Home About us Contact
|
Home About us Contact | ||
|
|
||
Shift Work (shift + work)
Selected AbstractsShift work, the anaesthetist and Santayana's warningANAESTHESIA, Issue 8 2004Article first published online: 19 JUL 200 No abstract is available for this article. [source] Sleep and the metabolic syndromeEXPERIMENTAL PHYSIOLOGY, Issue 1 2007Robert Wolk The metabolic syndrome represents a clustering of several interrelated risk factors of metabolic origin that are thought to increase cardiovascular risk. It is still uncertain whether this clustering results from multiple underlying risk factors or whether it has a single cause. One metabolic abnormality that may underlie several clinical characteristics of the metabolic syndrome is insulin resistance. This review discusses the evidence that sleep disturbances (obstructive sleep apnoea, sleep deprivation and shift work) may independently lead to the development of both insulin resistance and individual clinical components of the metabolic syndrome. The converse may also be true, in that metabolic abnormalities associated with the metabolic syndrome and insulin resistance may potentially exacerbate sleep disorders. The notion that sleep disturbances exert detrimental metabolic effects may help explain the increasing prevalence of the metabolic syndrome and insulin resistance in the general population and may have important implications for population-based approaches to combat the increasing epidemic of metabolic and cardiovascular disease. [source] Effect of Exogenous Melatonin on Mood and Sleep Efficiency in Emergency Medicine Residents Working Night ShiftsACADEMIC EMERGENCY MEDICINE, Issue 8 2000Milan Jockovich MD Abstract. Objective: To determine whether melatonin taken prior to attempted daytime sleep sessions will improve daytime sleep quality, nighttime sleepiness, and mood state in emergency medicine (EM) residents, changing from daytime to nighttime work schedules. Methods: A prospective, randomized, double-blind crossover design was used in an urban emergency department. Emergency medicine residents who worked two strings of nights, of at least three nights' duration each, and separated by at least one week of days were eligible. Subjects were randomized to receive either melatonin 1 mg or placebo, 30 to 60 minutes prior to their daytime sleep session, for three consecutive days after each night shift. Crossover to the other agent occurred during their subsequent night shifts. Objective measures of quality of daytime sleep were obtained using the Actigraph 1000. This device measures sleep motion and correlates with sleep efficiency, total sleep time, time in bed, and sleep latency. The Profile of Mood States (POMS) and the Stanford Sleepiness Scale (SSS) were also used to quantify nighttime mood and sleepiness. Results: Among the 19 volunteers studied, there was no difference in sleep efficiency (91.16% vs 90.98%, NS), sleep duration (379.6 min vs 342.7 min, NS), or sleep latency (7.59 min vs 6.80 min, NS), between melatonin and placebo, respectively. In addition, neither the POMS total mood disturbance (5.769 baseline vs 12.212 melatonin vs 5.585 placebo, NS) nor the SSS (1.8846 baseline vs 2.2571 melatonin vs 2.1282 placebo, NS) demonstrated a statistical difference in nighttime mood and sleepiness between melatonin and placebo. Conclusions: There are no beneficial effects of a 1-mg melatonin dose on sleep quality, alertness, or mood state during night shift work among EM residents. [source] Wage policy in the health care sector: a panel data analysis of nurses' labour supplyHEALTH ECONOMICS, Issue 9 2003Jan Erik Askildsen Abstract Shortage of nurses is a problem in several countries. It is an unsettled question whether increasing wages constitute a viable policy for extracting more labour supply from nurses. In this paper we use a unique matched panel data set of Norwegian nurses covering the period 1993,1998 to estimate wage elasticities. The data set includes detailed information on 19 638 individuals over 6 years totalling 69 122 observations. The estimated wage elasticity after controlling for individual heterogeneity, sample selection and instrumenting for possible endogeneity is 0.21. Individual and institutional features are statistically significant and important for working hours. Contractual arrangements as represented by shift work are also important for hours of work, and omitting information about this common phenomenon will underestimate the wage effect. Copyright © 2003 John Wiley & Sons, Ltd. [source] Juggling multiple temporalities: the shift work story of mid-life nursesJOURNAL OF NURSING MANAGEMENT, Issue 1 2009PhD (Macq), SANDRA WEST BSc (Macq) Aim, To explore the theme of multiple temporalities revealed through a phenomenological study of the experience of mid-life shift-working nurses. Background, There are few data on the experience of mid-life women working rotating shift systems that change frequently. Concomitantly, the age profile of the current nursing workforce demands exploration of such issues. Method, This phenomenological study sought the perspectives of 13 shift-working mid-life women. Results, Sociological discussion of the temporal nature of work describes temporality as the clock time associated with an individual as determined by the constraints of their life. Transcript analysis identified the numerous temporalities surrounding a shift-working mid-life woman and a sense of disjunction between the temporalities of individuals important to them which resulted in feelings of regret and guilt. The concept of juggling is introduced to illustrate the participants' need to ,keep everything going' for important individuals in their lives. Conclusion, The personal cost of effective juggling may be high for the jugglers themselves but also for health systems that provide the mid-life shift-working nurse with no alternative than a reduction in working hours. Implications for nursing management, The development of a personal ,time map' framed within the concept of multiple temporalities is suggested for use as a staff development tool to assist with staff retention by facilitating both group and individual discussions of rostering and the complexities of managing an intergenerational work force undertaking shift work. [source] Factors associated with safe patient handling behaviors among critical care nursesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Soo-Jeong Lee RN Abstract Background Patient handling is a major risk factor for musculoskeletal (MS) injury among nurses. The aims of the study were to describe nurses' work behaviors related to safe patient handling and identify factors influencing their safe work behaviors, including the use of lifting equipment. Methods A cross-sectional study using a mailed questionnaire with a nationwide random sample of 361 critical care nurses. Nurses reported on the physical, psychosocial, and organizational characteristics of their jobs and on their MS symptoms, risk perception, work behaviors, and demographics. Hierarchical multiple linear regression analyses were used to identify significant factors. Results More than half of participants had no lifting equipment on their unit, and 74% reported that they performed all patient lift or transfer tasks manually. Significant factors for safer work behavior included better safety climate, higher effort,reward imbalance, less overcommitment, greater social support, and day shift work. Physical workload, personal risk perception, or MS symptom experiences were not associated with safe work behavior. Conclusions Safe work behaviors are best understood as socio-cultural phenomena influenced by organizational, psychosocial, and job factors but, counter to extant theories of health behaviors, do not appear to be related to personal risk perception. Management efforts to improve working conditions and enhance safety culture in hospitals could prove to be crucial in promoting nurses' safe work behavior and reducing risk of MS injury. Am. J. Ind. Med. 53:886,897, 2010. © 2010 Wiley-Liss, Inc. [source] Biochemical hypoglycemia in female nurses during clinical shift work,RESEARCH IN NURSING & HEALTH, Issue 2 2004Kayoko Inoue Abstract Female nurses in Japan commonly experience symptoms similar to those of hypoglycemia while working. Biochemical hypoglycemia can lead to impaired cognition; thus, it is important to know the prevalence of biochemical hypoglycemia among nurses. Five hundred and sixty-eight female nurses (53% of the target population) in four hospitals completed questionnaires. They determined their blood glucose levels 12 times, at four points during three shifts. Fifty-seven nurses (10%) recorded biochemical hypoglycemia (,3.0 mM) at least once. Multivariate analysis revealed three independent risk factors for hypoglycemia: higher coefficient of variation of blood glucose level, lower body mass index, and not smoking. Subjective symptoms were not associated with hypoglycemia. More research on hypoglycemia is needed in order to improve working environment for nurses. © 2004 Wiley Periodicals, Inc. Res Nurs Health 27:87,96, 2004 [source] Evaluation of a Web-based Asynchronous Pediatric Emergency Medicine Learning Tool for Residents and Medical StudentsACADEMIC EMERGENCY MEDICINE, Issue 2009Kreg Burnette MD Abstract Objectives:, To examine the effectiveness of an asynchronous learning tool consisting of web-based lectures for trainees covering major topics pertinent to pediatric emergency medicine (PEM) and to assess resident and student evaluation of this mode of education. Methods:, PEM faculty and fellows created a 21-lecture, web-based curriculum. These 20-minute online lectures used Microsoft PowerPoint with the voice-over feature. A 75-question test was created to assess the effectiveness of the web-based learning model, administered online before and after the rotation in the pediatric emergency department (PED). All fourth-year medical students and residents (across all specialties) rotating through the PED were required to complete 10 of the 21 lectures during their 1-month rotation. The main outcome variable was difference in score between pre- and post-rotation tests of participants who viewed no lectures and those who viewed at least one lecture. Evaluation of the program was assessed by anonymous survey using 5-point discrete visual analog scales. Responses of 4 or 5 were considered positive for analysis. Results:, One hundred eleven residents and fourth-year medical students participated in the program. An initial 32 completed testing before implementation of the on-line lectures (March 2007,August 2007), and another five did not complete the on-line lectures after implementation (September 2007,February 2008). Seventy-one completed testing and on-line lectures, and all but three completed at least 10 on-line lectures during their rotation. Fourteen of 111 trainees did not complete the pre- or post-test (including two who viewed the lectures). The mean change in score was a 1% improvement from pre-test to post-test for trainees who viewed no lectures and a 6.2% improvement for those who viewed the lectures (mean difference = 5.2%, 95% confidence interval = 2.5% to 7.9%). In the linear regression model, the estimate of the coefficient was 0.43 (p < 0.001), meaning that, for each lecture viewed, post-test score rose by 0.43%. Sixty-nine of 75 test items (92%) had a point biserial correlation greater than 0.15. Thirty of the 72 trainees who completed the online lectures and testing (42%) returned surveys. All were comfortable using the Internet, and 87% (26/30) found the web-site easy to use. All felt that their educational goals were met, and 100% felt that the format would be useful in other areas of education. Conclusions:, Although not a replacement for traditional bedside teaching, the use of web-based lectures as an asynchronous learning tool has a positive effect on medical knowledge test scores. Trainees were able to view online lectures on their own schedules, in the location of their choice. This is helpful in a field with shift work, in which trainees rarely work together, making it difficult to synchronously provide lectures to all trainees. [source] Maternal sleep deprivation is a risk factor for small for gestational age: A cohort studyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009Chrishantha ABEYSENA Aims: To determine trimester-specific risk factors for small-for-gestational-age (SGA) infants. Methods: A population-based prospective cohort study was conducted in Sri Lanka from May 2001 to April 2002. Pregnant women were recruited on or before 16 weeks of gestation and followed up until delivery. The sample size was 690. Trimester-specific exposure status and potential confounding factors were gathered on average at 12th, 28th and 36th weeks of gestation. SGA was assessed using customised birth centile charts. Multiple logistic regression was applied, and the results were expressed as odds ratios (OR) and 95% confidence intervals (95%CI). Results: The risk factors for SGA less than 5th centile were shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters (OR 4.20, 95%CI 1.10,16.0), sleeping for less than or equal to 8 h during 2nd or 3rd or both trimesters (OR 2.23, 95%CI 1.08,4.59), walking for less than or equal to 2.5 h per day (OR 2.66, 95%CI 1.12,6.31) and alcohol consumption during the 3rd trimester (OR 14.5, 95%CI 2.23,94.7). Poor weekly gestational weight gain was significantly associated with both SGA < 10th and < 5th centiles. None of the other factors became significant for SGA < 10th centile. Conclusions: Risk factors for SGA less than 5th centile were sleep deprivation and shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters, less walking hours and alcohol consumption during 3rd trimester. Poor weekly gestational weight gain may be considered as a predictor of delivering an SGA infant. [source] A Review of the Effect of the Psychosocial Working Environment on Physiological Changes in Blood and UrineBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 2 2009Åse M. Hansen Literature databases (PubMed, Toxline, Biosis and Embase) were screened using the key words job, work-related and stress in combination with selected physiological parameters. In total, 51 work place studies investigated the associations between the psychosocial working environment and physiological changes, of which 20 were longitudinal studies and 12 population-based studies. The studied exposures in work place/population-based studies included: job demands (26/8 studies), job control (24/10 studies), social support and/or leadership behaviour (12/3 studies), effort,reward imbalance (three/one studies), occupational changes (four studies), shift work (eight studies), traumatic events (one study) and other (five studies). The physiological responses were catecholamines (adrenaline, noradrenaline) (14 studies), cortisol (28 studies), cholesterol (23 studies), glycated haemoglobinA1c (six studies), testosterone (nine studies), oestrogens (three studies), dehydroepiandrosterone (six studies), prolactin (14 studies), melatonin (one study), thyroxin (one study), immunoglobulin (Ig) A (five studies), IgG (four studies), IgM (one study) and fibrinogen (eight studies). In general, fibrinogen and catabolic indicators, defined as energy releasing, were increased, whereas the anabolic indicators defined as constructive building up energy resources were decreased when the psychosocial working environment was perceived as poor. In conclusion, in this review the association between an adverse psychosocial working environment and HbA1c, testosterone and fibrinogen in serum was found to be a robust and potential candidate for a physiological effect of the psychosocial working environment. Further, urinary catecholamines appear to reflect the effects of shift work and monotonous work. [source] Life Style and Urinary 8-Hydroxydeoxyguanosine, a Marker of Oxidative DNA Damage: Effects of Exercise, Working Conditions, Meat Intake, Body Mass Index, and SmokingCANCER SCIENCE, Issue 1 2001Hiroshi Kasai The urinary levels of 8-hydroxydeoxyguanosine (8-OH-dG), a marker of oxidative DNA damage, of 318 healthy men aged 18-58 were measured with high resolution by a newly developed automated high-pressure liquid chromatography (HPLC) system coupled to an electrochemical detector (ECD). The mean 8-OH-dG level (,Mg/g creatinine) was 4.12±1.73 (SD). An eleven-fold inter-individual variation was observed. The accuracy of the measurement estimated from the recovery of an added 8-OH-dG standard was 90-98%. By univariate analysis, it was found that moderate physical exercise (P=0.0023) and high body mass index (BMI) (P=0.0032) reduced the 8-OH-dG level, while physical labor (P=0.0097), smoking (P=0.032), and low meat intake (less than once/ week) (P=0.041) increased its level. Based on a multi-regression analysis of the log-transformed values, moderate physical exercise (P=0.0039), high BMI (P=0.0099), and age (P=0.021) showed significant reducing effects on the 8-OH-dG level, while low meat intake (P=0.010), smoking (P=0.013), and day-night shift work (P=0.044) increased its level. These results suggest that many types of life-style factors that either generate or scavenge oxygen radicals may affect the level of oxidative DNA damage of each individual. [source] | ||||||||||