same day. Multiple sensitivity analyses showed the same results. In addition, there was no association in cesarean deliveries between hospitals’ percentages on weekends and overall weekly numbers (P = 0.08). Multiple sensitivity analyses showed the same results, no systematic differences between large versus small obstetrical programs in the distributions of cesareans between weekends versus workdays. Finally, among the 19/73 hospitals ending obstetrics during the study period, all continued to perform surgery. ConclusionsLimitations in the anesthesia workforce did not constrain surgical obstetrical care statewide. Similarly, cesarean births were at most negligibly causing other inpatient surgical cases to be postponed to later days.

Peer Observation of Teaching Program for the Busy Hospitalist.

Background: Peer observation of teaching (POT) is a well-documented faculty development tool, but published research focuses mostly on programs in which participating physicians had protected time in their schedule in which to complete observations. Most programs nationally depend on hospitalists who have minimal, if any, protected time in their schedule and thus in order to complete these observations, will need to figure out a way to schedule these into their regular working day.Objective: We determined whether a POT program, focused on hospitalists with minimal non-clinical time, scheduled around clinical responsibilities, could be feasible and acceptable.Methods: Seven hospitalists participated in a POT pilot program from January 2019 to June 2019. Each hospitalist completed three 30-minute observations during this interval. At the completion of the pilot, the hospitalists were surveyed on their experience and results were assessed via open-ended narrative questions, which underwent thematic analysis.Results: Twenty of the 21 scheduled observations (95%) were completed. Of the completed observations, 100% were completed while the observer was assigned to concomitant clinical duties. The survey response rate was 100%. From free-text responses, the following themes emerged: (1) Acceptable time commitment with minor inconvenience, (2) learning through observing and reflecting for personal growth, and (3) stress-free peer observations.Conclusions: This study demonstrates the successful development and implementation of a POT program that served as a faculty development initiative focused primarily on hospitalists with minimal protected time.

Diurnal variations of resting-state fMRI data: A graph-based analysis

Circadian rhythms (lasting approximately 24 h) control and entrain various physiological processes, ranging from neural activity and hormone secretion to sleep cycles and eating habits. Several studies have shown that time of day (TOD) is associated with human cognition and brain functions. In this study, utilizing a chronotype-based paradigm, we applied a graph theory approach on resting-state functional MRI (rs-fMRI) data to compare whole-brain functional network topology between morning and evening sessions and between morning-type (MT) and evening-type (ET) participants. Sixty-two individuals (31 MT and 31 ET) underwent two fMRI sessions, approximately 1 hour (morning) and 10 h (evening) after their wake-up time, according to their declared habitual sleep-wake pattern on a regular working day. In the global analysis, the findings revealed the effect of TOD on functional connectivity (FC) patterns, including increased small-worldness, assortativity, and synchronization across the day. However, we identified no significant differences based on chronotype categories. The study of the modular structure of the brain at mesoscale showed that functional networks tended to be more integrated with one another in the evening session than in the morning session. Local/regional changes were affected by both factors (i.e., TOD and chronotype), mostly in areas associated with somatomotor, attention, frontoparietal, and default networks. Furthermore, connectivity and hub analyses revealed that the somatomotor, ventral attention, and visual networks covered the most highly connected areas in the morning and evening sessions: the latter two were more active in the morning sessions, and the first was identified as being more active in the evening. Finally, we performed a correlation analysis to determine whether global and nodal measures were associated with subjective assessments across participants. Collectively, these findings contribute to an increased understanding of diurnal fluctuations in resting brain activity and highlight the role of TOD in future studies on brain function and the design of fMRI experiments.

A 24-hour population distribution dataset based on mobile phone data from Helsinki Metropolitan Area, Finland

In this article, we present temporally dynamic population distribution data from the Helsinki Metropolitan Area, Finland, at the level of 250 m by 250 m statistical grid cells. An hourly population distribution dataset is provided for regular workdays (Mon – Thu), Saturdays and Sundays. The data are based on aggregated mobile phone data collected by the biggest mobile network operator in Finland. Mobile phone data are assigned to statistical grid cells using an advanced dasymetric interpolation method based on ancillary data about land cover, buildings and a time use survey. The dataset is validated by comparing population register data from Statistics Finland for night hours and a daytime workplace registry. The resulting 24-hour population data can be used to reveal the temporal dynamics of the city, and examine population variations relevant to spatial accessibility analyses, crisis management, planning and beyond.

Gravity Model Parameter Variation during a Long-Term Study using Mobile Phone Data in the Rio de Janeiro Metropolitan Area

Large-scale events are usually difficult for transportation planners because most survey data are focused on regular workdays. Mobile phone call records are low-cost and valuable data sources for transportation planning and monitoring. This work presents a long-term study of mobile phone call records collected throughout 2014 in the Rio de Janeiro Metropolitan Area. A careful aggregation of antenna coverage areas generated the useful spatial partition of the geographic area of study into geographic units. This spatial partition was used to identify presumed domiciles and to estimate four gravity models per day in four time-shifts. The power law gravity model distribution concerns the home distance of the visitors detected in the studied destination, Copacabana Beach, which was chosen because it is a frequent venue for several large-scale events in the city of Rio de Janeiro. The model results show that the power law parameters vary according to the type of day and the number of visitors. The analysis of parameter values reveals clusters of similar mobility patterns according to the type of day and time shift. The proposed methodology can be used as a first approach to simulate the mobility demand of new events complementing other transport planning approaches at a tactical and strategic levels.

DARK SIDE CASE: Black Employees (Should) Matter

This teaching case portrays a dilemma faced by Daniel, a young Brazilian black journalist who works for Globo Group, the country’s largest and dominant media conglomerate. He has been able to build a successful career start at GloboNews channel, which he – and his family – considered to be a dream job. It is a regular working day in early November 2019. Daniel looks at his appointments on the computer calendar and notices that the Brazilian national black awareness day – celebrated on November 20th – is approaching. This event has been a great advance in the Brazilian social agenda. At a glance, Daniel remembers that the country has the world’s largest population of black people outside Africa, and that blacks represent the majority of the Brazilian population. It is the result of a grievous time of more than 300 years of slavery, and almost 5 million people forcibly brought to the country. For an idea of the magnitude of this number, around 380 thousand enslaved people were taken to the USA during its slavery period, ten times less than the number received by Brazil. In this reflective moment, he finally realizes that the organization he proudly chose to work for, and that portrays “diversity” as a core value, has so few black workers, and almost none in leadership positions. Moreover, no one seemed to care much about it. What should Daniel do?

How The Covid-19 Pandemic Affected The Physical Activity Of Different Members Of A University Community

Adequate physical activity (PA) is important factor for improving or maintaining health and preventing chronic disease. The COVID-19 pandemic has resulted in a large scale transition to remote learning and working, which may have an impact on the daily PA that individuals obtain, potentially impacting their health. PURPOSE: To examine how the shutdown of a University due to COVID-19 impacted the PA habits of students and faculty/staff, and to explore whether either group was impacted to a greater extent. METHODS: Individuals who wore a commercial PA monitoring device for 30 days prior to, and after, the James Madison University (JMU) spring break in March 2020 were recruited from the JMU community. Spring break is when JMU transitioned from in-person to online instruction. Subjects completed an anonymous survey and input step data from their PA device. RESULTS: Eighty subjects (age = 32.2 ± 13.6, BMI = 26.3 ± 6.8, 62 females, 17 males) completed the survey. 42 were students and 38 were faculty/staff. For the 7 days prior to spring break compared to the 7 days after spring break, there was a main effect for time for steps per day (8688.7 ± 3365.3 vs. 7128.2 ± 3365.3, respectively; P < 0.001), but no difference between students and faculty/staff. 30 days prior to spring break compared to 30 days after, there was a group x time interaction, with the students decreasing their steps after spring break (8307.4 ± 3128.3 vs. 6159.7 ± 2737.6) to a greater extent than faculty/staff (8760.4 ± 3366.5 vs. 8109.8 ± 4160.7; P = 0.002). A group x time interaction was also seen for weekend days (P = 0.01). Students decreased their weekend steps after spring break (7543.6 ± 3291.6 vs. 6391.4 ± 3149.3) whereas faculty/staff did not (8750.0 ± 4305 vs. 8876.1 ± 4874.1). Finally, there was a group x time interaction for weekday steps (P = 0.003) with students decreasing (8621.6 ± 3225.9 vs. 6076.4 ± 2722.4) to a greater extent than faculty/staff (8741.8 ± 3212.6 vs. 7817.2 ± 4015.9). CONCLUSION: Results suggest that when JMU transitioned to online learning, students decreased their daily PA more than faculty/staff. This is likely due to the elimination of daily transport based PA that students would normally participate in, such as walking to classes, etc., whereas faculty/staff likely did less of this type of PA during a regular work day.

Factories Against the Clock: Time-discipline and Resistance in the Silk Reeling Factories of Bursa 1850-1915

What can the study of different regimes of time discipline in factories and deviations in their measurement tell us about the relationship between capital, labour and the state authority in the Ottoman Empire? In this article, I will answer this question by analysing the official letters and petitions of the Bursa Silk workers to explore how “watchless” people understand and negotiate new time patterns emerged from mechanized production. I argue that the mechanized factory production did not result in a clock-measured, regular working day up until the early twentieth century in silk factories of Bursa. These irregular labor patterns, however, cannot be explained by the immature scale of the industry or lack of labor rationalization. The answer lies at the heart of the working day: such irregularity enabled employers to increase, to say it in Marxist terms, the absolute surplus value. Furthermore, I will argue that the demand for regimented work hours came not from the capitalists, and it was not the Ottoman government`s top-down reforms. Rather, the demand to curb all-invading, irregular work hours came from the young female laborers who were deemed the least “time-conscious”. In this light, the story of Bursa decenters the male-dominated view in the global history of economy and labour and adds nuance to our understanding of the temporalities of capitalism.

How the first years of motherhood impact the cardiac autonomic profile of female healthcare professionals: a study by heart rate variability analysis

The conciliation between career and family is a relevant issue for working women, in particular during the first years of motherhood. Data about the state of the cardiac autonomic regulation in working women with preschoolers are lacking. Aim of this study was to compare the cardiac autonomic profile of female healthcare professionals with and without preschoolers via the analysis of the variability of the time distance between two consecutive R-wave peaks (RR) from standard 24-h Holter electrocardiogram (ECG). Fifty healthy active female healthcare professionals were enrolled: 25 with at least one preschooler (W_KID) and 25 without (W_NOKID). A standard Holter ECG was obtained during a regular working day. Segments of 5000 consecutive RRs were selected during daytime (DAY) and nighttime (NIGHT). Heart rate variability analysis was performed and the following parameters were considered for comparison between the two groups: mean (μRR), variance (σ2RR), and the absolute power in high frequency component (HF) of RR (HFRR) series. HFRR was considered as a marker of vagal cardiac modulation. Only µRR significantly increased from DAY to NIGHT in both groups (699 ± 88 vs 887 ± 140 ms in W_KID and 728 ± 90 vs 942 ± 166 ms in W_NOKID). Instead, σ2RR and HFRR increased from DAY to NIGHT only in W_NOKID (from 3334 ± 2153 to 4816 ± 4063 ms2 and from 356 ± 334 to 1397 ± 1629 ms2, respectively). W_KID showed lower σ2RR and HFRR during NIGHT, compared to W_NOKID (2336 ± 3170 vs 4816 ± 4063 ms2 and 556 ± 950 vs 1397 ± 1629 ms2, respectively). The perceived stress according to the visual analogue scale was similar in the two groups (4.7 ± 2.1 in W_KID, 5.7 ± 2.1 in W_NOKID). The presence of preschoolers lowered nocturnal cardiac vagal modulation in female healthcare professionals. This might represent an adaptation with a finalistic purpose, scilicet the facilitation of a prompt reaction in case of a child’s need.

Women in the State: Elected Women and the Challenge of Indian Politics (1957–62)

When Parvathi Krishnan (MP, Coimbatore Madras) entered India’s parliament on 28 March 1958, it was just a regular workday. She questioned a government minister about his policies toward railway workers, and solicited funds to repair a post office in her constituency. And yet as a woman legislator, she balanced the everyday tasks of governance with the difficulties of functioning in a male-centred institution. This essay, based on research in legislative debates in Madras and Bihar as well as in parliament, argues that especially for the period from 1957 to 1962, when so much of the legislative process was still in flux, women legislators challenged government structures even as they participated in making them. Their work—for the state and for their constituents—necessarily shaped the institutions to which they were elected. Looking beyond high-profile policies like the Five-Year Plans, this essay reveals the complex task of governing and the critical roles of women in it.

Analyzing Urban Freight System, Supply Chain Characteristics and Temporal Travel Pattern in Indian context

State of the art in understanding the urban freight system is quite challenging in developing countries, and India is one of them. Consequently, there is a paucity of knowledge in comprehending the urban freight system's supply chain characteristics and its impact on operation, infrastructure, and the environment. Therefore, this study aims to analyze the supply chain characteristics, estimate the freight trips and freight temporal travel patterns for different industrial sectors in the various establishments at a microscopic level. Using an establishment-based freight survey (EBFS) form, a total of 647 establishment data was collected from Tiruchirappalli, India. This study initially investigated the dynamic and robustness of the supply chain characteristics such as establishment, commodity, vehicular movements, and delivery patterns involved in the urban freight system at the microscopic level. Then, correlation tests were performed to understand the relationship between supply chain characteristics and freight trips at different confidence intervals. Business size variables (employment and gross floor area) were used to estimate the freight trip movement and generate a freight trip rate table for intermediate and pure receiver establishment. Freight trips rates for different industrial sectors were estimated using multiple classification analysis method and compared to various goodness of fit measures. Eventually, the urban freight temporal travel pattern was assessed and visualized by hourly travel distribution of the freight movements during regular working days in the various industrial sector for the Indian context.