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To synthesize evidence about the effect of individual circadian preference (chronotype) and gender in the development of sleep and mood problems in nursing professionals.Shift workers are more prone to having unhealthy habits and unfavourable clinical conditions than nonshift workers. These associations are mediated by chronotype and gender differences have also been detected.A quantitative systematic review.Electronic searches were performed in MEDLINE, Scopus, ScienceDirect, and Web of Science from 1 July 2012 - 1 July 2017.A systematic review was conducted using the Cochrane Collaboration guidelines and two quality assessment tools: the National Heart, Lung and Blood Institute and GRADE. Inclusion criteria were quantitative studies where the sample consists entirely of nurses, analysing circadian rhythms or individual chronotype or gender and sleep/mood disturbances in nursing activity. The review was reported using the PRISMA statement.A total of 23 studies were included in the review (five cohort studies and 18 cross-sectional studies). Data on gender-specific attention were scarce (two studies) and showed a higher incidence of sleep problems. Female nurses with eveningness-oriented personality seem to be more prone to having sleep disorders, insomnia, fatigue, and anxiety than male and morningness ones.Evidence seems to show that female nurses with an evening-oriented preference suffer more problems of insomnia, sleepiness, fatigue, and anxiety. The impact of our results may affect nurses, patient safety and the quality of clinical practice.目的: 综合个人昼夜节律偏好(时型)和性别对护理专业人员睡眠和情绪问题发展的影响的证据。 背景: 轮班员工比不轮班员工更容易养成不健康的习惯和不良的临床状况。这些联系由时型作为媒介,同时,也涉及性别差异。 设计: 定量系统性评价。 数据来源: 2012年7月1日至2017年7月1日期间,在MEDLINE、Scopus、Science-Direct和科学网进行电子搜索。 综述方法: 使用科克伦协作组织指南和两个质量评估工具进行系统性评价:国家心肺血液研究所和GRADE。纳入标准是定量研究,其中,样本完全由护士组成,以分析护理活动中的昼夜节律或个体时型或性别以及睡眠/情绪障碍。使用PRISMA声明对这项评价进行报告。 结果: 评价中共包含23项研究(五项队列研究和18项横向研究)。在性别方面,并无特别关注(两项研究),并且,性别方面的数据突显出睡眠问题的发生率较高。夜型人女性护士似乎比男性和晨型人更容易出现睡眠障碍、失眠、疲劳和焦虑。 结论: 证据似乎表明,有着夜型偏好的女性护士失眠、嗜睡、疲劳、焦虑等问题较多。研究结果可能会影响到护士、患者的安全以及临床实践的质量。.

Aims Although oral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), they are often underused in this particularly high-risk population. The aim of the present study was to assess the appropriateness of OAC prescription and its associated factors in hospitalized patients aged 65 years or older. Methods Data were obtained from the retrospective phase of Simulation-based Technologies to Improve the Appropriate Use of Oral Anticoagulants in Hospitalized Elderly Patients With Atrial Fibrillation (SIM-AF) study, held in 32 Italian internal medicine and geriatric wards. The appropriateness of OAC prescription was assessed, grouping patients in those who were and were not prescribed OACs at hospital discharge. Multivariable logistic regression was used to establish factors independently associated with the appropriateness of OAC prescription. Results A total of 328 patients were included in the retrospective phase of the study. Of these, almost 44% (N = 143) were inappropriately prescribed OACs, being mainly underprescribed or prescribed an inappropriate antithrombotic drug (N = 88). Among the patients prescribed OACs (N = 221), errors in the prescribed doses were the most frequent cause of inappropriate use (N = 55). Factors associated with a higher degree of patient frailty were inversely associated with the appropriateness of OAC prescription. Conclusions In hospitalized older patients with AF, there is still a high prevalence of inappropriate OAC prescribing. Characteristics usually related to frailty are associated with the inappropriate prescribing. These findings point to the need for targeted interventions designed for internists and geriatricians, aimed at improving the appropriate prescribing of OACs in this complex and high-risk population.

Object.—To investigate the rhythmicity of migraine episodes without aura in a pediatric population. Methods.—Time of occurrence of 2517 migraine attacks in 115 children was recorded, by means of a diary, both by hourly and monthly intervals. Results.—A significant circadian variation, characterized by a peak in the afternoon (P < .001) and one in the early morning (P= .002) was found. A seasonal peak was also observed between November and January, while a nadir was observed in July. Conclusions.—The clustering of attacks in the morning and midday and in autumn-winter, with a minimum frequency in July, suggests that school activities may represent an important cause of migraine.

Circadian occurrence of parasuicide was evaluated in relation to sex, violence of parasuicide method and psychiatric diagnosis. In all, 457 consecutive episodes of parasuicide were recruited during a 5-year period. Complete data for time of parasuicide, parasuicide method, parasuicide recurrency and psychiatric diagnosis (ICD-9) were available for 304 subjects. Parasuicide methods were classified into two groups depending on the violence of the method. Parasuicide occurred significantly more often in the afternoon and evening hours for both men and women, for both violent and non-violent methods, both in first-even cases and repeaters, and in the following diagnostic groups: organic mental and psychoactive substance disorders, neurotic disorders and personality disorders. The data support the hypothesis of a circadian rhythmicity of parasuicide, showing an area of chronobiological risk in the afternoon and early evening hours.