Night Duty Research Articles

Characteristics of hospital pediatricians and obstetricians/gynecologists working long hours in Tokushima, Japan: A cross-sectional study

Background This study aimed to determine the actual working conditions, including working hours and desired future working styles of hospital pediatricians and obstetricians/gynecologists (OB/GYNs) in Tokushima Prefecture. Method This cross-sectional study used a self-administered questionnaire. Pediatricians and OB/GYNs (n = 96) working at 14 hospitals in Tokushima Prefecture were surveyed. The questionnaire included items related to working hours, working status, number of medical institutions, task-shifting/task-sharing status, and preferred work style. Factors associated with work hours were analyzed. Results Approximately 40% and 10% of pediatricians and OB/GYNs worked ≥60 h/week and ≥80 h/week, respectively. Their weekly working hours were significantly positively associated with the number of nights and holidays worked and concurrent medical facilities they worked at. Multiple regression models showed that weekly working hours were significantly associated with working at night and day-off duties and the number of working medical institutions being worked at concurrently. Pediatricians and OB/GYNs who worked ≥60 h/week were not implementing a “multiple attending physician system” or “on-call system,” and task-shifting/task-sharing was inadequate. A significantly higher proportion of physicians who worked long hours (≥60 h/week or ≥80 h/week) wanted to reduce the number of night and day-off duties and work hours compared with those who did not. Conclusions The results of this study suggest that many pediatricians and OB/GYNs work long hours, and it is essential to improve their work environment, including task-shifting/task-sharing. Further enhanced recruitment and retention of hospital pediatricians and OB/GYNs is required. A detailed and large-scale study of pediatricians and OB/GYNs’ working environments is essential in the future.

Exploring factors affecting nurse anxiety in Northwest Ethiopia: a multicenter study.

Anxiety is a commonly reported mental health disorder that significantly contributes to the global burden of disease. However, proper counseling, problem-solving strategies, and promotion of healthy lifestyle practices have a positive effect on reducing nurse anxiety, but there is limited evidence in Ethiopia, particularly in this study area. Therefore, this study aimed to assess the prevalence and identify factors affecting nurse anxiety in Northwest Ethiopia's comprehensive specialized hospitals. An institution-based cross-sectional study was conducted among 746 study participants from April 14 to May 20, 2023.A simple random sampling technique was used. An interviewer-administered questionnaire was used. Data were entered into EpiData version 4.6.0 and exported to STATA version 17 for analysis. In binary logistic regression, variables with a p-value of less than 0.25 were considered candidates for multivariable logistic regression. An association was declared at a p-value of less than 0.05 with a 95% confidence interval. In this study, the prevalence of anxiety was 33.9%. Thus, being female [adjusted odds ratios (AOR) = 1.53, 95% CI = 1.08, 2.22], working in an emergency department (AOR = 3.65, 95% CI = 1.83, 7.28), working night duty shifts (AOR = 3.12, 95% CI = 2.19, 4.46), having conflict with coworkers (AOR = 1.7, 95% CI = 1.14, 2.51), and having poor social support (AOR = 2.13, 95% CI = 1.23, 3.69) were variables significantly associated with anxiety. This study revealed that one-third of nurses experienced anxiety, which is a critical indicator of mental health within this population. Important factors that were found to be significantly associated with anxiety include being female, working in the emergency department, having a conflict with coworkers, having poor social support, and working night duty shifts. These findings show the need for the implementation of counseling services and the adaptation of effective coping strategies for nurses working at comprehensive specialized hospitals. Understanding the impact of anxiety on nurses is important to design interventions aimed at improving their mental health and job satisfaction.

Unrecognized dislocation of the hand—a stumbling block while on night duty

Unrecognized dislocation of the hand—a stumbling block while on night duty

Standardized emergency protocols to improve the management of patients with suspected or confirmed inherited metabolic disorders (IMDs): An initiative of the French IMDs Healthcare Network for Rare Diseases

ObjectivesPatients with inherited metabolic disorders (IMDs) may require emergency hospital care to prevent life-threatening situations such as metabolic decompensation. To date, over one thousand different rare IMDs have been identified, which means that healthcare professionals (HCPs) initiating emergency treatment may not be familiar with these conditions. The objective of this initiative was to provide HCPs with practical guidance for the acute management of children and adults with IMDs who need emergency care, regardless of the underlying reason. MethodsWe outline how a multidisciplinary working group from the French IMDs Healthcare Network for Rare Diseases, known as G2M, has created concise and standardized protocols _each consisting of a single double-sided A4 sheet _ focused on a specific disease, a group of diseases, or a particular symptom. Prior to validation, these protocols were reviewed by all French reference and competence centres for IMDs, as well as by medical experts from other specialities when necessary, physicians from emergency and intensive care units, and representatives from patient associations. Results and conclusionIn total, 51 emergency protocols containing essential information have been developed and provided to affected patients. All the emergency protocols are freely available in both French and English at https://www.filiere-g2m.fr/urgences. These standardized protocols aim to enhance the emergency care of patients without delay, while also assisting HCPs by increasing their confidence and efficiency, minimizing the risk of dosage errors when administering specialized treatments, saving time, and reducing the number of phone calls to metabolic medicine specialists on night duty. The protocols are scheduled for annual review to facilitate further improvements based on feedback from HCPs and patients, as well as to accommodate any changes in management practices as they evolve.

Factors predicting menstrual irregularity among university students in Ho Chi Minh City, Vietnam: A cross-sectional study.

University students often face menstrual irregularities, particularly among healthcare students, due to rigorous study environments, such as night duties resembling professional staff responsibilities. This study aimed to examine the prevalence of and factors predicting menstrual irregularities among female students in Ho Chi Minh City, Vietnam. A cross-sectional study was conducted from April to July 2023 at the University of Medicine and Pharmacy at Ho Chi Minh City (UMP). Data were collected using self-administered questionnaires comprising sections on personal background, menstrual cycles, sleep duration, and academic stress. Descriptive statistics and multiple logistic regression were employed for data analysis. Approximately 48.3% of participants experienced menstrual irregularities. Overweight or obese students were more likely to experience irregularities compared to those of normal weight (AOR = 7.56, 95% CI = 1.34, 80.8). Nursing majors (including nursing, midwifery, and anesthesia resuscitation nursing) showed a higher likelihood of irregularities compared to other majors (AOR = 2.5, 95% CI = 1.35, 4.13). This study highlights a significant prevalence of menstrual irregularities among female students. Interventions in nursing education should focus on promoting healthy lifestyles and regular physical activity to manage weight and mitigate menstrual irregularities.

Night Physician-Nurse Collaboration: Developing the Scale of Physicians' Difficulties and Exploring Related Factors in Acute Care Hospitals.

Responding to inpatient deterioration is less favorable at night than during the day, and this may be related to barriers in collaboration between physicians and nurses. However, there had been no way to assess the problem. This study aimed to develop a scale for physicians to measure difficulties in nighttime collaboration with nurses in response to deteriorating inpatients and to identify factors associated with the developed scale scores. We developed a draft scale of Nighttime Collaboration Difficulties between Nurses and Physicians for Physicians (NCDNP-P) based on key informant interviews with physicians. Psychometric validations, including structural validity, criterion-related validity, and reliability tests, were conducted among physicians who worked on night duty or on call in acute-care hospitals in Japan using a cross-sectional web-based questionnaire. Multiple linear regression analyses were performed using independent variables including individual backgrounds, style of working at night, and facility characteristics. By performing exploratory factor analysis, we confirmed the structural validity of the NCDNP-P, consisting of seven items and two domains (Domain 1: Dissatisfaction with reporting, Domain 2: Barriers to working with nurses). Cronbach's alpha and McDonald's omega coefficients were 0.81-0.84 and 0.81-0.89, respectively. The criterion-related validity for interprofessional collaboration was confirmed. Multiple regression analysis revealed that the variables employment status, number of night shifts, frequency of nighttime calls about patients under another physician's charge, and handover between physicians before changing shifts were statistically significantly associated with NCDNP-P scores. We developed the NCDNP-P, confirming its reliability and validity. Identified factors reflect physicians' characteristics and the problems experienced working at night and may be associated with barriers in nighttime collaboration. The NCDNP-P can highlight issues in clinical settings and lead to the consideration of initiatives to address such issues.

Hybrid lighting approach to improve interior workspace environments: a case study in the UAE

PurposeInterior workspace environments use exclusively artificial light, resulting in a loss of biological connection and natural light quality, as well as greater energy consumption. The purpose of the study is to identify a suitable system that can provide natural light to such interior spaces throughout the day while supplementing it with artificial light when necessary. The fundamental aim is to provide insights into the most effective solutions for energy-efficient lighting design in the UAE's environment, with the potential to lower energy consumption related to interior lighting.Design/methodology/approachThe study adopted an empirical approach to gather and analyze primary data based on field measurements to understand and assess existing lighting conditions, as well as DIALux lighting simulation software to test the efficacy of the proposed HLS in terms of natural light delivery, illumination quality and energy consumption. A branch of a local bank in the United Arab Emirates, situated inside one of the shopping malls where there is no natural light penetration, has been chosen as a case study.FindingsThe findings of comparing the base case to four probable scenarios that used HLS revealed that the third scenario, which uses 100% pure sunshine and 35% artificial LED light during daylight operations and 100% LED light during night duty, is considered to be optimal in terms of illumination quality and energy efficiency.Originality/valueThe study demonstrated the potential of innovative lighting to improve the visual working environment in interior spaces with limited access to direct natural lighting, especially in arid regions, where sunlight is plentiful throughout the year. The study contributes new insights into the establishment of lighting-related recommendations and standards for the UAE context. This may include advice for sustainable construction practices, lighting guidelines or incentives to encourage the use of hybrid lighting technology in commercial and institutional buildings.

Effect of Altered Sleep, Perceived Stress on Muscle Strength between Night and Day Shift Workers: A Cross-Sectional Study in Chennai

A minimum of 20% of the global population suffers from sleep debt, which includes shift workers. The risks to one's health and well-being are caused by shift work, increased workload, and other substantial problems. Sleep disruptions will lead to stress, catabolize muscle proteins, and reduce muscular strength in night shift workers. To assess whether sleep quality and perceived stress level have an effect on muscle strength among shift workers. A cross-sectional analysis was performed on the airport workers. One hundred night duty workers and one hundred day duty workers aged 25-40 were randomly selected, and the study was conducted for four months in Sree Balaji Medical College and Hospital, Tamil Nadu. A validated questionnaire evaluated the quality of sleep and stress levels. Muscle strength was determined using Mosso’s ergograph. Version 3.6.3 of the R statistical software was used to analyze the data. Kolmogorov-Smimov ‘Z’ test was used to determine the data set's normality. Significant negative correlations are observed between Mosso'sergo graph and both PSS (r = -0.501, p <0.001) and global PSQI score (r = -0.331, p <0.001). P-value <0.05 was considered statistically significant. This indicates that higher muscle strength is related to decreased perceived stress levels and better sleep quality. Workplace health policies have to be improved. Adequate resting time and stress management training are essential to reduce the adverse effects of rotational work on theworker’s performance in addition to their well-being.

Sleep habits and its associated factors among medical students of a medical college in Telangana, India

Abstract Background: Sleep is vital for cognitive function and physical and mental well-being. Medical students are prone to reduced sleep because of extensive curriculum, competitive exam, tireless night duties, fear of failure, and countless other responsibilities. Objective: This study aims to assess the sleep quality and daytime sleepiness and to determine their associated factors related to poor sleep quality among medical students. Materials and Methods: A cross-sectional study was done among 435 students among undergraduates and postgraduates in Kakatiya Medical College, Warangal, Telangana, from January 2023 to April 2023. After obtaining informed consent, the data were collected using a self-administered questionnaire, in which sleep quality and excessive daytime sleepiness was assessed using Pittsburgh Sleep Quality Index and Epworth Daytime Sleepiness Scale, respectively. The collected data were entered into Excel sheet and exported to SPSS V 20. Data analysis was done using Chi-square test, Fisher’s exact test, and Pearson’s correlation coefficient. P < 0.05 was considered statistically significant. Results: Poor sleep quality and excessive daytime sleepiness were present in 297 (68.3%) and 105 (24.1%) students, respectively. Department of postgraduates, smoking, mobile phone use, academic performance, tea, coffee intake, and excessive daytime sleepiness had a significant association with poor sleep quality. Excessive daytime sleep and sleep quality had strong positive correlation (r = 0.823). Conclusion: Poor sleep quality was quite high among medical students. Daytime sleepiness was predominant among students with poor sleep.

Night Shift Duty of Nurses and its Effects on Family and Social Lives

Background: The problem with a night shift working at that, the human race is diurnal, who are functions during day time. Night workers report a number of health problems. Therefore these negative effects have consequences not just for individual, but also for work place, as decreased alertness and reduced job performance that could endanger human lives and affect the quality of life. The assumption is that ergonomically designed shift schedules will assist in the reduction of physiological and psychosocial hazards in the workplace. Objective: This study was aimed to find out the factors influencing night shift of nurses working in Shahid Ziaur Rahman Medical College Hospital, Bogra Methods: A descriptive study was used in this study. Data was collected using semi-structured questionnaire and the data was analyzed using SPSS. Results: Here, 16% of the respondents felt discomfort during night shift. 66% they don’t get enough sleep after night duty. 60% of the respondents mentioned that night shift sometimes affects their attitude negatively. 70% stated that night shift sometimes affects their mood. 70% also stated that night shift sometimes disturbs their social life. 80% mentioned that night shift sometimes increases interpersonal conflict in their family. Conclusion: The findings revealed that the participated nurses were not comfortable with night shift at all. Night workers accumulate a sleep deficit and sleepy workers make mistakes. The most dangerous are those who build up a “sleep debt” depriving themselves of sleep over long periods.

Contraception during medical studies: A French study of 2,323 residents.

The main objective of this work was to establish the contraceptive profile of French female medical residents and to assess the impact of workload on their choice of contraception method as well as difficulties encountered. We conducted a descriptive, cross-sectional, prospective national study over six months, between May and October 2019, using an anonymous online survey sent to all female medical residents in France. We formed two study groups according to reported working hours: W+ and W-. Grouping was based on three criteria: weekly workload, weekly night duty, and weekend duty per month. Of the 17,120 active female residents, the response rate was 15.42%. Oral contraception was the most commonly used method. The contraceptive profile of female residents was similar to that of the general French population. The W+ group of residents experienced more frequent contraceptive difficulties that had no impact on their choice of contraception. Despite the difficulties of using contraception, the W+ group used effective corrective methods, allowing them to prevent unplanned pregnancies. Residents in the W+ group reported more irregular gynecological follow-up. Better gynecological monitoring during medical studies would optimize contraceptive choices made by female medical residents in France.

Unexpected cardiac arrest in the neurosurgical ward

Objective: This study aimed to identify possible predictors of unexpected cardiac arrest (CA) in the neurosurgical ward.Methods: A retrospective review of 24 patients who experienced unexpected CA between December 2012 and March 2022 was conducted. Data on demographics, diagnoses, comorbidities, CA timing, pre-CA vital signs, transfer interval from intensive care unit (ICU) to ward, cardiac rhythm, neurological outcomes, and probable causes were collected. We excluded patients who died in the ICU and those with a do-not-resuscitate order.Results: The average age was 70.3 years. Vascular diseases and head traumas were common diagnoses. About 70.8% of arrests occurred during on-call time and 62.5% took place on weekends. The mean interval between ICU transfer and CA was 13.8±29.7 days, with 54.2% occurring within 4 days and 83.3% within 14 days. Pulseless electrical activity was the most frequent initial cardiac rhythm when CA occurred. Respiratory issues were the leading cause of CA (54.2%), and 91.7% of patients had poor neurological outcomes. Within 48 hours before CA, the average value of the lowest arterial oxygen saturation significantly deteriorated from 95.8±2.9% to 90.1±11.4%.Conclusion: Unexpected CA often occurred on weekends and during night duty. Half of the cases took place within 4 days and over 80% within 2 weeks of transferring from the ICU to the ward, with respiratory problems being the main cause. Greater attention should be given to patients’ breathing patterns during night shifts and weekends, especially within the first 2 weeks after patients leave the ICU.

24 HOURS CHRONOMICS OF AMBULATORY BLOOD PRESSURE/HEART RATE IN TERMS OF ACROPHASE & HYPERBARIC INDEX IN NIGHT SHIFT NURSING PROFESSIONALS: RISK FOR CARDIOVASCULAR DISEASES

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 < 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 & again 15 to 18 pm of SBP, DBP & 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 < 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.

Correlates of Perceived Stress and Professional Quality of Life Among Nurses Working in Neonatal Intensive Care Units (NICU) in North India: A Multicenter Study

Objective To estimate the levels of perceived stress and determine the professional quality of life domains namely, compassion satisfaction, burnout, and secondary trauma and their associated factors in neonatal intensive care unit (NICU) nurses. Methods A multicenter cross-sectional study was carried out across a number of NICUs in North India from May to June 2022. A total of 223 nurses included in the study were given a self-administered questionnaire consisting of their sociodemographic profile, work profile, PSS 14 scale, and ProQol 5 scale. Data was analyzed using descriptive statistics, correlation coefficient, and multiple regression. Results Based on PSS 14, 52(23.3%), 132(59.2%), and 39(17.5%) nurses experienced mild, moderate, and severe stress, respectively. Burnout and secondary trauma were found to be average in the majority of nurses (178[79.8%] and 175 [78.5%], respectively) in regard to professional quality of life domains. A sizable portion of the nurses was found to have average to high compassion satisfaction. Factors such as more number of night duties, alarms and lights in NICU, lesser professional experience, high workload, being unmarried, and having no children were found to be significant in association with perceived stress and professional quality of life. Conclusion According to this study, the majority of nurses who work in NICUs experience moderate levels of stress, which negatively impacts their professional quality of life. Therefore, it is important to consider various stress management programs based on the stressors.

1151 IMPROVING THE MEASUREMENT OF POSTURAL BLOOD PRESSURE WITH AD-HOC MOBILE TEACHING SESSIONS FOR NURSES AND HEALTHCARE ASSISTANTS

Abstract Introduction Falls are a major cause of morbidity and mortality in patients over 65. Unrecognised postural hypotension is a significant and treatable contributor. Training nurses and health-care assistants (HCAs) in correct measurement technique can be challenging, as these groups are rarely able to fully attend single sessions due to urgent clinical commitments, night duties and staff-shortages. We aimed to improve the frequency and quality of lying-standing blood pressure (LSBP) measurement in a Geriatric inpatient cohort. Methods Three PDSA cycles were performed over a 10-month period on a single Care of the Elderly ward, including an initial audit in March 2021. The outcome measures were: 1. the percentage of non-bedbound patients having LSBP correctly measured (5-min recumbent, 1 and 3-min standing readings), assessed by chart review and 2. the understanding and confidence of measurers in correct technique, as assessed by a questionnaire. The intervention was developed into three separate days of ad-hoc mobile teaching sessions to allow reinforcement of knowledge. Trainers moved from bay-to-bay delivering a 5-minute pre-prepared presentation/demonstration on the indications and correct technique of LSBP measurement. This was repeated throughout each day until all measurers had participated. Results On initial assessment, only 21% (6/28) of non-bedbound patients had LSBP correctly measured. This improved to 44% (8/18) by July and 62% (8/13) by December 2021. When sampled, measurers had sustained improvements from July (n=8) to December (n=7), in terms of self-rated confidence (mean 4.4/5 vs 4.9/5), correct technique (25% vs 100%), interpretation of results (25% vs 43%) and knowledge of contraindications to measurement (88% vs 100%). Conclusions We describe a strategy using ad-hoc mobile teaching sessions to train nurses and HCAs to measure LSBP in a Geriatric inpatient cohort, which resulted in sustained improvements. We believe this technique is readily applicable to other units and areas of practice.

Associations between work-related variables and workplace violence among Chinese medical staff: A comparison between physical and verbal violence.

Workplace violence (WPV) against medical staff has been an important public health and societal problem worldwide. Although numerous studies have implied the differences between physical violence (PV) and verbal violence (VV) against medical staff, few studies were conducted to analyze the different associations between work-related variables, PV, and VV, especially in China. A cross-sectional study was conducted among Chinese medical staff in public hospitals, and 3,426 medical staff were interviewed and analyzed. WPV, including PV and VV, were evaluated by the self-report of the medical staff. Work-related variables, physical disease, depression, and social-demographic variables were also measured. The work-related variables included types of medical staff, professional titles, hospital levels, managers, working years, job changing, working hours/week, night duty times/week, monthly income, self-reported working environment, and social position. Logistic regressions were conducted to examine the factors associated with PV and VV. A total of 489 medical staff (23.0%) reported the experience of PV and 1,744 (50.9%) reported the experience of VV. Several work-related variables were associated with PV and VV, including nurse (OR = 0.56 for PV, p < 0.01; OR = 0.76 for VV, p < 0.05), manager (OR = 1.86 for PV, p < 0.01; OR = 1.56 for VV, p < 0.001), night duty frequency/week (OR = 1.06 for PV, p < 0.01; OR = 1.03 for VV, p < 0.01), bad working environment (OR = 2.73 for PV, p < 0.001; OR = 3.52 for VV, p < 0.001), averaged working environment (OR = 1.51 for PV, p < 0.05; OR = 1.55 for VV, p < 0.001), and bad social position (OR = 4.21 for PV, p < 0.001; OR = 3.32 for VV, p < 0.001). Working years (OR = 1.02, p < 0.05), job changing (OR = 1.33, p < 0.05), and L2 income level (OR = 1.33, p < 0.01) were positively associated with VV, but the associations were not supported for PV (all p>0.05). The other associated factors were male gender (OR = 1.97 for PV, p < 0.001; OR = 1.28 for VV, p < 0.05) and depression (OR = 1.05 for PV, p < 0.001; OR = 1.04 for VV, p < 0.001). Both PV and VV were positively associated with work-related variables, such as doctor, manager, more night duty frequency, perceived bad working environment, or social position. Some variables were only associated with VV, such as working years, job changing, and monthly income. Some special strategies for the work-related variables should be applied for controlling PV and VV.

Assessment of Determinants of Sleep Deprivation amongst Post Graduate Students of Government Medical College, Amritsar

Background: Sleep is an active, repetitive and reversible state of perceptual disengagement from the environment.A chronic lack or poor quality sleep increases the risk ofvarious disorders.Post graduate students is at the top ofthe list of sleep deprived individuals.Material and methods: A cross sectional study was conducted amongst the post graduate students of GovernmentMedical College, Amritsar. All the post graduate students admitted to various pre, para and clinical departmentsduring the years 2018, 2019 and 2020 formulated the sample size for this study.Semi structured proformae weredeveloped for data collection. Chi-square test was applied, where p-value of &lt;0.05 (on both sides) was consideredto be statistically significantResults: According to PSQI poor sleep quality was among 178(58%) post graduate students , excessive daytimesleepiness according to ESS was among 120(40%) post graduate students and sleep hours &lt;7 hrs were among 182(66%) post graduate students. After compiling results of all three, 223(72%) post graduate students were foundto be sleep deprived. Association of sleep deprivation with sleep hygiene and night duties was found to bestatistically significant.Conclusion: Increased amount of workload on the residents and more number of night duties affect the sleep ofthe post graduate students and majority of them feel exhausted and fatigued after their night duties

Effect of Night Shift on the Quality of Life of Health Care Workers in Bhopal City w.s.r. to Nidra Vega – A Pilot Study.

Background: Vega (natural urges) is a unique concept of Ayurveda and according to Acharya Vagbhatta all disease arises from ‘Vega -Vidharana’ (suppression of natural urges). Night duty is the part and parcel of health care workers life so knowingly or unknowingly they are doing Nidra Vegadharana (Holding of sleep Urge). Thus, the present research work is planned to assess the effect of Night Shift in health care workers and its impact on Quality of Life. Objective: To find-out the impact of Night Shift on Quality of Life in health care workers. To identify symptoms of Nidra Vegadharan (Holding of sleep Urge) mentioned in Brihattrayi in Night shift health workers. Materials and Methods: This cross-sectional study was carried out as a pilot study among 30 health care workers who are doing night shift. To assess QoL, World Health Organization Quality of Life Questionnaire was used and assessment of other symptoms was done based on Classical Nidra Vegadharana (Holding of sleep Urge) Symptoms. Result: Domain wise QoL showed that maximum 60% had intermediate physical QoL, maximum 73.3% had intermediate psychological QoL, maximum 60.6% had very weak social QoL and maximum 70% had intermediate environmental QoL. No one has good score of physical and psychological QoL and only 10% and 6.66% had good social and environment QoL respectively. Conclusion: In this pilot study maximum night shift health workers had very weak, weak, or intermediate QoL so it can be concluded that Night shift has an impact on the health status of health care workers.

Pejzaże umierania i żałoby w polskiej literaturze ostatnich dekad

This article concerns the representations of loss and mourning in the recent Polish literature from the perspective of spacial turn. The author analyzes three literary works: Zapiski z nocnych dyżurów [Notes from night duty] by Jacek Baczak, Ostatnie historie [Recent stories] by Olga Tokarczuk and Sorge by Aleksandra Zielińska. The article seeks to demonstrate how such categories as affective heterotopia, emotive topography, affective geography and performativity of place can be useful to study the literary landscapes of dying, mourning and loss. The remarks aim to emphasize spatial, not only temporal, aspect of the experience of death.

A Study to Assess Changes in Cortisol Level and Heart Rate Variability between Fixed Duty and Shift Duty Health Care Providers in a Tertiary Care HospitalA Cross-Sectional Study

Introduction: Increased demand of service 24 hours around the clock has divided the workers into 2 domains as “Fixed duty” and “Shift duty”. Personals associated with shift duty are increasing in numbers day by day. Shift duty or more specifically night duty is associated with increased stress which results in high morbidity and decrease in work efficiency. Cortisol hormone and Heart Rate Variability (HRV) are useful parameters to determine the effects of stress. Aim: To find any change in cortisol levels, HRV, Athens score among the fixed duty and shift duty healthcare providers. Materials and Methods: A descriptive cross-sectional comparative study was conducted in a tertiary care hospital at Kolkata between July, 15th to Sept, 15th 2021. Predesigned and pretested questionnaire was made and ethical clearance was taken from institutional IEC. Then after taking consent total 120 (60 fixed duty and 60 shift duty) healthcare providers were recruited for the study. Subjects of the study filled up a questionnaire {including Athens Insomnia Scale (AIS)}. After applying exclusion criteria (any cardiovascular, neurological, psychological, sleep disorder) 120 health individuals were taken five minutes short-term HRV (time and frequency domain) recording in supine posture and 4 PM blood sample (for cortisol) were obtained from the participants which was further analysed in Chemiluminescence Immunoassay (CLI). Data was analysed in SPSS version 20.0. Statistical tests like student t-test, Cron bach’s alpha and chi-square tests were applied significant p&lt;0.05 (95% CI). Results: After analysis, shift duty workers showed a significant (p&lt;0.001, Odd’s 10.706) higher chance of having insomnia (Athens score &gt;6) than fixed duty workers. Blood test showed that shift duty workers had significantly high evening cortisol level than fixed duty workers (p= 0.036). The time domain of HRV showed that the parameters like Standard Deviation all NN interval (SDNN) (p=0.001), Mean HR (p=0.037), RMSSD (p &lt;0.001), NN50 (p=0.006), pNN50 (p=0.002) were significantly different in the two groups. Whereas the frequency domain of HRV showed that HF power was lower and LF power (p=0.002), LF/HF ratio (p &lt;0.001) were significantly higher in shift duty workers. Conclusion: The study showed that shift duty workers had comparatively higher stress levels resulting in significantly high sympathetic drive and increased risk of insomnia. This can be associated with morbidity and ill health in the shifting duty workers.