Working Day Research Articles

Real-world Glycemic and Person-Reported Outcomes after Tandem Control-IQ initiation in Children with Type 1 Diabetes.

This multicenter prospective observational cohort study assessed real-world changes in glycemic and person-reported outcomes one-year after Control-IQ initiation in children and adolescents with type 1 diabetes. Between October 2021 and December 2022, all children 6-18 years who started Control-IQ at 13 Belgian centers were consecutively recruited. Data were collected at start of Control-IQ and after 4, 8 and 12 months. Person-reported outcomes were evaluated through questionnaires (Diabetes Quality of Life for Youth [DQOLY], Hypoglycemia Fear Survey [HFS], HAPPI-D). Data are reported as mean ± SD or least-squares mean (95% CI). A total of 114 children were included, with a mean age of 12.0 ± 3.2 years and of whom 61.4% were girls. Time in range (3.9-10.0 mmol/L) increased from start (51.6% [47.6-55.5]) to 12 months (64.4% [61.2-67.5]) (p<0.001). After 12 months, HbA1c decreased from 62 mmol/mol (60-65) (7.8% [7.6-8.1]) to 54 mmol/mol (52-56) (7.1% [6.9-7.3]) and time <3.9 mmol/L from 3.9% (3.1-4.8) to 2.7% (1.9-3.5) (all p<0.001). Children scored better on DQOLY satisfaction (70.4 [67.8-73.0] vs 74.0 points [71.3-76.6]) and DQOLY impact (54.6 [50.9-58.3] vs 51.3 points [47.4-55.1]), and parents on HAPPI-D (22.5 [21.1-23.9] vs 19.6 points [18.2-21.0]) and HFS worry (25.0 [21.6-28.4] vs 20.3 points [17.0-23.5] (all p<0.001). Children missed fewer days of school (287 vs 30 days/100 person-years, p=0.001) and parents missed less days of work (247 vs 47 days/100 person-years, p<0.001). One-year use of Control-IQ was associated with improved glycemic management, more diabetes-related quality of life and fewer school/work absences.

Multivariate Analysis of Determinants of Student Learning Achievement: Discriminant Analysis and Random Forest Approach

This study aims to identify factors that influence student learning achievement using the Random Forest method and linear discriminant analysis (LDA). The data used include variables such as gender, part-time work, days of absence, extracurricular activities, weekly hours of independent study, and grades from various subjects. The results of the analysis show that weekly hours of independent study are the most dominant factor influencing student academic achievement, followed by involvement in extracurricular activities. In addition, student attendance was also found to be an important factor, with a significant correlation between days of absence and part-time work and gender. These findings provide valuable insights for educators and policy makers to encourage independent learning practices, support student involvement in extracurricular activities, and reduce student absenteeism. Educational strategies that focus on these factors are expected to significantly improve student academic achievement.

I'm tired of pretending that nothing's wrong: A mixed-methods study of financial barriers for individuals living with primary dysmenorrhea.

I'm tired of pretending that nothing's wrong: A mixed-methods study of financial barriers for individuals living with primary dysmenorrhea.

Herding Behavior in the Stock Market of Identified Boycotted Indonesian Stock Exchange Companies After the Determination of MUI Fatwa No. 83/2023

Research Aims: This study aims to detect herding behavior in the stock market of companies on the Indonesia Stock Exchange that are the targets of a boycott by the Indonesian people in rising, falling, and overall combined price conditions after the announcement of MUI Fatwa Number 83 of 2023. Design/methodology/approach: The analysis tool used is the Quantile Regression Test to detect herding behavior that occurs. There are 6 companies that can be identified with stock price data taken during 120 working days of the stock exchange in Indonesia after the fatwa was issued from November 9, 2023 to May 20, 2024. Research Findings: The results show that there is no indication of herding behavior when the market is rising, falling and overal from any quantile tested using quantile regression. Theoretical Contribution/Originality: This result is suspected because there is the use of words in the fatwa that cause debate and the absence of a list of products listed. Other supporters such as investor literacy have increased due to the rapid development of technology which is in line with the increasing ability to think or intellectually to make decisions in investing. On the other hand, because of the increased ability, investor confidence also increases so that decisions made can be rational in investing. Research limitation and implication: This research is limited to several companies that can be found by the researcher, and is limited by the time until this research is carried out. This research can provide an overview of the turmoil that occurs in the market and how the market responds to negative sentiment that is occurring. Keywords: Boycott, Fatwa MUI, Herding Behavior, Intellectual, Literacy

Периоперационная респираторная поддержка и послеоперационные исходы: российское национальное эпидемиологическое исследование «РуВент-А»: протокол исследования

INTRODUCTION: Annually, approximately 230 million patients undergo general anesthesia and mechanical ventilation, which is associated with a high incidence of postoperative pulmonary complications (PPC). Despite the proven efficacy of protective ventilation, the actual respiratory support strategies in Russian operating rooms remain insufficiently studied, underscoring the relevance of the RuVent-A study. MATERIALS AND METHODS: In the multicenter observational study RuVent-A, data will be collected using specialized electronic forms (Center Card and Patient Protocol) integrated into a secure web platform that ensures anonymization, regular backup, and quality control of the data. onditions: This is a multicenter observational study of patients undergoing surgical interventions under mechanical ventilation. Patients: The study includes all patients over 18 years of age undergoing surgical interventions under general anesthesia over a period of 5 working days. Interventions: The study records respiratory support parameters (tidal volume, PEEP, FiO₂, ventilation modes, etc.), the type of surgical intervention, comorbidities, and the subsequent occurrence of PPC, while no changes to clinical protocols are made. RESULTS: The developed study design has been registered in the ClinicalTrials.gov database, confirming its compliance with international standards and ensuring the transparency of the research. CONCLUSIONS: It is anticipated that the results of RuVent-A will help identify current respiratory support strategies, determine key risk factors for PPC, and formulate recommendations for optimizing perioperative ventilation in Russia, ultimately enhancing the quality of medical care and patient safety.

Penerapan Critical Path Method (CPM) Guna Meningkatkan Efisiensi Pada Perawatan C-Check Pesawat Boeing 737-500 (PK-NAS) (Studi Kasus di PT. Merpati Maintenance Facility)

Turn Around Time (TAT) in C-Check maintenance activities is a problem that often occurs in aircraft maintenance service organizations because it requires large operational costs for technicians, and there are losses due to waiting time for aircraft operations during maintenance. This research compares company TAT with TAT using the Critical Path Method (CPM) and the percentage of man-hours efficiency from calculating the CPM method. The research object and data were collected at the PT Merpati Maintenance Facility. The types and sources of data used in research are primary and secondary. The data analysis techniques used are Turn Around Time (TAT) planning calculations and the Critical Path Method (CPM) method, as well as analyzing calculations that have been carried out using Microsoft Excel. Based on the research results, it was found that the difference in results between company planning was 18.56 or 19 work days and planning using the CPM method was 16.94 or 17 work days, so that you get more efficient time for 2 work days in carrying out C-Check maintenance with a percentage of the man hours efficiency formula of 0.087%.

Assessing the burden of diseases attributed to exposure to ambient particulate matter by air quality modeling.

This study aimed to assess PM2.5 exposure levels in Ahvaz, Iran, and quantify the associated burden of disease attributable to particulate pollution. To quantify uncertainty mortality and morbidity, the exposure response function model for probabilistic risk assessment was used. The analysis of aerosol variations by the Aerosol Optical Thickness indicated a decline in PM2.5 concentrations during pandemic. During the study period, the annual mean of PM2.5 concentrations exceeded the annual limit value established by the World Health Organization. Cause-specific mortality, including trachea bronchus lung cancer, stroke, and acute lower respiratory infections, also decreased by 14-28% in 2020. Restricted activity days and work days lost decreased by 11.8% and 13.8%, respectively, correlating with lower PM2.5 concentrations. Years lived with disability dropped from 242.7 to 170.4 years per 105 capita in 2020 during the pandemic. Mitigation strategies, including green infrastructure, industrial regulation, and improved urban planning, are needed to reduce health risks in this highly polluted region.

The Role of Interns in Improving the Efficiency and Transparency of Legal Services in the Banjarbaru District Court

This service aims to increase the efficiency and transparency of legal services at the Banjarbaru District Court through the active role of intern students. It is carried out in the form of Legal Proficiency Practice (PKH) for 25 working days, from January 6, 2025 to February 7, 2025. The method of implementing PKH starts from forming a group, debriefing, delivery, and ends with pick-up again. Students are involved in administrative activities such as activities at PTSP, case data input, and moot-court. The PKH schedule adjusts to the working hours of employees at the Banjarbaru District Court. The results of this service show that the involvement of interns is able to accelerate the administrative process and improve the quality of public services. The implications of the results of the implementation of PKH show that collaboration between educational institutions and legal institutions can strengthen accountable digital-based services.

High Amount of Physical Activity on Work Days Is Associated with More Intense Musculoskeletal Symptoms in Nurses: Seven-Day Observational Study

Background: Musculoskeletal problems contribute to nurse attrition, which compromises patient safety and costs healthcare organizations millions of dollars. Recent research describes a physical activity paradox in which high amounts of work-related physical activity may be detrimental to health; however, there is a lack of evidence on the physical activity paradox with respect to musculoskeletal health in nurses. The purpose of this study was to examine the relationship between musculoskeletal symptoms (MSSs) and high amounts of physical activity at work in nurses. Methods: This was a 7-day observational design using direct measurement of physical activity and self-reported MSSs in nurses. Physical activity was measured in step counts using a wearable accelerometer and MSSs were reported using ecological momentary assessment. Step counts and MSSs were compared between work days and days off, and a regression model analyzed the combined effect of physical activity and work days on MSSs while controlling for age, exercise, and body mass index. Results: Musculoskeletal symptoms and step counts were significantly higher on work days compared to days off. Higher step counts on work days resulted in significantly higher expected MSS ratings than the same number of steps taken on a day off. Conclusions: This study supports the existence of a physical activity paradox in nurses with respect to MSSs. Understanding this paradox in the nursing workforce can translate to interventions that reduce the detrimental health effects of high levels of physical activity at work, which can minimize nurse attrition, improve patient outcomes, and reduce costs in healthcare organizations.

Formalization of approaches to the definition of criteria irregular working hours of a medical workers

An analysis of the issues of law enforcement practice arising in the implementation of the rights of medical workers performing their professional duties in the regime of irregular working hours is carried out. The novelties of the rules for granting annual additional paid leave for work in the irregular working hours regime to employees of federal state institutions coming into force on September 01, 2025 are considered; projected amendments to the Labor Code of the Russian Federation concerning the limitation of the annual duration of work in the irregular working day regime and the establishment of the duration of annual additional paid leave depending on the actual time worked in excess of the duration of the working day established for the employee.

Abstract 7178: Advancing WGS and WTS diagnostic testing for pediatric leukemia: fast-tracking CNV, ploidy, and fusion oncogene detection in 5 days

Abstract Leukemia is the most common cancer in children, with ∼75% being acute lymphocytic leukemia (ALL) and most of the rest acute myeloid leukemia (AML). More than half of pediatric acute leukemias are characterized by chromosome translocations, 40% of B-ALLs by ploidy changes, and a subset of AMLs harbor adverse cytogenetic aberrations defined by large-scale copy number changes (LS-CNV). Whole genome (WGS) and whole transcriptome sequencing (WTS) enable comprehensive molecular diagnosis, but often take weeks. We introduce a rapid workflow integrating WGS and WTS for tumor profiling, using advanced bioinformatic tools to evaluate LS-CNVs, tumor ploidy, and gene fusions, yielding results within 5 working days. Samples with &amp;gt;30% tumor content were used for WGS and WTS. We developed tumor-only WGS-based copy number profiling (WGS-CNP) using the Illumina DRAGEN CNV pipeline and an internal post processing analysis to generate genome-wide CNV results within 2-3 hours post-sequencing. Further on, we developed and automated an algorithm which compares test samples to a normal diploid reference, factoring in DNA gains/losses identified by WGS-CNV analysis to calculate DNA index (DI) for tumor ploidy estimates within minutes. We also implemented Fuzzion2, a rapid pattern-matching algorithm, to identify fusion transcripts from WTS data within ∼1 hour. This integrated rapid approach was tested in a total of 117 AML and ALL cases previously diagnosed using standard WGS/WTS pipelines (CREST/CICERO/CONSERTING) and flow cytometry for DI, including 67 cases with characteristic fusion oncogenes, 40 ALLs defined by ploidy change, and 65 cases with LS-CNVs. For gene fusion detection, Fuzzion2 identified all expected fusion oncogenes with no false positives, according to the established criteria. For LS-CNV, findings between WGS-CNP and the standard pipeline were concordant in all tested cases. For tumor ploidy, WGS-DI showed values concordant with Flow-DI in 33/40 cases. The 7 remaining cases were identified as masked low-hypodiploid by WGS-based CNV and B-allele frequency profiling, of which Flow-DI values were above 1.1 representing the actual tumor DNA content due to genome doubling. When using post-genome doubling (4n) as the ploidy baseline to generate CNVs, the calculated WGS-DI was below 0.75, reflecting the original clone before genome doubling. Our pilot studies show that the WGS-CNP reliably reproduced previously observed LS-CNVs, accurately established tumor ploidy changes and distinguished masked low-hypodiploidy from hyperdiploidy. Together with the implementation of Fuzzion2 algorithm for gene fusion detection, this integrated rapid approach may detect 80-90% of disease-defining genetic alterations in pediatric acute leukemia with high sensitivity and specificity within 5 days, dramatically expediting the diagnostic process using WGS and WTS. Citation Format: Rebecca K. Voss, Maria Cardenas, Meiling Jin, Yen-Chun Liu, Alexa N. Siskar, Stephen V. Rice, Michael N. Edmonson, Jennifer L. Neary, Caleb Gallops, Jiali Gu, Jamie L. Maciaszek, Michael Rusch, Mark R. Wilkinson, David Rosenfeld, Priya Kumar, Jeffery M. Klco, Charles G. Mullighan, Jinghui Zhang, David A. Wheeler, Lu Wang. Advancing WGS and WTS diagnostic testing for pediatric leukemia: fast-tracking CNV, ploidy, and fusion oncogene detection in 5 days [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7178.

Correlation between occupational hazard exposure and abnormal bone mineral density in steelworkers

ObjectivesTo investigate the relationships between abnormal bone mineral density (BMD) and exposure to single or combined occupational hazards in steelworkers by analyzing the correlations between various occupational hazards (night-shift work, high temperature, dust and noise) and abnormal BMD with both a single-risk score model (SRSM) and a hybrid-risk score model (HRSM).MethodsParticipants were selected from a cross-sectional study called “Cohort Study on the Health Effects of the Occupational Population in the Beijing–Tianjin–Hebei Region”. A total of 6816 participants were recruited for this study. Night-shift work and high temperature, dust and noise exposure were considered occupational hazards and were analyzed separately and in combination (coexposure). The health risk factor score and partial regression coefficient were used to establish an SRSM and an HRSM.ResultsThe rate of abnormal BMD in steelworkers was 27.6% (28.0% in males and 23.3% in females). Logistic regression revealed that, compared with that of individuals with 0 cumulative days of night-shift work, the risk of abnormal BMD for individuals with various amounts of night-shift work was as follows: ~927.20 days (OR = 1.40, 95% CI: 1.15 ~ 1.72), ~ 1772.02 days (OR = 1.45, 95% CI: 1.19 ~ 1.77), and ≥ 2573.50 days (OR = 1.55, 95% CI: 1.27 ~ 1.89). Compared with that of the cumulative exposure to high temperatures in the 0 °C·y group, the risk of abnormal BMD in the other groups was as follows: 667.49~°C·y (OR = 1.34, 95% CI: 1.06 ~ 1.71) and ≥ 790.30 °C·y (OR = 1.32, 95% CI: 1.03 ~ 1.69). Compared with that of the cumulative amount of dust exposure in the 0 mg/m3·y group, the risk of abnormal BMD for the other groups was as follows: 30.42 ~ mg/m³·y (OR = 1.23, 95% CI: 1.02 ~ 1.49) and ≥ 40.17 mg/m³·y (OR = 1.37, 95% CI: 1.14 ~ 1.65). Compared with that of the cumulative amount of noise exposure in the 0 dB(A)·y group, the risk of abnormal BMD for the other groups was as follows: ≥1707.47 dB(A)·y (OR = 1.17, 95% CI: 1.00 ~ 1.40). When an SRSM was used, compared with that in the control group (score < 0.42), the risk of abnormal BMD in the other groups was as follows: ~0.42 (OR = 1.24, 95% CI: 1.03 ~ 1.19), ~ 0.72 (OR = 1.51, 95% CI: 1.24 ~ 1.83), and ≥ 0.97 (OR = 2.11, 95% CI: 1.71 ~ 2.60). When an HRSM was used, compared with that of the reference group (score < 0.360), the risk of abnormal BMD for the other groups was as follows: ~0.360 (OR = 1.26, 95% CI: 1.05 ~ 1.52), ~ 0.576 (OR = 1.43, 95% CI: 1.18 ~ 1.74), and ≥ 0.779 (OR = 2.08, 95% CI: 1.70 ~ 2.55).Conclusions(1) Night-shift work and high temperature and dust exposure may contribute to abnormal BMD in steelworkers. (2) The higher the corresponding risk score of occupational hazard coexposure is, the greater the risk of abnormal BMD in steelworkers. When workers are exposed to multiple occupational hazards at the same time, coexposure models could reveal the relationships between occupational hazard exposure and abnormal BMD in steelworkers more accurately.

Analysis of Delays in Construction Time of the Banjarsari Water Gate Project, Sidoarjo District Using Critical Path Method

The Banjarsari sluice gate, located on the Sidoarjo district's shipping river, faces various challenges that can affect its performance. These challenges include sedimentation, damage to building structures, and decreased water quality due to domestic and industrial waste. The implementation of the Banjarsari Water Gate maintenance project, especially the floor work, experienced seepage at the bottom of the water gate floor, resulting in structural failure of the water gate building. CPM method duration planning is a recommendation in choosing from the many methods available, because there is a calculation of the earliest time the project starts, the latest time the project begins, the earliest time completed, and the latest time completed, so that the time lag of all activities can be known. Analyze the acceleration of work duration by adding workers to the work on the critical path. The purpose of this research is to analyze the length of time required by the CPM (Critical Path Method) method for the work of the Banjarsari floodgate. In this study, the time analysis uses the CPM (Critical Path Method) method and is assisted by Microsoft Project 2021 Software. The analysis results obtained work through the critical path, namely demolition work and cyclope concrete casting, and obtained the results of the duration of work on the Banjarsari floodgate work after crashing to 66 working days from the initial duration of 72 working days.

Time and Cost Control Analysis of Disaster Emergency Response Handling Project Construction in Mojokerto District Using Critical Path Method

Landslides along the Sumber Pasinan River in Mojokerto Regency, East Java, pose significant risks due to soil erosion and increased flooding during the rainy season. This study aims to analyze the acceleration of construction for a disaster emergency response project using the Critical Path Method (CPM) to minimize time and costs. Employing a quantitative research approach, primary data was gathered through direct observations at the project site, complemented by secondary data from relevant literature and project documents. The findings indicate that the implementation period was successfully reduced from 71 working days to 47 days, achieving a time acceleration of 24 days. This required the addition of 11 workers for the critical task of installing river stone masonry, which constituted 70.16% of the project's workload. The application of CPM proved effective in managing time and resources efficiently. The implications of this research highlight the importance of employing structured project management methodologies in disaster response construction projects. By demonstrating the effectiveness of CPM in accelerating project timelines while controlling costs, this study provides a valuable reference for future projects facing similar challenges. It also opens avenues for further research into the long-term impacts of workforce augmentation on project quality and cost-effectiveness in disaster management contexts.

Investigating the Role of Working Patterns in Tinnitus: Results From a Large UK Population.

This study aimed to examine the association of different working patterns and tinnitus. This cross-sectional study (2006-2010, n = 91,089) was a secondary analysis of existing data from the UK Biobank. It exploratorily evaluated the association between various working patterns, including shift work (day workers/sometimes/frequent), night shift work (day workers/rarely/sometimes/frequent), heavy work (never/sometimes/usually/always), work satisfaction (very happy/moderately happy/moderately unhappy/very unhappy), standing work (never/sometimes/usually/always) and workplace noise (no/exposing <1 year/1 to 5 years/>5 years) and the occurrence (yes/no), frequency (constant/transient) and severity (troublesome/not troublesome) of tinnitus. Univariate and multivariable logistic regression analysis models were conducted. Sub-analysis was performed to estimate the effects of age, sex, and different working factors on tinnitus. The study results showed that occasional shift and night shift were associated with an increased risk of tinnitus, while frequent shift/night shift showed no such association. This risk was further exacerbated by increased heavy work, prolonged standing work, lower job satisfaction, and extended exposure to noisy workplaces. Specifically, being occasionally engaged in shift/night shift, increasing workload, and short-term noise exposure (<1 year) were correlated with "transient tinnitus," while long-time noise exposure (>5 years) was identified as a significant risk factor for "constant tinnitus." Lower work satisfaction and noise exposure for more than 1 year were positively associated with "troublesome tinnitus." Irregular working shifts, increasing physical workload, lower work satisfaction, and longer noise exposure were related to the occurrence, frequency, and severity of tinnitus in the UK Biobank cohort. Therefore, targeted interventions aimed at improving working patterns may help prevent tinnitus.

E001 Evaluating the use of fast track out-patient clinics in the management of patients with suspected giant cell arteritis

Abstract Background/Aims Giant cell arteritis (GCA) is an immune mediated condition of unknown aetiology that primarily affects large and medium- sized arteries, most commonly the temporal arteries. Early diagnosis and prompt treatment are critical to prevent severe complications such as irreversible vision loss. The British Society for Rheumatology (BSR) guidelines emphasize the importance of rapid assessment and management of suspected GCA cases. The implementation of fast-track clinic (FTC) has been shown to be beneficial to facilitate timely diagnosis and initiation of treatment for GCA. BSR recommends that people with suspected GCA should be urgently referred and seen by a specialist, ideally on the same working day and in all cases within three working days. The FTC has been implemented at University Hospitals Dorset with the intention to follow the BSR recommendations. This audit evaluates the effectiveness of the FTC in managing suspected GCA cases, focusing on timely diagnosis, treatment initiation and adherence to recommended protocols. Methods In this retrospective audit, data of all the GCA referrals between 01/09/2021 and 31/08/2022 was extracted and reviewed. An Excel worksheet was used for data collection and collation. The available data were analysed against BSR standards. A diagnosis of GCA was made by a consultant rheumatologist and a patient was classified as having GCA if hard evidence of arterial inflammation was demonstrable ultrasonographically, histologically or on PET imaging. Results A total 124 patients were referred to the FTC clinic, Poole Hospital during the period of 01/09/21 to 31/08/22. Male to female ratio was 0.60. The age of the patients referred ranged from 48.5 years to 93.0 years with mean of 71.1 years and median age of 72.6 years. Among them 82 (66.94%) patients were referred within one working day, 31 (25%) patients within 7 days and 10 (8.07%) patients beyond 7 days. 99 patients (79.84%) were reviewed in the FTC within 3 days, 20 patients (16.13%) were reviewed within 7 days and 5 (4.03%) patients were reviewed within 14 days. Conclusion Our study showed the crucial role of the GCA FTC in timely management of suspected GCA and our results are comparable to the BSR standards. A review of the single referral pathway via primary care has been implemented and the secondary care referral route has been streamlined. Further education and training in both primary and secondary care on GCA and the referral options available to them will enable the timely provision of the FTC. However, certain areas such as timeliness of diagnostic testing and specialist availability, require improvement to optimize patient outcomes and enhance the adherence to guidelines. Disclosure T. Nasrin: None. M. Khurshid: None. D. Mynors-Wallis: None. C. Fox: None.

Nurse Staffing Configurations and Nurse Absence Due to Sickness

Rates of work-related stress and sickness absence are high among nurses. The consequences of sickness absence are severe for health systems' efficiency and productivity. To examine the association between nurse staffing configurations and sickness absence in hospital inpatient unit nursing teams. This retrospective longitudinal case-control study using routinely collected hospital data among 4 general acute care hospitals in England examined 18 674 registered nurses (RNs) and nursing support (NS) staff working in 116 hospital units. Data were analyzed from April 1, 2015, to February 29, 2020. Nursing team skill mix, temporary staffing hours, understaffing, proportion of long shifts (≥12 hours) worked, and full-time or part-time work status in the previous 7 days. The main outcome was the number of episodes of sickness absence, which was defined as a sequence of sickness days with no intervening days of work. There were 2 690 080 shifts and 43 097 sickness episodes. The incident rates for starting a sickness episode were 2.0% for NSs and 1.4% for RNs. In total, there were 18 674 members of staff; 2 188 562 (81.6%) were shifts by staff classified as working full time and 493 400 (18.4%) by staff classified as working part time. A skill mix composed of more RNs was associated with a 2% reduction in the odds of RN sickness absence for each 10% change in the proportion of RN hours (odds ratio [OR], 0.98; 95% CI, 0.96-0.99). Moving from the lower quartile skill mix (ie, approximately 55% of the nursing hours worked by RNs) to the upper quartile (ie, approximately 75% of the nursing hours worked by RNs) was associated with a 4% reduction in odds of sickness absence. Working only long shifts in the prior 7 days was associated with a 26% increase in the odds of sickness absence for RNs compared with working no long shifts (OR, 1.26; 95% CI, 1.19-1.33). Part-time work for RNs was associated with higher sickness absence (OR, 1.09; 95% CI, 1.03-1.15). For RNs, there was a significant interaction between part-time work and RN understaffing, whereby short staffing in the previous week increased sickness absence for full-time staff but not among those working part time. NS understaffing was not associated with sickness absence for any staffing group. This retrospective case-control study found that exposure to RN understaffing increased the risk of sickness absence in nursing teams. Adverse working conditions for nurses, already known to pose a risk to patient safety, may also create risks for nurses and the possibility of further exacerbating staff shortages.

Analysis of the nurse workload and impact of patient volume and flow in a Surgical ICU.

Analysis of the nurse workload and impact of patient volume and flow in a Surgical ICU.

Quality improvement project to reduce beta-D-glucan turnaround times in an NHS pathology network.

Beta-D-glucan (BDG) is a cell wall component of many fungi, detecting this in patients' serum permits early diagnosis of invasive fungal infections, particularly in patients with haematological malignancy. In critically ill patients in an intensive-care unit, where the prevalence of invasive fungal infection is lower, the high negative predictive value of BDG facilitates withholding or discontinuation of empirical antifungal therapy, contributing to antifungal stewardship. However, for the results of BDG testing to impact patient management, they need to be available within a clinically useful timeframe.The South West London Pathology (SWLP) network routinely sent samples for BDG testing from hospital trusts in our area to the UK Health Security Agency Mycology Reference Laboratory (MRL) at Bristol for analysis. In 2021, the mean turnaround time (TAT) was more than two times the 5-working-days standard stated in the SWLP user handbook. In this quality improvement project (QIP), we identified that the greatest delay was the MRL posting hardcopy reports. We investigated electronic reporting, first for all patient samples, and then only for intensive-care patients. However, we found that information technology (IT) and staffing limitations meant this was not viable.We then investigated commercial solutions and identified an innovative assay, which enabled the implementation of in-house BDG testing that was a good fit with our available staffing resource and laboratory environment. Our aim was to achieve at least 90% of BDG results authorised within 5 working days of sample receipt. Our QIP improved performance on this from 0.88% to 92.8% and reduced the mean TAT from 11.6 to 2.5 days and at lower unit cost. The change has been well received by our laboratory staff, and our pathology operational leads have had very positive feedback from our clinical teams and our antifungal steward.

Estimation of the budget impact of the dual dispensing circuit of emicizumab in France: The HemiValue study.

Estimation of the budget impact of the dual dispensing circuit of emicizumab in France: The HemiValue study.