The association between vigour and flexibility with injury and alertness during shift work.

Models of shift work and health suggest that individual differences in circadian rhythm characteristics may moderate the relationship between night shift work and injury, but this argument has not been directly tested. In this study, we tested the efficacy of two circadian rhythm characteristics-vigour and flexibility-as moderators of the path between shift work and injury. In addition, we aimed to replicate the association between vigour, flexibility, and alertness by time of day, and the measurement properties of the Circadian Type Inventory.

Segmental Testicular Infarction Due to Arterial Atheroma: A Case Report.

Segmental testicular infarction is an uncommon condition, of which the majority of cases are idiopathic. Cases associated with atherosclerotic disease are extremely rare, with only two other cases reported in the literature to our knowledge. We report the case of a 71-year-old man who presented with left testicular pain and a mass.

Supporting a Learning System in Pediatric Emergency Pathways: Using Organizational Comparisons, Serious Incidents, and Near-Miss Events to Improve the Diagnosis and Treatment of Testicular Torsion.

Background: Scrotal pain is a common presentation to the emergency department requiring prompt investigation and management to identify testicular torsion and increase the opportunity for testicular salvage. Using national data obtained from the NHS Improvement, we aim to identify key suboptimal areas in the acute diagnosis and management of testicular torsion with a view to learning from these and improving outcomes.

Methods: A freedom of information request was made to all 134 hospital groups in England and Wales that manage testicular torsion.

Serious incidents in testicular torsion management in England, 2007-2019: optimizing individual and training factors are the key to improved outcomes.

Objectives: To establish the healthcare factors that contribute to testicular torsion adverse events (orchidectomies) and 'near misses'. The secondary objective was to identify areas suitable for impactful quality improvement initiatives to be undertaken by National Health Service (NHS) healthcare providers nationally.

Materials And Methods: This was a retrospective record review and analysis, carried out in four phases.

The management of testicular torsion in the UK: How can we do better? A national quantitative and qualitative analysis of the factors affecting successful testicular salvage.

Background: Testicular torsion is a surgical emergency, requiring time-critical surgery to avoid potential organ loss. This study collates national data on paediatric testicular torsion, offering a comprehensive insight into the current standard of care in England for paediatric patients with suspected testicular torsion.

Methods: National data collection using Freedom of Information requests.

Night shift work and immune response to the meningococcal conjugate vaccine in healthy workers: a proof of concept study.

Background: It is well-established that sleep regulates immune functions. Immunological functions are dependent on circadian rhythms and regular sleep as both have an impact on the magnitude of immune responses following antigenic challenge (eg, in vaccination). Here we investigated whether nocturnal shift work can influence post-vaccination response.

Percutaneous nephrostomy in obstructing pelvic malignancy does not facilitate further oncological treatment.

Objective: The optimal management of patients with ureteric obstruction in advanced malignancy is unclear. How quality of life is affected by a nephrostomy and how many of these patients undergo further oncological treatment remains uncertain. The objective of this retrospective multicentre study was to look at the outcomes of patients who had percutaneous nephrostomy insertion for malignancy.

A multicentre prospective audit of bedside hydration in hospital.

Introduction: access to water at the bedside is a cornerstone of patient care. Among bedbound inpatients, water within reach at the bedside is a basic human dignity and one that ought not to be neglected.

Aim: the authors sought to identify the extent to which accessible hydration facilities were provided to a bedbound inpatient population.

Reno-duodenal fistula as a complication of longstanding renal tract calculus.

We present a rare case detailing the investigations and subsequent treatment of a lady who presented with a reno-duodenal fistula and perinephric abscess as a complication of staghorn calculus and recurrent upper urinary tract infections. Treatment involved antibiotics, nephrostomy, endoscopic closure of the fistula tract with clips, radiological drain insertion and, ultimately, nephrectomy with primary omental patch closure of the duodenal defect. We discuss the incidence of fistula tract formation as a complication of staghorn calculi, as well as investigations and management strategies employed in the literature to treat such complications, which span from conservative treatment to nephrectomy and closure of the intestinal defect.

Working Time Society consensus statements: A multi-level approach to managing occupational sleep-related fatigue.

A substantial body of literature indicates that shift workers have a significantly higher risk of workplace accidents and injuries, compared to workers in regular daytime schedules. This can be attributed to work during nights which require workers to stay awake during normal sleeping hours and sleep during natural waking hours, leading to circadian desynchronization, sleep disruption and cognitive impairment. A fatigue-risk trajectory model developed by Dawson and McCulloch has been used to describe the series of events which may precede fatigue-related incidents.

Skin lesions caused by in a patient with occupational exposure.

infections are associated with specific occupational risk factors and often have a delay to diagnosis. We present the case of a young tropical fish whole-sale worker presenting with skin lesions on the hand.

Updating the "Risk Index": A systematic review and meta-analysis of occupational injuries and work schedule characteristics.

Fatigue is a major risk factor for occupational 'accidents' and injuries, and involves dimensions of physical, mental, and muscular fatigue. These dimensions are largely influenced by temporal aspects of work schedules. The "Risk Index" combines four fatigue-related components of work schedules to estimate occupational 'accident' and injury risk based on empirical trends: shift type (morning, afternoon/evening, night), length and consecutive number, and on-shift rest breaks.

Factors affecting planned return to work after trauma: A prospective descriptive qualitative and quantitative study.

The use of patient reported outcome measures (PROMs) in trauma is limited. The aim of this pilot study is to evaluate qualitative responses and factors affecting planned return to work following significant trauma, for which there is currently a poor evidence base. National ethical approval was obtained for routine prospective PROMs data collection, including EQ-5D, between Sept 2013 and March 2015 for trauma patients admitted to the Sussex Major Trauma Centre (n=92).

HLA Correlates of Long-Term Survival in Vertically Infected HIV-1-Positive Adolescents in Harare, Zimbabwe.

African infants with vertically acquired HIV infection progress rapidly, with only 50% surviving beyond 2 years in the absence of treatment. Despite this high initial mortality, recent reports describe a substantial burden of older children living with untreated vertically acquired HIV infection in Southern Africa. The immunological and genetic factors associated with long-term survival following vertical infection are poorly understood.

Chronic effects of shift work on cognition: findings from the VISAT longitudinal study.

Objectives: Shift work, like chronic jet lag, is known to disrupt workers' normal circadian rhythms and social life, and to be associated with increased health problems (eg, ulcers, cardiovascular disease, metabolic syndrome, breast cancer, reproductive difficulties) and with acute effects on safety and productivity. However, very little is known about the long-term consequences of shift work on cognitive abilities. The aim of this study was to assess the chronicity and reversibility of the effects of shift work on cognition.

Towards a more comprehensive definition of shift work tolerance.

The aim of the present study was to define the nature of individual differences in shift work tolerance (SWT). This was investigated by an exploratory factor analysis of scores from a wide range of established instruments designed to measure sleep, sleepiness, fatigue, social functioning, as well as physical and mental health. Data were collected from a representative sample of 1,529 Norwegian nurses engaged in rotating shift work.

A rare case of localised oral amyloid of the labial mucosa.

Amyloidosis is often a systemic process, and localised oral amyloidosis is rare. We present the case of a young woman with amyloid deposition in the labial mucosa of her lower lip. Systemic involvement was excluded by comprehensive assessment at the UK Amyloidosis Centre.

Chronotypes of bipolar patients in remission: validation of the French version of the circadian type inventory in the FACE-BD sample.

Circadian rhythm disturbances have been associated with bipolar disorder (BD) during both the mood episodes and the periods of remission. Circadian phase preferences for the evening have been reported for remitted patients, whereas the amplitude and stability of their rhythms have never been assessed using questionnaires. The primary aim of our study was the validation of a French version of the Circadian Type Inventory (CTI), whereas its secondary aim was the comparison between remitted patients with BD and healthy controls for rhythm stability and amplitude and for phase preference.