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Sleep loss due to short time off between shifts has been proposed as a mechanism contributing to impaired functioning in occupational settings. This laboratory crossover trial (ClinicalTrials.gov identifier: NCT05162105, N = 66) compared subjective sleepiness, mood, and cognitive performance on a day shift after an evening shift with only 8 h off between shifts (quick return, QR) to a day shift after another day shift with 16 h off between shifts (control). Results indicated higher subjective sleepiness (Karolinska Sleepiness Scale) during the QR condition compared to the control condition (p < 0.001). No significant differences were found on mood (Positive and Negative Affect Schedule) and cognitive performance (Psychomotor Vigilance- and Digit Symbol Substitution Test) between the conditions. Findings of increased subjective sleepiness corroborate previous field studies. This trial is to our knowledge the first to compare mood and cognitive performance after a QR to a longer shift transition using an experimental design. Future research should explore the effects of accumulated sleep loss associated with QRs (e.g. having several QRs within a short time period) on behavioral outcomes. [ABSTRACT FROM AUTHOR]

Background: Global nursing shortages necessitate the identification of mitigatable factors that may reduce nursing absence and turnover. Fatigue has been shown to be associated with these issues. This study aimed to identify factors leading to development of or recovery from excessive fatigue in nurses as these can offer actionable avenues for protecting nurses against fatigue or supporting fatigue recovery. Methods: A longitudinal study among nurses randomly sampled from the Norwegian Nurse's Organization. The Chalder Fatigue Questionnaire measured fatigue. Dichotomized scoring was used, with scores ≥ 4 considered excessive fatigue. The study included questions on shift work schedules, psychosocial work characteristics, sleep, body mass index, physical activity, caffeine, alcohol, mental health, etc. Two sets of logistic regression analysis were conducted (one for development of and one for recovery from excessive fatigue), evaluating how changes in work, lifestyle and health between baseline (2015) and follow-up (2018) affected first, odds of development of excessive fatigue and second, odds of recovery from excessive fatigue. Results: Among 1,311 included nurses, 21.6% maintained, 13.3% developed, and 18.0% recovered from excessive fatigue (2015–2018). Within work characteristics, increased psychological work demands were associated with development of excessive fatigue OR = 1.77 (CI = 1.11–2.82). Several work characteristics were associated with recovery from excessive fatigue, including decreased decision latitude (OR = 0.39; CI = 0.19–0.82) and increased coworker support (OR = 1.90; CI = 1.11–3.24). Shift work variables were not associated with fatigue outcomes. Amongst lifestyle factors, changes in sleep duration, obesity, and exercise were significant. Notably, developing inappropriate sleep duration (OR = 2.84; CI = 1.47–5.48) increased odds of developing excessive fatigue, while maintaining inappropriate sleep duration (< 6 h or > 8 h) (OR = 0.19; CI = 0.54–0.65) decreased odds of recovering. All assessed health conditions (depression, anxiety, insomnia, and shift work disorder) were related to development of (ORs 2.10–8.07) or recovery from (ORs 0.10–0.50) excessive fatigue. Depression, for example, increased odds of development of (OR = 8.07; CI = 2.35–27.66) and decreased odds of recovery (OR = 0.10; CI = 0.04–0.26) from excessive fatigue. Conclusions: Changes in lifestyle factors, health conditions, and psychosocial work factors were associated with development of and recovery from excessive fatigue. Sleep and psychosocial work factors played important roles. We found no relationship with shift work schedules. [ABSTRACT FROM AUTHOR]

Background Aim Method Results Conclusions Implication for nursing and health policy Rotating‐shift nurses are susceptible to sleep disorders due to numerous factors, such as their biological clock, emotions, and age. At present, a lack of research exists on whether chronotype and shift type jointly influence the sleep quality of nurses.To verify whether chronotype is a moderator variable of the relationship between shift type and sleep quality in nurses in order to provide empirical evidence for future mental and physical health improvement.Clinical rotating‐shift nurses at a medical center in northern Taiwan were recruited as participants between November 1, 2023, and December 13, 2023. All of the nurses were working a monthly rotating shift schedule. Hierarchical multiple regression analysis was employed to investigate whether the influence of shift type on sleep quality in nurses varied with chronotype. The STROBE checklist was used for reporting this study.The participants were 255 rotating‐shift nurses in this study. Hierarchical multiple regression results revealed that rotating‐shift nurses who were older (B = 0.19, p = 0.029), had greater physical fatigue (B = 0.27, p = 0.016), and had more negative emotions (B = 0.17, p = 0.011) suffered from poorer sleep quality. After controlling the above factors, we further found that chronotype indeed had moderating effects on the influence of shift type on sleep quality (B = −1.83, p = 0.049).This study demonstrates that early‐ and intermediate‐type nurses are more suitable for working the day and evening shifts, whereas late‐type nurses are more suitable for working the night shift.Coordinating chronotype with shift type will ensure that shift schedules better match the biological clocks of nurses; such individual considerations could help to improve their sleep quality. [ABSTRACT FROM AUTHOR]

Abstract Sleep disorders are common, and largely undiagnosed in early-career workers. The combination of sleep disorders and shift work has implications for mental health, workplace safety, and productivity. Early identification and management of sleep disorders is likely to be beneficial to workers, employers and the community more broadly. We assessed the feasibility and acceptability of a tailored sleep disorder screening and management pathway for individuals with future shift work requirements. Paramedic students were invited to complete an online sleep health survey, which included validated sleep disorder screening questionnaires for insomnia, obstructive sleep apnea and restless legs syndrome. Participants were able to express interest in participating in a sleep monitoring and management study. Participants at risk for a sleep disorder were identified, contacted by the study physician (RJA), notified of their sleep disorder screening results and provided with information regarding management options. Feasibility of the screening and management pathways were determined by completion of the 12 week follow-up, and ability to engage with health services for diagnostic testing or treatment. Acceptability of these pathways was assessed with a semi-structured interview on completion of the study at 12 weeks. Screening was completed in thirty participants (mean age 22.5 ± 6.7, 63% female), 17 of whom were ‘at-risk’ for a sleep disorder and offered a management pathway. All participants engaged with the study physician (RJA), with 16 completing the study (94% completion rate). Three participants with excessive daytime sleepiness received feedback from the study physician (RJA) and no further care required. Of the remaining 14 participants, 11 (78%) engaged with health services after speaking with the study physician (RJA). Those who engaged with diagnostic and management services reported that a structured pathway with online screening was convenient and easy to follow. Facilitating screening and management of sleep disorders in students with future shift work requirements is both feasible and acceptable. These findings can inform the development of a preventive strategy for sleep disorders and ideally, a health services feasibility trial for future shift workers.

Introduction: Fibromyalgia (FM) is a non-articular, chronic rheumatic disease with unknown etiology, characterized by widespread musculoskeletal pain, sleep disorder, fatigue, and the presence of numerous tender points. Working with the shift work and night shift system contradicts the normal biological rhythm of the body and negatively affects the person in many ways. The complaint of sleep disorder is widespread in patients with FM; close to 100% prevalence has been reported in some studies. This study aimed to investigate the relationship between fibromyalgia and shift working order in our hospital staff.Methods: This cross-sectional study was conducted in our university hospital. 120 people who met the inclusion criteria were included in the study, and 80 were accepted. As a control group, 95 people were reached, 80 of whom agreed to participate in the study. The Fibromyalgia Impact Scale (FES) was questioned in cases with fibromyalgia. The SF-36 quality of life questionnaire was applied to all the cases in which the study was conducted. 1990 ACR Fibromyalgia Diagnostic Criteria were used for diagnosis. The Fibromyalgia Impact Scale (FES) was questioned in cases with FM.Results: The average score of all SF-36 quality of life questionnaire sub-field groups was significantly higher in the control group than in the group who stand duty (p

Abstract Background Regularity of menstrual cycles is an important indicator of women’s health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms. Methods This was a secondary analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design. Results Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule). Conclusions Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity.

Background: Despite the challenge of nursing shortage in the world and its subsequent impact on care quality as well as aggravation of the situation by intention to leave service, this issue has not been properly addressed, especially among neonatal and pediatric nurses. The present study aims to identify the relationship between mental workload and musculoskeletal disorders with intention to leave the service among nurses working at neonatal and pediatric departments. Methods: This descriptive-analytical study was conducted on 145 nurses working at neonatal and pediatric departments in six hospitals in Bushehr Province using full-census method. The data were collected using national aeronautics and space administration-task load index (NASA-TLX), Cornell musculoskeletal discomfort questionnaire(CMDQ) and Mobley and Horner's voluntary turnover questionnaire. The data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, Pearson's and Spearman correlation tests and hierarchical linear regression in simultaneous model in SPSS 19.0. Results: The mean score of intention to leave the service was 9.57 ± 3.20 (higher than the moderate level) and the mean mental workload was 71.65 ± 15.14 (high level). Pain in at least one of the legs (100%), back (77.3%) and knees (76.6%) was highly prevalent. However, no statistically significant correlation was found between musculoskeletal disorder categories and intention to leave the service (p > 0.05). The regression analysis results revealed among mental workload domains, only effort-induced workload was negatively and significantly correlated with intention to leave the service (p = 0.003; β=-0.078). However, the number of night shifts per month was positively and significantly correlated with intention to leave the service (p = 0.001; β = 0.176). Conclusions: Planning for appropriate allocation of night shifts, investigating the etiology of musculoskeletal disorders and providing solutions for reducing mental workload should be prioritized by policymakers, while maintaining pediatric nurses' motivation for making efforts. [ABSTRACT FROM AUTHOR]

Background: Regularity of menstrual cycles is an important indicator of women's health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms. Methods: This was a secondary analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design. Results: Age at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule). Conclusions: Intervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions. Objectives: The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being. Design: A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences. Methods: Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study. Results: The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes. Conclusion: The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level.

Objective: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. Methods: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. Results: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). Conclusion: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work. [ABSTRACT FROM AUTHOR]

STUDY QUESTION To what extent do self-reported sleep duration and non-daytime work schedules in either partner affect the rate of spontaneous abortion (SAB)? SUMMARY ANSWER Incidence of SAB had little association with female sleep duration and a modest positive association with male short sleep duration, female work at night, and discrepant work schedules among partners. WHAT IS KNOWN ALREADY Several studies have reported an association between short sleep duration in either partner and reproductive health outcomes, including fecundability. Moreover, certain types of female occupational exposures during pregnancy have been associated with an increased risk of SAB. No studies have evaluated SAB risk in relation to male sleep and work schedules, or joint exposures within a couple. STUDY DESIGN, SIZE, DURATION This prospective cohort study included 9357 female participants and 2602 of their male partners residing in North America (June 2013 to April 2023). PARTICIPANTS/MATERIALS, SETTING, METHODS Participants enrolled when they were attempting pregnancy and completed self-administered baseline questionnaires about their average sleep duration and work schedules. Among those who conceived, we ascertained SAB and gestational age at loss via follow-up questionnaires. We used multivariable Cox proportional hazards models with gestational weeks as the time scale to estimate hazard ratios (HRs) and 95% CIs relating SAB with sleep duration and non-daytime work schedules for female and male participants, and the couple. We used inverse probability weighting to account for potential selection bias due to the possibility of differential participation of male partners with respect to the exposures. MAIN RESULTS AND THE ROLE OF CHANCE Compared to female participants with recommended sleep (7–8.9 h), those reporting short sleep duration (<6 h) did not have a higher rate of SAB (HR 0.88, 95% CI 0.69, 1.13). Short self-reported sleep duration among male participants was modestly associated with a higher rate of SAB (adjusted and weighted HR 1.30, 95% CI 0.96, 1.75). Female night work at night (adjusted HR 1.19, 95% CI 1.02, 1.38) and male non-daytime work (adjusted and weighted HR 1.26, 95% CI 1.00, 1.59) were associated with modestly higher rates of SAB, whereas female rotating shift work was not (adjusted HR 0.91, 0.78, 1.05) compared with daytime workers. Couples in which work schedules were discrepant had an elevated rate of SAB if the male partner worked a non-daytime shift (adjusted and weighted HR 1.46, 95% CI 1.13, 1.88) compared with couples in which both members worked during the day. The corresponding HR if only the female partner worked a non-daytime shift was 1.21 (95% CI 0.92, 1.58). LIMITATIONS, REASONS FOR CAUTION Data on sleep duration and work schedules were based on self-report, which is vulnerable to misclassification, particularly since participants were asked to report their average sleep duration during the past month. Work exposures were heterogeneous, as many different types of employment may require night and shift work and may have different associations with SAB. WIDER IMPLICATIONS OF THE FINDINGS Our findings are consistent with previous research indicating that some types of female employment schedules may be associated with SAB incidence. This is the first study to indicate a relationship between SAB and male employment schedules, indicating that discrepant work schedules within a couple might be relevant. STUDY FUNDING/COMPETING INTEREST(S) This work was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grants R01HD105863 (PIs: L.A.W. and M.L.E.), R01HD086742 (PIs: L.A.W. and E.E.H.), and R21HD072326 (PI: L.A.W.). PRESTO has received in-kind donations from Swiss Precision Diagnostics and Kindara.com for primary data collection. L.A.W. is a consultant for AbbVie, Inc. and the Gates Foundation. M.L.E. is an advisor for and holds stock in Ro, Hannah, Dadi, Underdog, Vseat, & Doveras. The other authors have no competing interests to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services. Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences. There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care. Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management. • Shift workers perceive their work arrangements impact access to effective diagnosis and management for sleep disorders. • Shift work can be perceived as 'the problem', delaying investigations for sleep disorders. • A faster diagnosis and management was possible with strong existing health care provider (HCP) relationships. • Shift workers with sleep disorders would like to increase the focus on education for themselves, workplaces and HCPs. • There is an urgent need for tailored models of care which support shift workers with sleep disorders. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: to analyze sleep duration and sleep quality in nursing professionals who work in shifts. Method: this is a cross-sectional, analytical research, carried out between September 2017 and April 2018, at a public hospital in southern Brazil, with the nursing team. A socio-occupational and health symptoms questionnaire, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index were used. Data are presented as descriptive and inferential statistics, bivariate analysis, and binary logistic regression. Results: participants were 308 nursing professionals with a predominance of long-term sleep, absence of drowsiness, and poor sleep quality. Short-term sleep (

Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians' work as a previously unrecognized source of systematic bias in pain management. We hypothesized that during night shifts, sleep deprivation, fatigue, and stress would reduce physicians' empathy for others' pain, leading to underprescription of analgesics for patient pain relief. In study 1, 67 resident physicians, either following a night shift or not, performed empathy for pain assessment tasks and simulated patient scenarios in laboratory conditions. As predicted, following a night shift, physicians showed reduced empathy for pain. In study 2, we explored this phenomenon in medical decisions in the field. We analyzed three emergency department datasets from Israel and the United States that included discharge notes of patients arriving with pain complaints during 2013 to 2020 (n = 13,482). Across all datasets, physicians were less likely to prescribe an analgesic during night shifts (compared to daytime shifts) and prescribed fewer analgesics than generally recommended by the World Health Organization. This effect remained significant after adjusting for patient, physician, type of complaint, and emergency department characteristics. Underprescription for pain during night shifts was particularly prominent for opioids. We conclude that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain. We consider the implications for hospitals and other organizations employing night shifts.

Background: Noise pollution is a serious issue in hospitals, especially in emergency departments where high noise levels from emergency patients and treatments can negatively affect medical personnel and patients. This study aimed to measure noise levels during day and night shifts in three major hospitals affiliated with Tehran University of Medical Sciences (Imam Khomeini, Shariati, and Sina hospitals) and investigate the level of annoyance experienced by medical staff. Methods: In this cross-sectional studyTES-1351B sound level meter was used to measure sound pressure levels and the measurement stations were determined according to ISO 9612 standard. A general questionnaire was used to determine demographic characteristics. Also, by a valid self-reporting questionnaire, the feeling about environmental noise intensity and noise annoyance was measured. Statistical analysis was done by SPSS software using ANOVA and t-test. Results: The average sound pressure level in the emergency departments of the studied hospitals was 67.940±7.70 dB. Significant differences were found between morning and evening shift noise levels. (p-value=0.001). The highest average sound pressure level occurred during the evening shift with an average of 72.382±4.35 db. Also, there was a significant difference between the feeling about environmental noise intensity and noise annoyance in Imam Khomeini and Sinai hospitals respectively, (p-value=0.037) (p-value=0.011). Conclusion: The study concludes that noise pollution in the emergency departments of these hospitals needs attention. Implementing administrative and technical-engineering measures to reduce noise pollution is essential to enhance the well-being of medical staff and patients and ensure a more satisfactory healthcare environment.

Background: Shift work is inevitable for nurses in intensive care units. Various studies explored nurses' fatigue in multiple hospital wards. However, few studies focused on fatigue among nurses in intensive care units. Aims: To determine the association between shift work schedules, compensatory sleep, work–family conflict, and fatigue of shift‐working nurses in critical care units. Study Design: A descriptive cross‐sectional multi‐center study was conducted in March 2022 among intensive care nurses from five hospitals. Methods: Data were collected by online survey, including self‐designed demographic questions, the Fatigue Scale‐14, the Chinese adult daytime sleepiness scale, and the work‐family scale. Pearson correlation was conducted for bivariate analysis. Independent‐sample t‐test, one‐way ANOVA, and multiple linear regression analysis were performed to examine fatigue‐related variables. Results: A total of 326 nurses responded to the survey with an effective response rate of 74.9%. The mean scores of physical fatigue and mental fatigue were 6.80 and 3.72, respectively. The bivariate analyses showed that work–family conflict was positively correlated with physical (r = 0.483, p <.001) and mental fatigue (r = 0.406, p <.001). Multiple linear regression results showed that work–family conflict, daytime sleepiness, and shift system were statistically significant factors influencing physical fatigue (F = 41.793, p <.001). Work–family conflict, sleep duration after the night shift, and daytime sleepiness were the main influencing factors of mental fatigue (F = 25.105, p <.001). Conclusions: Nurses with higher work–family conflict, daytime sleepiness, and working 12‐h shifts have higher levels of physical fatigue. Higher work–family conflict, shorter sleep duration after night shifts, and daytime sleepiness are associated with higher mental fatigue among intensive care nurses. Relevance to Clinical Practice: Nursing managers and nurses should consider work‐family factors and compensatory sleep in their efforts to reduce fatigue. It is necessary to strengthen work‐supporting strategies and compensatory sleep guidance for nurses to promote fatigue recovery. [ABSTRACT FROM AUTHOR]

Background. Obesity is a complex medical problem which still needs options of pathogenetic treatment. Objectives. To determine the effect of the complex therapy of patients with obesity and circadian rhythm sleep-wake disorders (shift work disorder) by armodafinil in addition to motivational counselling in primary care. Material and methods. 38 obese patients with shift work disorder were treated with armodafinil 150 mg daily and an motivational interview regarding healthy lifestyle. The examinations were at baseline after the 1st, 3th and 6th months and included: BMI, waist and hip circumference, body surface area, Waist-to-Hip Ratio, Conicity Index, A body shape index, Abdominal Volume Index, blood pressure, levels of serotonin, leptin, glucose, lipidogram, International Questionnaire on Physical Activity, FINDRISC, HADS, Beck&Hamilton Scale, Dutch Eating Behaviour Questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Questionnaire, and SF-36. Statistical analysis was carried out with SPSS Statistics, Statistica 12, Excel 2010. Results. BMI at baseline of the study was 33.85 ± 0.5 kg/m2 . The percentage of body weight showed a significant loss starting from the 3rd month (р < 0.0001). Impaired carbohydrate tolerance, dyslipidaemia, moderate risk of developing diabetes, low serotonin levels and physical activity improved their values over time. Patients had clinically pronounced depression and anxiety, disturbed eating behaviour, excessive daytime sleepiness, poor sleep quality and quality of life at baseline, which normalised by the 6th month. Conclusions. The complex treatment of obese patients with shift work disorder by motivational counselling with a patient-oriented approach enhanced by armodafinil 150 mg daily allowed them to reduce body weight by 15% in 6 months, as well as reduce metabolic, eating, mental and sleep disorders and improve quality of life. [ABSTRACT FROM AUTHOR]

Abstract Background There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. However, to this date no state-wide analysis exists in any European country. Objectives Our aim is to describe the shift work scheduling and to detail the degree of compliance with the Spanish legislation and the European Working Time Directive (EWTD) of Spanish resident physicians, focusing on territorial and specialty distribution. Material and methods A descriptive cross-sectional analytical study was designed through an online survey adapted from the existing literature. Results Out of the 2035 surveyed resident physicians undergoing PGT in Spain, 80.49% exceeded the 48 h per week limit set by the EWTD and 13% of them did not rest after a 24-h on-call shift. The mean number of on-call shifts in the last 3 months was 15.03, with the highest mean reported in Asturias, La Rioja, and Extremadura. 51.6% of respondents had a day-off after a Saturday on-call shift. Significant differences are observed by region and type of specialty. Conclusion Resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labor regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed.

Shift work in services and industry is increasing in developing countries, especially industrialized ones, due to the need for a flexible workforce and to achieve maximum efficiency. Shift working can cause problems for people's health and bodily functions. This study aims to determine the relationship between dietary intake, obesity, and shift working among employees of Pasargad Petrochemical Company. Methods: This was a cross-sectional study conducted on 119 employees within the age range of 25-60 years and an average body mass index (BMI) of 25.67. Their food intakes were extracted using Food Frequency Questionnaires. Data analysis was performed through STATA data analysis software. Results: 119 male participants with a mean age of 33.62 ±7.12 year were included in the study, of whom 64.7% were non-shift workers and 35.3% were shift workers. The daily calorie intake of the participants was 2864.54 ± 1184.43 kcal. Although non-shift workers consumed a higher but insignificant amount of energy, no statistical differences were found in dietary intake between shift workers and non-shift workers (P

Objective: Multiple factors contribute to decision fatigue experienced by emergency physicians (EPs). This study examines the association between decision fatigue and the frequency of computed tomographic (CT) scan requests and inpatient referrals among EPs. Methods: This retrospective database analysis was done for 3 months. Scans and inpatient referral requests were coded and analyzed to assess the impact of physician fatigue on decision-making. Subsequently, the outcomes were evaluated. Results: The majority of patients (n - 481; 51.1%) had a CT brain request. Among these requests, the morning shift (8:00 a.m.-3:00 p.m.) accounted for the highest number (n - 400; 42.5%), followed by the evening shift (3:00-11:00 p.m.) (n -345; 36.7%). Approximately one-third of the patients (n - 301; 31.9%) had positive CT scan findings. Statistical analysis comparing the first and the second halves of each shift did not reveal significant variations in the percentage of negative CT results (p-value: 0.093). Inpatient referral was necessary for over half of the patients (n - 1048; 52.7%), and the majority of these referrals (n - 778; 74.2%) were deemed necessary for treatment under various surgical or medical specialties. There was a statistically significant difference in the proportion of negative inpatient referrals between the first and the second halves of the afternoon shift (p-value < 0.001). Conclusions: Fatigue among EPs was observed, leading to more frequent consultations without inpatient admission during the latter half of the afternoon shift. However, the study found no significant impact of decision fatigue on CT scan decision-making. [ABSTRACT FROM AUTHOR]

Background: There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. However, to this date no state-wide analysis exists in any European country. Objectives: Our aim is to describe the shift work scheduling and to detail the degree of compliance with the Spanish legislation and the European Working Time Directive (EWTD) of Spanish resident physicians, focusing on territorial and specialty distribution. Material and methods: A descriptive cross-sectional analytical study was designed through an online survey adapted from the existing literature. Results: Out of the 2035 surveyed resident physicians undergoing PGT in Spain, 80.49% exceeded the 48 h per week limit set by the EWTD and 13% of them did not rest after a 24-h on-call shift. The mean number of on-call shifts in the last 3 months was 15.03, with the highest mean reported in Asturias, La Rioja, and Extremadura. 51.6% of respondents had a day-off after a Saturday on-call shift. Significant differences are observed by region and type of specialty. Conclusion: Resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labor regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed. [ABSTRACT FROM AUTHOR]

IntroductionCareer firefighters experience chronic circadian rhythm disruption, increasing their risk of cardiometabolic disease. The recent discovery that eating patterns regulate circadian rhythmicity in metabolic organs has raised the hypothesis that maintaining a consistent daily cycle of eating and fasting can support circadian rhythms and reduce disease risks. Preclinical animal studies and preliminary clinical trials have shown promising effects of time-restricted eating (TRE) to reduce disease risk without compromising physical performance. However, there is a lack of research on TRE in shift workers including firefighters. This study aims to investigate the feasibility and efficacy of 10-hour TRE on health parameters that contribute to cardiometabolic disease risks among career firefighters who work on a 24-hour shift schedule.Methods and analysesThe Healthy Heroes Study is a randomised controlled parallel open-label clinical trial with 150 firefighters over 1 year. Firefighters are randomised with a 1:1 ratio to either the control or intervention group. The control group receives Mediterranean diet nutritional counselling (standard of care, 'SOC'). The intervention group receives the same SOC and a self-selected 10-hour TRE window. After the 2-week baseline, participants enter a 3-month monitored intervention, followed by a 9-month self-guided period with follow-up assessments. The impact of TRE on blood glucose, body weight, body composition, biomarkers (neuroendocrine, inflammatory and metabolic), sleep and mood is evaluated. These assessments occur at baseline, at the end of intervention and at 6, 9 and 12-month follow-ups. Temporal calorie intake is monitored with the smartphone application myCircadianClock throughout the study. Continuous glucose monitors, wrist-worn actigraphy device and questionnaires are used to monitor glucose levels, activity, sleep and light exposure.Ethics and disseminationThe study was approved by the Institutional Review Boards of the University of California San Diego and the Salk Institute for Biological Studies. Results will be disseminated through peer-reviewed manuscripts, reports and presentations.Trial registration numberNCT03533023; Pre result.

Purpose This study investigated the dietary behavior of experienced shiftwork nurses and aimed to identify factors related to dietary behavior. Methods This study was a secondary analysis based on the Shift Work Nurses’ Health and Turnover study (2018-2021) among Korean nurses. In total, 247 experienced (>12 months) shiftwork nurses were included in this study. The participants’ dietary behavior, depression, level of occupational stress, fatigue, physical activity, and general characteristics were measured. Descriptive statistics, Pearson correlation coefficients, independent t-test, one-way analysis of variance, the Kruskal-Wallis test, and multiple regression analysis were conducted. Results The dietary behavior score of the participants using the Mini-Dietary Assessment Index was 29.35±5.67. Thirty percent of the participants were depressed, the participants experienced moderate occupational stress, and 74.1% of the participants engaged in an inadequate amount of physical activity. The factors influencing shiftwork nurses’ dietary behavior were having child(ren) (β=.16, p=.027), depression (β=–.13, p=.032), level of occupational stress related to occupational climate (β=–.13, p=.035), and an inadequate amount of physical activity (β=–.17, p=.006). These factors explained 10.4% of the variance in experienced shiftwork nurses’ dietary behavior scores. Conclusion Experienced nurses with child(ren) tended to have healthier diets. However, a higher level of occupational stress related to occupational climate, depression, and engaging in an inadequate amount of physical activity were associated with a higher risk of having an unhealthy diet. Therefore, strategies are needed to encourage physical activity and alleviate adverse occupational climate and depression among experienced nurses.

Objectives To verify the relationships between sleep duration (Total Sleep Time – TST) and postural control of female night workers before and after shift. As well as, to verify if there is an influence of the body mass index (BMI) on the postural control of these female workers before and after shift. Methods A total of 14 female night workers (mean age: 35.0 ± 7.7 years) were evaluated. An actigraph was placed on the wrist to evaluate the sleep-wake cycle. The body mass and height were measured, and BMI was calculated. Postural control was evaluated by means of a force platform, with eyes opened and eyes closed before and after the 12-hour workday. Results There was an effect of the BMI on the velocity and the center of pressure path with eyes opened before (t = 2.55, p = 0.02) and after (t = 4.10, p

OBJECTIVE: This study aimed to find out whether utilizing a shift schedule evaluation tool with ergonomics recommendations for working hours has favorable effects on the incidence of occupational injuries. METHODS: This 4-year prospective cohort study (2015–2018) consisted of a dynamic cohort of healthcare shift workers (N=29 237) from ten hospital districts and six cities in Finland. Working hour characteristics and occupational injuries were measured with daily registry data. Multilevel generalized linear model was used for the analyses, and the estimates were controlled for hierarchical structure of the data and confounders. RESULTS: Ward heads of the cities used the shift schedule evaluation tool 3.2 times more often than ward heads of the hospital districts. Overall incidence of workplace and commuting injuries did not differ between users and non-users of the evaluation tool. The incidence of dislocations, sprains, and strains was lower in the users than non-users [adjusted odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78–0.99]. Approximately 13% of this association was mediated by increase in realized shift wishes and 10% by increase in single days off. In subgroup analyses, the incidence of workplace injury (OR 0.83, 95% CI 0.69–0.99), and among types of injuries, the incidence of dislocations, sprains, and strains (OR 0.69, 95% CI 0.55–0.85) and falling, slipping, tripping, or overturning (OR 0.75, 95% CI 0.58–0.99) were lower in users than non-users among employees of the cities, but no association was found among employees of the hospital districts. CONCLUSION: The use of ergonomics recommendations for working hours is associated with a reduced risk of occupational injuries.

Abstract Aim This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift‐working nurses (SWNs). Design A cross‐sectional study. Methods Three‐hundred and seventy‐nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures. Results Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs.

The cognitive ability to self-monitor one's current performance is important for hospital nurses to maintain safety and health. However, studies on the effects of rotating shift work on self-monitoring ability are insufficient. We examined the differences in self-monitoring accuracy across shifts in a rotating three-shift system among 30 female ward nurses (mean age 28.2 years). Their self-monitoring ability was calculated by subtracting the predicted reaction times of the psychomotor vigilance task performed just before exiting the workplace from the actual reaction times. A mixed-effect model was employed to assess the effects of shift, awake hours, and prior sleep duration on self-monitoring ability. We observed impaired self-monitoring ability in nurses, particularly after the night shift. Although actual performance remained high across all shifts, their self-predictions on reaction times became pessimistic in the night shift, resulting in a difference of approximately−100 msec. The effect of the shift on self-monitoring was obvious even after adjusting for sleep duration and hours awake. Our findings indicate that the misalignment between their working hours and circadian rhythms may affect even professional nurses. Occupational management that emphasizes maintaining circadian rhythms will improve the safety and health of nurses. [ABSTRACT FROM AUTHOR]

Background: Shift work in services and industry is increasing in developing countries, especially industrialized ones, due to the need for a flexible workforce and to achieve maximum efficiency. Shift working can cause problems for people's health and bodily functions. This study aims to determine the relationship between dietary intake, obesity, and shift working among employees of Pasargad Petrochemical Company. Methods: This was a crosssectional study conducted on 119 employees within the age range of 25-60 years and an average body mass index (BMI) of 25.67. Their food intakes were extracted using Food Frequency Questionnaires. Data analysis was performed through STATA data analysis software. Results: 119 male participants with a mean age of 33.62 ±7.12 year were included in the study, of whom 64.7% were non-shift workers and 35.3% were shift workers. The daily calorie intake of the participants was 2864.54 ± 1184.43 kcal. Although non-shift workers consumed a higher but insignificant amount of energy, no statistical differences were found in dietary intake between shift workers and non-shift workers (P<0.05). Furthermore, multiple linear regressions regarding shift work did not have a significant effect on BMI and waist circumference. Conclusion: Although no statistically significant relationship was found between food intake and shift work, it is suggested that future studies be conducted with a larger sample size because of the importance of shift work. [ABSTRACT FROM AUTHOR]

The mediating role of fatigue in the relationship between the quality of sleep and quality of life of shift-working nurses has been predicted in previous studies. Interventions that focus on improving the quality of life of a nurse, who works 24 h shifts in close proximity to patients, should take the mediating role of fatigue into account. This study investigates the mediation of fatigue in the relationship between sleep quality and quality of life for shift-working nurses. This cross sectional study collected self-reported questionnaire responses on variables including sleep quality, quality of life, and fatigue of shift-working nurses. We performed a three-step mediating effect verification procedure with 600 study participants. We found a negative and significant correlation between sleep quality and quality of life, a significant positive correlation between sleep quality and fatigue, and a negative correlation between quality of life and fatigue. We found: (1) that the quality of sleep affects the quality of life of shift-working nurses, (2) that the quality of sleep is correlated with the degree of fatigue, and (3) that the degree of fatigue is high, which means that quality of life decreases. Thus, it is necessary to develop and apply a strategy to reduce shift-working nurses' fatigue to improve their sleep quality and quality of life. [ABSTRACT FROM AUTHOR]

ObjectivesHere we examine the association between shift work sleep disorder (SWSD) and erectile dysfunction (ED) in shift workers.MethodsMen presenting to a single andrology clinic between January 2014 and July 2017 completed validated questionnaires: International Index of Erectile Function (IIEF), Patient Health Questionnaire-9 (PHQ-9), and the nonvalidated SWSD Questionnaire. Men were also asked about shift work schedule, comorbidities, phosphodiesterase 5 (PDE5) inhibitor use, and testosterone use. Serum total testosterone values were determined for each visit. Linear regression was performed controlling for testosterone use, testosterone levels, PDE5 inhibitor use, age, and comorbidities to determine the effect of SWSD on ED as assessed using the IIEF.ResultsOf the 754 men completing questionnaires, 204 reported nonstandard shift work (begins before 7 am or after 6 pm, regularly extends out of that frame, or rotates frequently) and 48 were found to have SWSD using a screening questionnaire. Nonstandard shift work alone did not result in worse IIEF-EF scores (P = .31), but those who worked nonstandard shifts and had SWSD demonstrated IIEF-EF scores 2.8 points lower than men without SWSD (P

Abstract Background In-depth investigation of the factors that exacerbate sleep disturbance among night-shift workers is essential to develop a successful implementation strategy to improve sleep. Although some characteristics of work associated with sleep disturbances have been investigated, there are inconsistencies in the findings. This study aimed to assess the influence of working time and work characteristics on sleep disturbance among night-shift workers. Methods This study was a secondary data analysis of a nationally representative sample of data from the fifth Korean Working Condition Survey in 2017. A total of 1,790 wage workers aged between 19 and 64 years with night shift schedules were selected and analyzed. A multiple logistic regression analysis was conducted to analyze the influences of working time characteristics, including shift type, frequency of night shift, and extended work; as well as work characteristics, including physical work demands, workload, emotional work demands, social support, and communication, on sleep disturbance among night-shift workers. Results Of those analyzed, 8.4% of night-shift workers experienced sleep disturbances. Night-shift workers with extended work, higher workloads, and emotional work demands were more likely to experience sleep disturbances (OR = 1.53, 95% CI = 1.05 to 2.23; OR = 1.01, 95% CI = 1.01 to 1.03; OR = 1.03, 95% CI = 1.02 to 1.05; respectively). Conclusion Extended work, higher workload, and emotional work demands were significant factors for sleep disturbance among night-shift workers. These findings highlight the importance of adjusting work demands and mitigating extended work to reduce sleep disturbance in night-shift workers.

Background Shift work is associated with obesity and metabolic syndrome. However, this association in the normal-weight population remains unclear. This study aimed to investigate whether shift work is associated with normal-weight obesity (NWO). Methods From the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES) dataset (2008 to 2011), 3,800 full-time workers aged ≥19 years with a body mass index (BMI) ≤25 kg/m2 were analysed. We defined NWO as BMI ≤25 kg/m2 and body fat percentage ≥25% in men and ≥37% in women. Working patterns were classified into “daytime,” “other than daytime,” and “shift.” Multivariable logistic regression analysis was performed to evaluate the relationship between shift work and NWO. Results Shift work was associated with higher odds of NWO than daytime work (adjusted odds ratio [aOR], 1.47; 95% confidence interval [CI], 1.04 to 2.09) and night/evening work (aOR, 1.87; 95% CI, 1.11 to 3.14) after adjustment for type of work, working hours, age, sex, BMI, 25-hydroxyvitamin D levels, homeostatic model assessment for insulin resistance, and other sociodemographic factors. In subgroup analyses, the association between shift work and NWO was more robust in those aged ≥60 years and those working ≥56 hours/week. Conclusion Shift work was associated with NWO in community-dwelling Korean adults, independent of age, sex, BMI, and other covariates.

Abstract Background Healthcare professionals worldwide are prone to sleep disturbance. Such sleep disturbance is associated with lower patient safety and quality of care. Therefore, this study aimed to identify the prevalence of sleep disturbance and determine the effect of work schedule characteristics on sleep disturbance among healthcare professionals in Europe and South Korea. Methods We used the sixth European Working Conditions Survey and the fifth Korean Working Conditions Survey for analyses. The study included 2285 healthcare professionals aged 18–65 years. Work schedule characteristics included shift work, night work, working hours per week, long work hours (i.e., more than 10 hours per shift), quick return to work, having to come to work on short notice, and changes in work schedules. A multiple logistic regression analysis was performed. Results The overall prevalence of sleep disturbance was 37.7%. The multivariate logistic regression model indicated that long work hours, quick return to, having to come to work on short notice, and changes in work schedules were significant factors associated with sleep disturbance among healthcare professionals. Conclusion The findings revealed that several work schedule-related factors were associated with sleep disturbances in healthcare professionals in Europe and Korea. Institutions and policymakers should implement strategies and policies to reduce the unpredictability of work schedules to ensure an adequate rest period between shifts and to reduce sleep disturbances.

Objective This study aimed to find out whether utilizing a shift schedule evaluation tool with ergonomics recommendations for working hours has favorable effects on the incidence of occupational injuries. Methods This 4-year prospective cohort study (2015-2018) consisted of a dynamic cohort of healthcare shift workers (N=29 237) from ten hospital districts and six cities in Finland. Working hour characteristics and occupational injuries were measured with daily registry data. Multilevel generalized linear model was used for the analyses, and the estimates were controlled for hierarchical structure of the data and confounders. Results Ward heads of the cities used the shift schedule evaluation tool 3.2 times more often than ward heads of the hospital districts. Overall incidence of workplace and commuting injuries did not differ between users and non-users of the evaluation tool. The incidence of dislocations, sprains, and strains was lower in the users than non-users [adjusted odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78-0.99]. Approximately 13% of this association was mediated by increase in realized shift wishes and 10% by increase in single days off. In subgroup analyses, the incidence of workplace injury (OR 0.83, 95% CI 0.69-0.99), and among types of injuries, the incidence of dislocations, sprains, and strains (OR 0.69, 95% CI 0.55-0.85) and falling, slipping, tripping, or overturning (OR 0.75, 95% CI 0.58-0.99) were lower in users than non-users among employees of the cities, but no association was found among employees of the hospital districts. Conclusion The use of ergonomics recommendations for working hours is associated with a reduced risk of occupational injuries. [ABSTRACT FROM AUTHOR]

Aim: This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift‐working nurses (SWNs). Design: A cross‐sectional study. Methods: Three‐hundred and seventy‐nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures. Results: Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs. [ABSTRACT FROM AUTHOR]

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Background: Shift work disrupts the sleep rhythm and leads to daily sleepiness and physical and mental complications. Objectives: This study aimed to investigate the predictive role of shift work in poor sleep quality and daytime sleepiness in railway personnel. Methods: This descriptive-analytical and cross-sectional study was conducted on the employees of the Khorasan railway in Iran in 2021, 450 individuals of whom were selected as a sample using the census sampling method. The data collection method was through a checklist containing demographic information and related factors (e.g., employment history) and through a physician to evaluate underlying diseases, body mass index (BMI), smoking and use of substances (past medical history), and completion of standard questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), and STOP-BANG questionnaire. The data were analyzed using the t-test and simultaneous multivariate regression analysis by SPSS software (version 24). Results: Out of 450 employees, 144 (32%) and 306 (68%) subjects were day workers and shift workers, respectively. The average age of the participants was 40 ± 5.97 years. A significant difference was observed between the BMI with PSQI, KSS, and STOP-BANG scores (P = 0.001). Additionally, binary logistic regression analysis showed that shift work had a significant effect as a risk factor on both PSQI scores (CR = 1.25, 95% CI: 1.16-1.32, P = 0.001) and KSS scores (CR = 1.43, 95% CI: 1.29 - 1.59, P = 0.001). Conclusions: Shift work could increase the amount of sleepiness during work in personnel as the main cause, along with other effective factors, such as personal and occupational characteristics. [ABSTRACT FROM AUTHOR]

Objective: To determine the difference in the sleep quality and work performance of nurses between one shift duty, two shifts duty, and three shifts duty in intensive care units at a government hospital in the Kingdom of Bahrain. Methods: This cross-sectional study was conducted at a government hospital of Bahrain from February to April 2021. A total of 200 nurses worked for at least one year in an intensive care units were eligible for the study. A questionnaire was administered online to collect data. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality while Nurse Work Function Questionnaire (NWFQ) was used to measure work performance. Results: There were 145 (72.5%) females and 55 (27.5%) males with a mean age of 38.2 ± 8.2 years. Most of the nurses were staff nurses 188 (94%), and shift workers 178 (89%). The mean PSQI of nurses who work only one shift reported normal sleep quality of 1.3 ± 1.0 where those who work two shifts had poorer sleep quality measured 9.2 ± 0.8 and nurses who work three shifts had reported even worse sleep quality with a statistically significant difference 15.6 ± 1.8 (p-value <0.0001). Moreover, the more variety of shifts the critical care nurses work, the more impaired their performance was (p-value <0.001). Conclusion: The more shift work schedules the nurse works, the worse is the reported sleep quality and work performance. [ABSTRACT FROM AUTHOR]

BackgroundSleep disturbance is a common issue among rotating night shift workers and is closely related to health risks. The present study aimed to determine the effectiveness of pharmacological and non-pharmacological sleep interventions for the management of sleep disturbance among rotating night shift workers.MethodsFor this systematic review and meta-analysis, we searched six electronic databases—EMBASE, CINAHL, Cochrane Library, PubMed, Scopus, and Web of Science—for randomized controlled trials and clinical trials published from January 1990 to June 2022. The quality of eligible studies was independently assessed by three authors using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. The meta-analysis was performed based on the random effects model using the Comprehensive Meta-Analysis software. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsOf the 1019 studies retrieved, 30 met the inclusion criteria for the systematic review; 25 were selected for the meta-analysis. Sleep interventions were categorized as follows: pharmacological approach (n = 7), light therapy (n = 9), cognitive behavioral approach (n = 7), aroma or alternative therapy (n = 4), and shift schedule modification (n = 3). The overall mean effect size of the interventions was moderate (Hedges' g = 0.59; 95% confidence interval = 0.33–0.84, z = 4.50, p < 0.001).ConclusionSleep interventions were effective in promoting sleep or reducing sleep disturbance among rotating night shift workers. These findings provide evidence of the effectiveness of various pharmacological and non-pharmacological sleep interventions for managing sleep health in the work environment of rotating night shift workers.

Objectives Shift work, such as alternating day and nights, causes chronobiologic disruptions which may cause an increase in hypertension risk. However, the relative contributions of the components of shift work ‒ such as shift type (eg, night work) and rotations (ie, switching of shift times; day to night) ‒ on this association are not clear. To address this question, we constructed novel definitions of night work and rotational work and assessed their associations with risk of incident hypertension. Methods A cohort of 2151 workers at eight aluminum manufacturing facilities previously studied for cardiovascular disease was followed from 2003 through 2013 for incident hypertension, as defined by ICD-9 insurance claims codes. Detailed time-registry data was used to classify each worker's history of rotational and night work. The associations between recent rotational work and night work in the last 12 months and incident hypertension were estimated using adjusted Cox proportional hazards models. Results Elevated hazard ratios (HR) were observed for all levels of recent night work (>0-5, >5-50, >50-95, >95-100%) compared with non-night workers, and among all levels of rotational work (10-20, >20-30, and >30%) compared with those working

Introduction: Sleep quality disorders may cause a decrease in concentration and work performance of individual. It is also believed that nurses with work shifts as health workers may run into sleep quality disorders. Several researches have shown the relationship between sleep quality and the work performance of nurses in shifts duty. This study aimed to determine the relationship of sleep quality and vigilance of nurses in shifts duty in Raden Mattaher hospital Jambi. Methods: A cross sectional study was performed recruiting 97 nurses working shifts in 3 inpatients wards of the Raden Mattaher Hospital Jambi. Socio-demographic details and data nurses alertness were collected using ad hoc questionnaires, data sleep quality were collected using the Pittsburgh Sleep Quality Index. Relationships among sleep patterns and alertness variables were investigated. Data were analyzed by univariate and chi-square test (CI 95%). Statistical analysis was performed using the SPSS version 16.0. Results: Results showed an average of 29.4 years of age. Respondents were mostly female, married with working time

Shortage of doctors in emergency departments (EDs) is a root issue in maintaining ED-based residency programs. This study describes the efficiency of emergency practice according to board certification; 3 board-certified physicians versus a pediatric resident. Of 342 children, we found no differences as per the board certification in the ED length of stay, acuity, and return visits with more frequent hospitalization by the board-certified physicians. This result suggests that with a proper residency program, both board-certified physicians and residents can make a decision on hospitalization.

Introduction: Exposure to the low frequency electric and magnetic fields (ELF-EMF) is very common in workers occupied in the combined cycle power plant during work shifts The present study aimed to measure ELF-EMF flux density among shift and non-shift workers, determine job stress among workers and office workers, and identify major factors associated with job stress in the studied groups. Materials and Methods: In this cross-sectional study, the exposed group was divided into 75 shift workers and 75 non-shift workers. Seventy-five office workers were selected as the reference group. The participants’ exposure to ELF-EMF was measured by the EMF-828 device. In addition, Osipow Occupational Stress Questionnaire was used to assess the participants’ stress levels. Results: Maximum levels of ELF-EMF among shift workers, non-shift workers, and office workers were 28.67 μT, 23.43 μT, and 0.06 μT, respectively. Although the explosion rate to ELF-EMF was higher in the shift and non-shift workers than the office one's, this rate in both of them were lower than the recommended limit as suggested by the American Conference of Governmental Industrial Hygienists (ACGIH). The highest stress score was related to shift workers exposed to ELF-EMF, in which 42.7% of them experienced moderate to high levels of job stress. Multivariate linear regression analysis showed a significant association between shift work and exposure to ELF-EMF with increased stress. Conclusion: The findings suggested that exposure to ELF-EMF, even at low intensities, is associated with increased stress. Moreover, Shift work is another risk factor for stress.