Physicians prescribe fewer analgesics during night shifts than day shifts

Can self-pain sensitivity quantify empathy for others' pain?

Many studies suggested shared psychological and neural representations for first‐hand physical pain and empathy for others' pain, both of which depend strongly upon top–down controlled mechanisms such as attention. This study aimed to assess the interindividual variation in first‐hand physical pain and empathy for pain, and whether their relationship is dependent upon attention. We recruited participants exhibiting high and low sensitivity to first‐hand pain (HPS and LPS), and adopted pain empathy paradigms involving attention directed toward or withdrawn from pain of another. Relative to the LPS group, participants in the HPS group estimated greater pain intensity experienced by others, felt greater unpleasantness when viewing others in pain, and exhibited greater sensitivity in discriminating others' pain. Electroencephalographic data showed that when attention was directed toward others' pain, only participants in the HPS group exhibited significant pain empathic effects on the N1 component of event‐related potentials and on the α‐oscillation response. These empathic neural responses mediated the linkage between first‐hand pain sensitivity and empathic behavioral responses. Nevertheless, empathic responses were comparable between two groups when attention was withdrawn from others' pain. These results demonstrate a shared sensitivity to first‐hand pain and empathy for pain provided that attention is directed toward pain.

Introduction: Shift work is associated with increased incidence of obesity and other features of the metabolic syndrome. Health problems in shift workers are caused by several factors, one of these factors is the stress hormone cortisol. Aim of the work: to assess the association between night shift work and the changes in body mass index (BMI), fasting blood glucose, lipid (total cholesterol, HDL, and triglycerides) levels, cortisol hormone secretion, uric acid blood level and salivary cortisol level. Materials & Methods: this study was conducted on 160 male security personnel, their age ranging from 35 to 40 years in Cairo . Regarding the work schedule 80 subjects worked daytime for 8 hours, whereas 80 individuals worked only night shift for 12 hour with one day off, for at least continuous 5 years. Results: the results showed no significant difference between night shift and day workers as regard age and working years. As regard body mass index (BMI) there was highly significant difference (<0.001) between night and day workers. There was no significant difference between night and day shift workers as regard total cholesterol level, triglycerides, and fasting blood glucose (P< 0.05) where as there is a significant difference between night and day shift workers as regard HDL –cholesterol (P<0.05) and a highly significant difference between night and day shift workers as regard uric acid blood level (P<0.001).A significant difference was detected in salivary cortisol levels among night shift workers where the salivary cortisol level is higher in the evening than in the morning, also there is a significant difference in salivary cortisol level among day shift workers where the salivary cortisol level is higher in the morning than in the evening (P<0.05). Conclusion: Our results suggest an association between long-term shift work and increased body mass index, elevation cortisol level, HDL–cholesterol, fasting blood glucose and uric acid level. Further studies are needed to understand the biological mechanisms involved and the complex behavioral and social adaptations experienced by night-shift workers. Regular screening health programs should be done to maintain the health of shift workers.

Empathy is a complex form of psychological inference that enables us to understand the personal experience of another person through cognitive/evaluative and affective processes. Recent findings suggest that empathy for pain may involve a 'mirror-matching' simulation of the affective and sensory features of others' pain. Despite such evidence for a shared representation of self and other pain at the neural level, the possible influence of the observer's own sensitivity to pain upon his perception of others' pain has not been investigated yet. The aim of this study was to explore how patients with congenital insensitivity to pain (CIP), who are largely deprived of common stimulus-induced pain experiences, perceive the pain of others. Ratings of verbally presented imaginary painful situations showed that CIP patients' semantic knowledge regarding the pain of others did not differ from control subjects. Moreover, the propensity to infer pain from facial expressions was very similar between CIP patients and control subjects. On the other hand, when asked to rate pain-inducing events seen in video clips in the absence of visible or audible pain-related behaviour, CIP patients showed more variable and significantly lower pain ratings, as well as a reduction in aversive emotional responses, compared with control subjects. Interestingly, pain judgements, inferred either from facial pain expressions or from pain-inducing events, were strongly related to inter-individual differences in emotional empathy among CIP patients, while such correlation between pain judgement and empathy was not found in control subjects. The results suggest that a normal personal experience of pain is not necessarily required for perceiving and feeling empathy for others' pain. In the absence of functional somatic resonance mechanisms shaped by previous pain experiences, others' pain might be greatly underestimated, however, especially when emotional cues are lacking, unless the observer is endowed with sufficient empathic abilities to fully acknowledge the suffering experience of others in spite of his own insensitivity.

IntroductionNight work may be organized as permanent night work or as part of shift work, which in turn may affect sleep and health. We aimed to compare timing and duration...

Objective: Night shift work disrupts normal circadian rhythms, which is hypothesized to lead to negative impacts on cardiovascular health. The underlying mechanisms remain poorly understood. We examined the associations between night shift work and cardiovascular risk factors, including blood pressure (BP), body mass index (BMI) and waist-to-hip ratio (WHR). Materials and Methods: We used data from the Exposome Project for Health and Occupational Research study (EPHOR), which included night and day shift workers from Spain, Sweden, and Denmark. We included participants with complete data on BP, BMI, and WHR. We used linear regression for the continuous outcomes and logistic regression for the binary outcomes, adjusting for relevant confounders. We conducted sex-stratified analyses, since sex may modify the relationship between night shift work exposure and cardiometabolic outcomes. Results: The analytic sample comprised 805 participants, 58% of whom were night shift workers with a mean age of 42 years (SD 11). The majority were female (87%). Compared to day workers, night shift workers had a higher BMI (β coeff. 1.10, 95%CI 0.37, 1.83), a higher odds of overweight/obesity (OR 1.39, 95%CI 1.03, 1.88), and a higher odds of moderate-high risk WHR (OR 1.39, 95%CI 1.00, 1.93). Blood pressure and the odds of hypertension were also elevated among night shift workers, but 95% CIs overlapped with the null. In the sex-stratified analyses, the point estimates were elevated among women (Table 1). Conclusion: Compared with day workers, night shift workers showed a worse cardiometabolic profile, particularly among women, indicating that cardiometabolic problems may be compounded among female night shift workers. These findings are in line with earlier research indicating that night shift work is associated with an increased cardiometabolic risk. We plan to further explore whether shift work characteristics, for example intensity of night shifts, may influence these findings.

Objective: This study was aimed to investigate the effect of Light at night and Rotating night shift as risk factor for cardiovascular diseases. 24 hours chronomics of BP/HR in terms of Double amplitude, Acrophase and Hyperbaric index and its relation with circadian rhythm of salivary cortisol and 6 sulfatoxy melatonin levels in night shift nursing professional. Design and method: 56 night shift nurses, aged 20 to 40 years, performing day and night shift duties were recruited from the Trauma Center, KGMU, India, and 56 age sex matched actual day workers were also enrolled as controls. During their night and day shift duties, BP/HR were recorded by Ambulatory Blood Pressure Monitoring (ABPM) along with circadian pattern of cortisol in saliva, metalonin in urine also tested. Results: Highly significant difference was found in double amplitude (2DA) of among between night (23.10 ± 14.68) and day shift (34.27 ± 16.44) (p &lt; 0.0005). In night shift, hyperbaric index (HBI) of mean SBP was found to be increased at 00 to 03 am (midnight) while during day shift, peak was found at 06 to 09 am. HBI of mean HR was found to be increased at 18 to 21 pm during night shift while in controls, peak was found at 09 to 12 &amp; again 15 to 18 pm of SBP, DBP &amp; HR. Alterations in Acrophase of BP/HR were very common among night shift workers and Ecphasia was found in few nights shift workers. Difference was found in night cortisol levels among night (4.08 ± 3.28) vs day shift (2.62 ± 2.37), while in comparison to night shift or day shift with controls (1.82 ± 1.18) these difference was significant (p &lt; 0.05). Conclusions: Alteration in morning melatonin and Night cortisol level were found during night shift. Reverse pattern of Acrophase and HBI of BP/HR along with salivary cortisol during night shift represents desynchronization. It indicates that the circadian rhythm was disrupted during night shift and incomplete recovery occurs during day shift. It may leads to future cardio vascular diseases risk.

Night shift work may disrupt the normal nocturnal rise in melatonin, resulting in increased breast cancer risk, possibly through increased reproductive hormone levels. We investigated whether night shift work is associated with decreased levels of urinary 6-sulfatoxymelatonin, the primary metabolite of melatonin, and increased urinary reproductive hormone levels. Participants were 172 night shift and 151 day shift-working nurses, aged 20-49 years, with regular menstrual cycles. Urine samples were collected throughout work and sleep periods and assayed for 6-sulfatoxymelatonin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estrone conjugate (E1C). 6-Sulfatoxymelatonin levels were 62% lower and FSH and LH were 62% and 58% higher, respectively, in night shift-working women during daytime sleep than in day shift-working women during nighttime sleep (P ≤ 0.0001). Nighttime sleep on off-nights was associated with 42% lower 6-sulfatoxymelatonin levels among the night shift workers, relative to the day shift workers (P < 0.0001); no significant differences in LH or FSH were observed. 6-Sulfatoxymelatonin levels during night work were approximately 69% lower and FSH and LH were 35% and 38% higher, compared with day shift workers during nighttime sleep. No differences in E1C levels between night and day shift workers were observed. Within night shift workers, 6-sulfatoxymelatonin levels were lower and reproductive hormone levels were higher during daytime sleep and nighttime work, relative to nighttime sleep (P < 0.05). These results indicate that night shift workers have substantially reduced 6-sulfatoxymelatonin levels during night work and daytime sleep and that levels remain low even when a night shift worker sleeps at night. Shift work could be an important risk factor for many other cancers in addition to breast cancer.

The frontoinsular cortex (FI) and the anterior cingulate cortex (ACC) are thought to be involved in empathy for others' pain. However, the functional roles of FI and ACC in empathetic responses have not yet been clearly dissociated in previous studies. In this study, participants viewed color photographs depicting human body parts in painful or nonpainful situations and performed either pain judgment (painful/nonpainful) or laterality judgment (left/right) of the body parts. We found that activation of FI, rather than ACC, showed significant increase for painful compared with nonpainful images, regardless of the task requirement. Our data suggest a clear functional dissociation between FI and ACC in which FI is more domain-specific than ACC when processing empathy for pain.

Objective: The present study was aimed to investigate effect of Light exposute at night on 24 hours chronomics of BP/HR in terms of Double amplitude, Acrophase and Hyperbaric index and its relation with circadian rhythm of salivary cortisol and 6 sulfatoxy melatonin in rotating night shift nursing professionals and actual day workers. Design &amp; Methods: 56 night shift nurses, aged 20 to 40 years, performing day and night shift duties were recruited from the Trauma Center, KGMU, India, and 56 age sex matched actual day workers were also enrolled as controls. BP and HR were recorded by Ambulatory Blood Pressure Monitoring (ABPM) at every 30 min intervals in day time and each hour in night time during shift duties. Results: Highly significant difference was found in double amplitude (2DA) of among between night (23.10 ± 14.68) and day shift (34.27 ± 16.44) (p &lt; 0.0005). In night shift, hyperbaric index (HBI) of mean SBP was found to be increased at 00 to 03 am (midnight) while during day shift, peak was found at 06 to 09 am. HBI of mean HR was found to be increased at 18 to 21 pm during night shift while in controls, peak was found at 09 to 12 &amp; again 15 to 18 pm of SBP, DBP &amp; HR. Alterations in Acrophase of BP/HR were very common among night shift workers and Ecphasia was found in few nights shift workers. Difference was found in night cortisol levels among night (4.08 ± 3.28) vs day shift (2.62 ± 2.37), while in comparison to night shift or day shift with controls (1.82 ± 1.18) these difference was significant (p &lt; 0.05). Conclusion: Alteration in mean morning melatonin and Increased Night cortisol level were found during night shift. Reverse pattern of Acrophase and HBI of BP &amp; HR along with salivary cortisol during night shift represents desynchronization. It indicates that the circadian rhythm was disrupted during night shift and recovery occurs during day shit.

Language contexts modulate instant empathic responses to others' pain.

Night shift work has been associated with an increased risk for breast and prostate cancer. The effect of circadian disruption on sex steroid production is a possible underlying mechanism, underinvestigated in humans. We have assessed daily rhythms of sex hormones and melatonin in night and day shift workers of both sexes. We recruited 75 night and 42 day workers, ages 22 to 64 years, in different working settings. Participants collected urine samples from all voids over 24 hours on a working day. Urinary concentrations of 16 sex steroid hormones and metabolites (estrogens, progestagens, and androgens) and 6-sulfatoxymelatonin were measured in all samples. Mean levels and peak time of total and individual metabolite production were compared between night and day workers. Night workers had higher levels of total progestagens [geometric mean ratio (GMR) 1.65; 95% confidence intervals (CI), 1.17-2.32] and androgens (GMR: 1.44; 95% CI, 1.03-2.00), compared with day workers, after adjusting for potential confounders. The increased sex hormone levels among night shift workers were not related to the observed suppression of 6-sulfatoxymelatonin. Peak time of androgens was significantly later among night workers, compared with day workers (testosterone: 12:14 hours; 10:06-14:48 vs. 08:35 hours; 06:52-10:46). We found increased levels of progestagens and androgens as well as delayed peak androgen production in night shift workers compared with day workers. The increase and mistiming of sex hormone production may explain part of the increased risk for hormone-related cancers observed in night shift workers.

&lt;div&gt;Abstract&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Night shift work has been associated with an increased risk for breast and prostate cancer. The effect of circadian disruption on sex steroid production is a possible underlying mechanism, underinvestigated in humans. We have assessed daily rhythms of sex hormones and melatonin in night and day shift workers of both sexes.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; We recruited 75 night and 42 day workers, ages 22 to 64 years, in different working settings. Participants collected urine samples from all voids over 24 hours on a working day. Urinary concentrations of 16 sex steroid hormones and metabolites (estrogens, progestagens, and androgens) and 6-sulfatoxymelatonin were measured in all samples. Mean levels and peak time of total and individual metabolite production were compared between night and day workers.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Night workers had higher levels of total progestagens [geometric mean ratio (GMR) 1.65; 95% confidence intervals (CI), 1.17–2.32] and androgens (GMR: 1.44; 95% CI, 1.03–2.00), compared with day workers, after adjusting for potential confounders. The increased sex hormone levels among night shift workers were not related to the observed suppression of 6-sulfatoxymelatonin. Peak time of androgens was significantly later among night workers, compared with day workers (testosterone: 12:14 hours; 10:06-14:48 vs. 08:35 hours; 06:52-10:46).&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; We found increased levels of progestagens and androgens as well as delayed peak androgen production in night shift workers compared with day workers.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Impact:&lt;/b&gt; The increase and mistiming of sex hormone production may explain part of the increased risk for hormone-related cancers observed in night shift workers. &lt;i&gt;Cancer Epidemiol Biomarkers Prev; 24(5); 854–63. ©2015 AACR&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;

&lt;div&gt;Abstract&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Night shift work has been associated with an increased risk for breast and prostate cancer. The effect of circadian disruption on sex steroid production is a possible underlying mechanism, underinvestigated in humans. We have assessed daily rhythms of sex hormones and melatonin in night and day shift workers of both sexes.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; We recruited 75 night and 42 day workers, ages 22 to 64 years, in different working settings. Participants collected urine samples from all voids over 24 hours on a working day. Urinary concentrations of 16 sex steroid hormones and metabolites (estrogens, progestagens, and androgens) and 6-sulfatoxymelatonin were measured in all samples. Mean levels and peak time of total and individual metabolite production were compared between night and day workers.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; Night workers had higher levels of total progestagens [geometric mean ratio (GMR) 1.65; 95% confidence intervals (CI), 1.17–2.32] and androgens (GMR: 1.44; 95% CI, 1.03–2.00), compared with day workers, after adjusting for potential confounders. The increased sex hormone levels among night shift workers were not related to the observed suppression of 6-sulfatoxymelatonin. Peak time of androgens was significantly later among night workers, compared with day workers (testosterone: 12:14 hours; 10:06-14:48 vs. 08:35 hours; 06:52-10:46).&lt;/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; We found increased levels of progestagens and androgens as well as delayed peak androgen production in night shift workers compared with day workers.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Impact:&lt;/b&gt; The increase and mistiming of sex hormone production may explain part of the increased risk for hormone-related cancers observed in night shift workers. &lt;i&gt;Cancer Epidemiol Biomarkers Prev; 24(5); 854–63. ©2015 AACR&lt;/i&gt;.&lt;/p&gt;&lt;/div&gt;

Night shift work is associated with risk of overweight and obesity. In night shift workers, short sleep duration combined with circadian misalignment may contribute to altered food intake regulation, favoring positive energy balance and weight gain. Prior work investigating food intake in shift workers has suffered methodologically due to reliance on subjective self-report for dietary assessment. No study has yet been done to examine the impact of night shift work on food intake in real-life shift workers using objective measures. Female day (n = 12) and night (n = 12) shift workers from a hospital setting participated in a laboratory-based objective food intake assessment. Participants entered the laboratory in the fasted state after awakening from the sleep episode following a final work shift, and underwent an ad libitum 14-item test meal buffet to objectively quantify food choice/intake. Sleep duration (measured via wrist-accelerometry) during the sleep episode before laboratory assessment was significantly longer in day vs. night workers (373.9 ± 127.5 vs. 260.6 ± 102.9 min, p = 0.03). No significant group difference was observed in calories consumed during the test meal (943.08 ± 469.55 vs. 878.58 ± 442.68 kcal, p = 0.74). When expressed as percent of energy consumed, day workers had higher protein consumption vs. night workers (16.03 ± 5.69 vs. 11.82 ± 4.05%; p = 0.05). To our knowledge, this is the first laboratory-based behavioral assessment of food choice/intake in actual night and day shift workers. Although not studied here, work by others has linked protein intake to satiety. This may be a potential pathway placing shift workers at risk for overweight and obesity.