Changing schedules take a toll on medical interns

Source: Kara Gavin, Futurity, March 18, 2018

This year’s crop of graduating medical students just found out what hospital they’ve “matched” to for the residency training they’ll start this summer. A new study suggests the changing schedules they’ll have to endure as residents may take a heavy toll on sleep, physical activity, and mood. ….

Effects of Sleep, Physical Activity, and Shift Work on Daily Mood: a Prospective Mobile Monitoring Study of Medical Interns Authors Authors and affiliations
Source: David A. Kalmbach, Yu Fang, J. Todd Arnedt, Amy L. Cochran, Patricia J. Deldin, Adam I. Kaplin, Srijan Sen, Journal of General Internal Medicine, First Online: March 14, 2018

From the abstract:
Although short sleep, shift work, and physical inactivity are endemic to residency, a lack of objective, real-time information has limited our understanding of how these problems impact physician mental health. Objective To understand how the residency experience affects sleep, physical activity, and mood, and to understand the directional relationships among these variables.

A prospective longitudinal study. Subjects Thirty-three first-year residents (interns) provided data from 2 months pre-internship through the first 6 months of internship.

Main Measures:
Objective real-time assessment of daily sleep and physical activity was assessed through accelerometry-based wearable devices. Mood scaled from 1 to 10 was recorded daily using SMS technology. Average compliance rates prior to internship for mood, sleep, and physical activity were 77.4, 80.2, and 93.7%, and were 78.8, 53.0, and 79.9% during internship.

Key Results:
After beginning residency, interns lost an average of 2 h and 48 min of sleep per week (t = − 3.04, p < .01). Mood and physical activity decreased by 7.5% (t = − 3.67, p < .01) and 11.5% (t = − 3.15, p < .01), respectively. A bidirectional relationship emerged between sleep and mood during internship wherein short sleep augured worse mood the next day (b = .12, p < .001), which, in turn, presaged shorter sleep the next night (b = .06, p = .03). Importantly, the effect of short sleep on mood was twice as large as mood’s effect on sleep. Lastly, substantial shifts in sleep timing during internship (sleeping ≥ 3 h earlier or later than pre-internship patterns) led to shorter sleep (earlier: b = − .36, p < .01; later: b = − 1.75, p < .001) and poorer mood (earlier: b = − .41, p < .001; later: b = − .41, p < .001). Conclusions: Shift work, short sleep, and physical inactivity confer a challenging environment for physician mental health. Efforts to increase sleep opportunity through designing shift schedules to allow for adequate opportunity to resynchronize the circadian system and improving exercise compatibility of the work environment may improve mood in this depression-vulnerable population.

Recent stock market sell-off foreshadows a new Great Recession

Source: Steven Pressman, Robert H. Scott III, The Conversation, March 19, 2018

In early February, concerns about inflation and rising interest rates sent global financial markets into a frenzy, prompting the biggest single-day drop ever in the Dow Jones Industrial Average. Stocks have since recovered some of their losses.

A similar episode occurred exactly 10 years earlier, though few may remember. In February 2008, the failure of an obscure market precipitated a similar selling frenzy. At the time, this sell-off went mostly unrecognized as a harbinger of something worse because the stock market quickly recovered.

Just as the world shouldn’t have been complacent in 2008, we shouldn’t rest easy today. Both events are proverbial dead canaries in a coal mine.

That’s because they have something else in common. Both stemmed from worries that rising borrowing costs would hurt debt-burdened consumers, the housing market and ultimately the U.S. economy.

Our soon-to-be-published research shows that the same problems that led to the biggest financial market meltdown since the Great Depression are alive and well today…..

Heat Rising

Source: Mark Zandi, Regional Financial Review, Volume 28 Number 6, February 2018
(subscription required)

The economy is strong and growing. And, with big deficit-financed tax cuts and government spending increases kicking in, growth will accelerate over the coming year. Unemployment appears headed into the low threes, close to the lowest jobless rate the nation has ever experienced. But this is unsustainable. The economy is likely to overheat, with wage and price pressures intensifying and interest rates rising. There will be heightened volatility in financial markets as investors are forced to adjust to the higher rates. Once the fiscal stimulus fades early in the next decade, the odds of a sharp slowing in growth are high. A recession is possible.

Rating revisions: Upgrades top downgrades in 2017, though downgraded debt is higher

Source: Shelby Schwabauer, Florence Zeman, Kurt Krummenacker, Naomi Richman, Kendra M. Smith, Leonard Jones, Alexandra S. Parker, Timothy Blake, Michael Mulvaney, Gail Sussman, Moody’s, Sector In-Depth, March 12, 2018
(subscription required)

Upgrades topped downgrades for the third year in a row in 2017, indicating continued improvement in credit quality across public finance as a whole. However, there are pockets of weakness, notably the healthcare and higher education sectors, which both saw downgrades widely outpace upgrades in 2017. In total, across the 11,344 public finance obligors, upgrades exceeded downgrades by 68% in 2017. The dollar value of downgraded debt, however, was double that of upgraded debt; the State of New Jersey (A3 stable), State of Illinois (Baa3 negative), State of Connecticut (A1 stable) and Puerto Rico (Ca negative) and its related issuers accounted for almost 70% of the downgraded debt (see page 3 for explanations).

Assaults on Days of Campaign Rallies During the 2016 US Presidential Election

Source: Christopher N. Morrison, Benjamin Ukert, Aimee Palumbo, Beidi Dong, Sara Jacoby, Douglas, J. Wiebe, Epidemiology, Published Ahead-of-Print, Post Acceptance: March 12, 2018
(subscription required)

From the abstract:
This study investigates whether assault frequency increased on days and in cities where candidates Donald Trump and Hillary Clinton held campaign rallies prior to the 2016 US Presidential election.

We calculated city-level counts of police-reported assaults for 31 rallies for Donald Trump and 38 rallies for Hillary Clinton. Negative binomial models estimated the assault incidence on rally days (Day 0) relative to that on 8 control days for the same city (Days -28, -21, -14, -7, +7, +14, +21, and +28).

Cities experienced an increase in assaults (Incidence Rate Ratio [IRR]=1.12, 95%CI: 1.03-1.22) on the days of Donald Trump’s rallies, and no change in assaults on the days of Hillary Clinton’s rallies (IRR=1.00, 95%CI: 0.94-1.06).

Assaults increased on days when cities hosted Donald Trump’s rallies during the 2016 Presidential election campaign.

America’s Growing ‘Guard Labor’ Force

Source: Richard Florida, City Lab, March 13, 2018

Many large urban areas in the U.S. now have more “guard labor” than teachers. ….

…. Our definition of guard labor is narrower than that of Bowles and Jayadev, limited to what they call “protective guard labor”—that is, police officers and detectives, prison guards, private security guards, transportation security screeners, and other protective service workers. Our definition of teachers includes pre-school, elementary, middle-school, and high-school teachers, as well as special-education teachers.

For each metro, we looked at the change in guard labor over time, the number of guards per 10,000 people, the location quotient for guard labor, and—most importantly for our purposes—the ratio of guards to teachers. ….

Libraries Respond to #MeToo Movement

Source: Julia Eisenstein, American Library Association, March 9, 2018

Libraries have long been in the forefront when it comes to responding to social justice issues. The current focus on the #MeToo and Time’s Up movements are no exception. ….

…. The University of Minnesota (U of M) Libraries runs a regular blog titled A Matter of Facts. Kimberly Clarke and Karen Carmody-McIntosh wrote the February 7 post Me Too: Hashtag and Social Movement. In it contains links to resources regarding the origin of the #MeToo movement Helpful books, ebooks, databases, journal articles are available only to U of M faculty and students, but the Newspaper, Magazine articles and websites are available for anyone to view.

Many academic libraries are creating LibGuides on sexual harassment providing links to resources for both scholars who are researching sexual harassment and survivors of sexual harassment. Examples include Tulane University’s Howard Tilton Memorial Library guide on Sexual Violence Prevention Resources, the University Library at the University of Illinois at Urbana-Champaign guide on Sexual Harassment, and New York’s Adelphi University guide on Sexual Harassment Resources. ….

Harassment Resources

Do Not Let Love Turn Into Liability

Source: Maureen Minehan, Employment Alert, Volume 35, Issue 6, March 20, 2018
(subscription required)

Romeo and Juliet lost their lives for love. In modern times, jobs are often what’s at risk.

While not every office romance ends badly, many do, both personally and professionally. A new survey by global outplacement and executive coaching firm Challenger, Gray & Christmas found that when workplace courtships go awry, 33% of the time they end up in termination for at least one person. …. Over 62% of HR executives said they have had to deal with a failed or inappropriate relationship at work. While one-third ended in at least one person’s separation from the company, another 17% of employers moved one party to a different department. Five percent of these failed relationships led to litigation. ….

The Lessons of West Virginia

Source: Eric Blanc, Jacobin, March 9, 2018

West Virginia’s historic wildcat strike has the potential to change everything. ….

…. The Great West Virginia Wildcat is the single most important labor victory in the US since at least the early 1970s. Though the 1997 UPS strike and the 2012 Chicago teachers’ strike also captured the country’s attention, there’s something different about West Virginia. This strike was statewide, it was illegal, it went wildcat, and it seems to be spreading. ….