Night Shift Research Articles

Sources of Sound Exposure in Pediatric Critical Care.

Sound levels in the pediatric intensive care unit (PICU) are often above recommended levels, but few researchers have identified the sound sources contributing to high levels. To identify sources of PICU sound exposure. This was a secondary analysis of continuous bedside video and dosimeter data (n = 220.7 hours). A reliable coding scheme developed to identify sound sources in the adult ICU was modified for pediatrics. Proportions of sound sources were compared between times of high (≥45 dB) and low (<45 dB) sound, during day (7 AM to 6:59 PM) and night (7 PM to 6:59 AM) shifts, and during sound peaks (≥70 dB). Overall, family vocalizations (38% of observation time, n = 83.9 hours), clinician vocalizations (32%, n = 70.6 hours), and child nonverbal vocalizations (29.4%, n = 64.9 hours) were the main human sound sources. Media sounds (57.7%, n = 127.3 hours), general activity (40.7%, n = 89.8 hours), and medical equipment (31.3%, n = 69.1 hours) were the main environmental sound sources. Media sounds occurred in more than half of video hours. Child nonverbal (71.6%, n = 10.2 hours) and family vocalizations (63.2%, n = 9 hours) were highly prevalent during sound peaks. General activity (32.1%, n = 33.2 hours), clinician vocalizations (22.5%, n = 23.3 hours), and medical equipment sounds (20.6, n = 21.3 hours) were prevalent during night shifts. Clinicians should partner with families to limit nighttime PICU noise pollution. Large-scale studies using this reliable coding scheme are needed to understand the PICU sound environment.

The effect of cumulative night shift duties on insomnia, fatigue, and mental health in intensive care unit

BackgroundNight shift duties are crucial in the ICU to ensure care continuity, where critically ill patients require round-the-clock care. However, cumulative night shift duties may disturb circadian rhythm, insomnia, fatigue, and depression, and require further elucidation. ObjectivesThis study aims to examine the negative consequences of various night shift patterns on insomnia, fatigue, and mental health of ICU Workers. MethodsA cross-sectional study examined how cumulative night shift duty affects insomnia, fatigue, and mental health in critical care providers (CCPs). ResultsA total of 1006 participants completed this study between June 2022 and March 2023, including 54.5 % males. About 35 % were between 20 and 30 years of age, and Respiratory Therapists accounted for approximately 46.5 % of the entire sample. Most of our respondents (476; 47 %) reported working night shifts, with a monthly range of 8–15 nights. The prevalence rates for moderate to severe clinical insomnia, fatigue, and moderate to severe depression were 42 %, 48 %, and 32 %, respectively. CCPs working 8–15 nights had a 2-fold risk of clinical insomnia than those working fewer than eight nights with (AOR) and 95 % (CI) of 2.12 and 1.41–3.20, while those working ≥16 nights per month had a greater incidence of clinical insomnia compared to those working <8 nights per month, AOR (CI): 3.09 (1.90–5.03). Only those working ≥16-night shifts per month had a substantially higher fatigue risk compared to those working < 8-night shifts per month, with an AOR (CI) of 1.92 (1.19–3.08). Working 8–15-night shifts per month increases depression risks by 34 % compared to the <8-night shifts group, AOR (CI): 1.34 (0.87–2.08). Those working ≥16-night shifts per month showed a higher depression risk than those working <8-night shifts, AOR (CI): 2.53 (1.53–4.19). ConclusionA cumulative night shift above eight nights per month is linked with an increased risk of insomnia, fatigue, and depression. The risk of these conditions was significantly directly proportional to the number of night shifts performed per month.

Transition status and influencing factors of newly graduated nurses: A descriptive survey design

AimsTo assess the transition status of newly graduated nurses in China and identify its influencing factors. BackgroundNewly graduated nurses are the indispensable part of nursing human resource. The successful transition of into clinical work is crucial for their future career development. However, the transition status of new nurses in China remains inadequately explored. DesignA descriptive survey design was employed in this study. MethodsFrom October 2022 to January 2023, 1261 newly graduated nurses were surveyed online with the Transition Status Scale for Newly Graduated Nurses. Description statistical analysis was adopted to evaluate the transition status of new nurses. Independent-samples t-test, Analysis of Variance and Multiple Regression Analysis was used to explore the influencing factors of the transition status. ResultsThe total mean score of Transition Status Scale for Newly Graduated Nurses was 4.00 (SD=0.61). Competence for nursing work (Mean=4.20; SD=0.57) was rated the highest among the five dimensions of the scale, while the dimension of balance between work and life (Mean=3.65; SD=0.89) was rated the lowest. Mentored by senior nurses, night shift, attribute of working hospital, educational background, interned in the same department, tertiary general hospital, reasons for choosing nursing and working time can affect the transition status of new nurses, accounting for 17.9% of the variance in transition status (R²= 0.179, P＜0.001). ConclusionThe transition status of newly graduated nurses in China is at a relatively high level, especially in the dimension of competence for nursing work. However, newly graduated nurses are in a relatively poor status of work-life balance. Nurse educators and managers need to pay more attention to the transitional training of highly educated nursing talents and the optimization of clinical transition training programs to prevent talent loss. Experienced tutors should be allocated to provide guidance for newly graduated nurses.

Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design

This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.

The Prevalence and Predictors of Sleep Disorders and Their Impact on Academic Performance Among Saudi University Students: A Cross-Sectional Study.

University students encounter a variety of sleep problems that have an impact on their health and academic performance. Therefore, the aim of this study was to evaluate the prevalence of sleep disorders and their impact on academic performance among Saudi university students. This is an online cross-sectional study that involved university students and was conducted between November 2022 and February 2023 in Saudi Arabia. Sleep disorders were examined among undergraduate students through online screening surveys including the Epworth Sleepiness Scale (ESS) to assess excessive daytime sleepiness, the Insomnia Severity Index (ISI) to measureinsomnia, and the Berlin questionnaire to examine obstructive sleep apnea (OSA). Restless leg syndrome (RLS) was measured using the RLS rating.SPSSversion 29.0 (IBM Corp., Armonk, NY, USA)was used for all statistical analyses. Binary logistic regression analysis was used to identify predictors of having excessive daytime sleepiness, insomnia, sleep-disordered breathing, and RLS. The sample included 449 participants. According to the ESS, 56.6% (n=254) of students reported excessive daytime sleepiness. Using the ISI, 78.4% (n=352) of students were found to have insomnia. The Berlin questionnaire indicated that 6.7% (n=30) of students had sleep-disordered breathing. Additionally, 13.6% (n=61) of students reported having RLS. Male students had higher odds of sleep-disordered breathing compared to females (p<0.01), while marital status showed that married students had higher odds of sleep-disordered breathing (p<0.05). Students who reported nighttime sleeping had lower odds of insomnia and restless leg syndrome (p<0.05). Having regular sleeping times was associated with higher odds of insomnia (p<0.05). Napping sometimes was associated with higher odds of excessive daytime sleepiness and sleep-disordered breathing (p<0.05). Students working day and night shifts had higher odds of sleep-disordered breathing (p<0.01). Interestingly, students with comorbidities had lower odds of RLS (p<0.01). This study established that sleep disturbances among students significantly reduce grade point averages (GPAs), where the most affected were male students and those who were married. The government should implement sleep education programs, provide resources for the management of sleep, encourage consistent sleep schedules, and come up with targeted interventions for at-risk groups. More research is also recommended on effective sleep interventions.

Prediction of pregnancy disorders in female workers in the industrial sector

ContextAs female workers face a higher risk of exposure to workplace hazards than women in general, it is imperative that measures be put in place in the workplace to ensure safe and healthy pregnancies. ObjectivesThis study aimed to analyze the effects of occupational hazards in the workplace environment on the potential for pregnancy disorders experienced by female workers. MethodsThis was an analytical, observational study with a case-control design. The participants were female workers who worked in industrial environments in both formal and nonformal industries. The inclusion criteria used in this study were female workers who had been or were pregnant at the time of the study, had worked in the industrial sector for at least one year, and did not smoke or consume alcohol. The samples were collected from 144 female workers. Midwives assisted in collecting data and conducting examinations of female workers. This study was conducted in Surabaya and Sidoarjo between June and December 2020. Data were analyzed descriptively, and a multivariable logistic regression test was performed. The study was conducted in accordance with the health protocols and prevention of COVID-19. ResultsThe results showed that occupational hazards in the workplace environment that affect pregnancy disorders include workload (p = 0.004, OR = 28.676 (2.979–276.076); hot working environment (p = 0.014, OR = 3.077 (1.254–7.552); strong odors (p = 0.017, OR = 7.640 (1.436–40.656); shift work (p = 0.023, OR = 8.063 (1.337–48.623); irregular shift work (p = 0.018, OR = 7.371 (1.409–38.557); and night shift work (p = 0.015, OR = 11.780 (1.605–86.450). ConclusionsCompanies are expected to pay special attention to female workers regarding various workplace controls to prevent potential pregnancy-related disorders.

Timing of acute cold exposure determines thermoregulatory responses - possible interactions between the thermal environment and circadian clocks

Introduction: Shift workers are frequently exposed to the harsh combination of night work in a low-temperature environment. In this project, we aimed to determine if acute induction of thermoregulatory markers UCP1 and FGF21 by cold exposure depend on the timing of the exposure, and to investigate if the neural processing of thermal information has a potential role. Methods: Six groups of C57BI/J6 mice (N=8) were habituated for 2 months to a 12 h light/ 12 h dark regiment at thermoneutral temperature 27 °C (TN). After this period, groups were acutely exposed to an ambient temperature of 15 °C (COLD) or a continuation of TN temperature. Temperature exposures of groups were applied at three different time-points of the day lasting for 8 hours before tissues were harvested at ZT4, ZT12 or ZT20 (i.e. 4, 12 or 20 hours after the light is on, respectively). Thermoregulatory markers were measured in plasma, brown adipose tissue (BAT), liver and the peripheral somatosensory neurons in dorsal root ganglion (DRG) using RTPCR and immunodetection. Furthermore, behaviour testing was used to evaluate thermal preference. Results: UCP1 expression increased in BAT from COLD mice, as compared to TN mice. A higher induction of UCP1 was observed at ZT12 than the other time points. Plasma levels of FGF21 were induced acutely in COLD mice at ZT4 and ZT12, compared to the time-matched TN controls, but COLD mice at ZT20 did not display increase of FGF21 plasma levels. Cold exposure affected mRNA expression patterns of core circadian clock components in BAT (Bmal1, Clock, Per1/2/3, Cry1/2, Nr1d1/2), but in liver these transcripts were not affected. Behavior testing showed that COLD mice developed cold tolerance behaviors at ZT4 but less at ZT12. Analyses of gene expression in the somatosensory DRG neurons revealed circadian oscillations of core components and gene regulation due to cold exposure. Summary: In a nutshell, data suggest that the timing of cold exposure might impact physiological and behavioural adaptations to cold environments. This was associated with diurnal variations of gene expression in DRG neurons. Supported with an internal grant at STAMI. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

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 &lt;0.001) and global PSQI score (r = -0.331, p &lt;0.001). P-value &lt;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.

Patterns of Musculoskeletal Disorders among Staff Nurses in the Emergency Department in Saudi Arabia: A Cross-sectional Study

Background: The physically demanding and high-stress environment of Emergency Departments (EDs) significantly contributes to the heightened risk of musculoskeletal disorders (MSDs) among ED nurses. Despite this known association, there is a lack of comprehensive understanding of the prevalence rates and contributing factors within ED settings in Saudi Arabia, necessitating further investigation.Purpose: This study delves into the prevalence and potential predictors of MSDs among nurses in this critical healthcare setting.Methods: A cross-sectional survey was conducted in March 2023 using convenience sampling of 177 ED nurses across 16 public hospitals in Hail, Saudi Arabia. The Nordic Musculoskeletal Questionnaire was employed, with SPSS analyses covering frequency and percentage of pain prevalence via cross-tabulation, and logistic regression to identify risk factors.Results: Over the past year, 68.9% of participants reported lower back pain affecting normal activities in 55.4% of cases. Neck pain was more likely in individuals aged 20-29 and former smokers accounting for 47.6% of the variance (p=0.001). Shorter shifts under 8 hours reduced neck pain risk, whereas a schedule with 50% of night shifts heightened the risk, contributing to 28.4% of the variance (p=0.001). Nurses aged 40-49 and those with significant childcare duties faced higher shoulder pain risk (p=0.024), and adult caregiving duties was linked to upper back pain explaining 40.6% of the variance (p=0.017). No significant links were found for other musculoskeletal pains.Conclusion: The study reveals a significant prevalence of MSDs among the evaluated ED nurses, significantly influenced by specific demographic and work-related factors. Addressing these through ergonomic interventions, optimal scheduling, and wellness programs is crucial for nurse well-being and patient care. Future research should focus on creating holistic wellness programs that support nurses musculoskeletal health.

Altered coordination between sleep timing and cortisol profiles in night working female hospital employees

BackgroundCortisol typically peaks in the morning after waking up and declines throughout the day, reaching its lowest levels during nighttime sleep. Shift work can cause misalignment between cortisol levels and sleep-wake timing. We analyzed this misalignment in female shift workers focusing on the timing and extent of these changes. MethodsWe conducted a cross-sectional study involving 68 shift workers (aged 37 ± 10 years) and 21 non-shift workers (aged 45 ± 10 years) from a hospital. Shift workers were monitored through two day shifts and three night shifts, whereas non-shift workers were monitored during two day shifts. Each participant collected six to eight saliva samples (depending on their shift type) and provided sleep timing information, which was recorded via polysomnography and sleep diaries. Generalized additive mixed models were used to estimate shift-specific differences in cortisol smooth curves. Summary measures calculated for the cortisol smooth curves included cortisol awakening response, peak-to-bed slope, and total output. ResultsBetween shift workers and non-shift workers, we observed similar diurnal cortisol profiles with a steep negative diurnal slope during day shifts. In shift workers on night shifts, a flattened U-shaped cortisol profile after the post-awakening maximum was observed, with a peak-to-bed slope close to zero. When comparing night to day shifts in the group of shift workers, mean cortisol levels were lower between 42 and 56 minutes and 1.8–11.9 hours after waking up, and higher between 14.9 and 22 hours after waking up. ConclusionOur findings indicate altered cortisol profiles in female hospital employees on night shifts. Specifically, cortisol levels were lower at night when higher levels would typically be necessary for work activities, and higher at bedtime after a night shift, when levels should normally be low.

Investigation of the Relationship among Work Shift, Sleep Quality, and Work Ability Index in Pre-Hospital Emergency Personnel in Urmia City in 2023

Objectives: Nowadays, due to the increase in the volume of accidents, pre-hospital emergency personnel, as the frontline of treatment by providing relief and assistance to patients and victims of various incidents, have encountered various work-related challenges and problems, including cardiovascular diseases, digestive diseases, excessive fatigue, and reduced sleep quality. In this regard, the present research aimed to study the relationship among shift work, sleep quality, and work ability index in pre-hospital emergency personnel. Methods: This research was performed on 102 operational personnel of a pre-hospital emergency department in Urmia, Iran. After the collection of demographic information, the number of work shifts per week, the number of working hours per month, the quality of sleep, and the work ability of the personnel were measured by the Petersburg sleep quality questionnaire and work ability index questionnaire. The relationship between research variables was investigated using correlation coefficient, Fisher's exact test, and one-way analysis of variance tests. Results: Mean total sleep quality score of the personnel was 6.01 ± 2.38, which indicated poor and unfavorable sleep quality. Moreover, work ability index scores of 34.3%, 52%, and 13.7% of participants were at poor, moderate, good, and excellent levels, respectively. Regarding the comparison between the two variables of shift work and sleep quality, there was a significant difference, and a strong and significant relationship was observed between sleep quality and work ability index. Conclusion: Through the increase in the number of work shifts and working hours, the sleep quality of the personnel became unfavorable and weak which led to a decrease in the work ability index score and a reduction in the job performance of the personnel. Reduction of working hours, usage of young people with high work ability, management and control of the number of work shifts of the personnel by considering resting and closure time, consideration of morning-evening and night shifts in a balanced and equal manner, and prevention of people from working in monotonous shifts (activity only in the form of night work or only day work), and avoidance of working in consecutive work shifts without rest and vacation in order to improve the quality of sleep and work performance is recommended.

Factors and age-related drivers that influence self-rated bad health in police officers: A cross-sectional study

ObjectiveAlthough some previous studies have investigated health in police officers, investigations of related factors have been limited to work-related associations or those affecting certain police officers. To address this gap, this study investigated relationships between sociodemographic factors, work-related factors, health behaviors, health conditions, and self-rated bad health (SRBH) in Korean police officers. MethodsIn 2021, we conducted a cross-sectional survey in cooperation with the Korean National Police Agency (KNPA). The respondents were 6,591 police officers aged 21–60 years, all of whom agreed to complete the survey online using the police agency’s intranet. After collecting data, we conducted a multiple logistic regression analysis to examine factors that were associated with SRBH, with calculations for adjusted odds ratios (ORs) and 95 % confidence intervals (CIs). The study model included a range of individual socioeconomic characteristics, work-related variables, health behaviors, and health conditions. ResultsAlthough the associated factors varied according to age group, several factors generally related to SRBH, including the lack of exercise, stress, having one or more chronic diseases, and work-related pain. By contrast, neither sex nor sleep duration were associated with SRBH of respondents. Monthly night work, smoking, and alcohol consumption were only associated with SRBH of certain age groups. ConclusionsSeveral variables clearly related to SRBH of police officers. In this context, health-related associations, especially stress and chronic diseases, tended to differ according to age, including those that should be considered to improve health. These findings have important implications for relevant healthcare programs and interventions.

Exploring workability in an older working population: associations with cognitive functioning, sleep quality, and technostress.

This observational study investigates workability and its associations with cognitive functioning, sleep quality and technostress among an older working population, also shedding light on potential differences between two occupational categories with different work schedules. Workers aged over 50, employed in different working sectors (banking/finance, chemical and metal-mechanic industry) were administered a self- report questionnaire including Work Ability Index (WAI), cognitive tests (Stroop Color Task, Corsi Blocks, Digit Span), sleep quality questionnaires (Pittsburgh Sleep Quality Index-PSQI; Insomnia Severity Index-ISI; Ford Insomnia Response to Stress Test-FIRST) and technostress scale. Linear regression models evaluated associations among variables, interaction effects investigated potential moderators. A total of 468 aged workers categorized as white (WCWs; N = 289, 62%) or blue collars (BCWs; N = 179, 38%) were enrolled; most BCWs (N = 104; 58%) were night shift workers. WCWs reported higher workability, cognitive functioning, sleep quality and lower technostress (except for invasion and privacy subscales) than BCWs. Associations between cognitive functioning and workability were statistically significant only for BCWs [slopes equal to 0.2 (0.33), 0.8 (0.34), -0.02 (0.001) for Memory Span Corsi, Block Span Digit and Interference Speed respectively]; additionally, sleep quality significantly moderated this association (p = 0.007). Higher levels of technostress were associated with lower workability, and this relationship was stronger for BCWs. The aging of the workforce has important implications for occupational health and safety. Our findings suggest potential interventions and protective measures to promote older workers' wellbeing; blue-collar workers particularly should benefit from tailored intervention to sustain workability and prevent technostress, considering the role of healthy sleep habits promotion.

Investigation of occupational stress among radiologic technologists in Saudi Arabia using HSE stress indicator tool

BackgroundThe increasing concern about occupational stress and its effects on radiologic technologists (RTs) has been noted, as it can lead to decreased productivity and compromised healthcare quality. This study aimed to evaluate occupational stress and pinpoint the primary indicators of organizational psychosocial hazard exposures among RTs working in hospitals under the Saudi Ministry of Health. The Health and Safety Executive Indicator Tools (HSE-IT) for occupational stress were utilized for this assessment. MethodsThe study employed a cross-sectional online survey that utilized both quantitative and qualitative methods. The quantitative method was based on the HSE-IT, which focuses on six HSE Management Standards that represent potential stress hazards, namely: demands, control, support, relationships, roles, and change. The qualitative method, on the other hand, was based on narrative comments that shed light on the most common sources of occupational pressure and suggestions on how to alleviate this pressure in the radiology department. ResultsA total of 864 responses were collected from RTs in Saudi Arabia. This study revealed that urgent action was needed for demand, managers’ support, workplace relationship, and organizational roles, while assessment of control and organizational change standards were indicated as a “clear need for improvement” and “good, but in need of improvement”, respectively. This study identified particular areas of concern such as workload, shortage of staff, lack of control, feedback, social support, personal harassment, job description, and consultation of staff with changes in their work environment. The relationship between the sociodemographic data and the overall stress results revealed statistically significant differences related to gender (P = 0.020), living place, and working night shifts (P = 0.003). ConclusionThe study found that the risks of occupational stress for RTs are substantial and are not being appropriately addressed. The need for awareness to manage occupational stress is warranted, and therefore, this study presented recommendations for reducing the risks associated with occupational stress.

Investigation of the possible effects of night shift on telomere length and mtDNA copy number in nurses

In this study, we aimed to investigate the impacts of altered circadian rhythm on telomere length and mtDNA copy number (mtDNA-CN) in nurses working night shifts. In our study, 52 healthy nurses working in shifts at Ondokuz Mayıs University Hospital and 45 healthy control subjects working during the day were included. qRT-PCR technique was used for the determination of telomere length and mtDNA-CN. It was observed that the shift-work group had poor sleep quality (p = 0.004), feeling tired (p < 0.01) and stressed (p = 0.02) more than control group working during the day. Nurses working in shifts were found to have 1.18 times longer telomeres with respect to the control group working during the day (p = 0.005). When compared among shift workers, poor sleep quality and insufficient sleep duration shortened telomeres (r = 0.32; p = 0.02). There was no statistically significantdisparity regarding mtDNA-CN among the nurses working in shifts and the control group working during the day (p = 0.07). Insufficient sleep was associated with decreased mtDNA-CN when shift-working nurses were compared according to sleep quality (p = 0.006). Furthermore, mtDNA-CN of nurses with poor sleep quality was correlated with lower mtDNA-CN in comparison to nurses with good sleep quality (r = 0.284; p = 0.04). The mtDNA-CN of the nurses was positively associated with the sleep duration the night sleep before the night shift (r = 0.32; p = 0.02). Inadequate sleep duration and quality were observed to cause a reduction in mtDNA-CN of nurses. In conclusion, it has been observed that poor sleep quality and duration are related to shortened telomere length and decreased mtDNA-CN in night shift nurses.

Construct validity and test-retest reliability of a chrononutrition questionnaire for shift work and non-shift work populations

ABSTRACT The irregular eating patterns of both shift workers and evening chronotypes adversely affect cardiometabolic health. A tool that conveniently captures temporal patterns of eating alongside an indicator of circadian rhythm such as chronotype will enable researchers to explore relationships with diverse health outcome measures. We aimed to investigate the test-retest reliability and convergent validity of a Chrononutrition Questionnaire (CNQ) that captures temporal patterns of eating and chronotype in the general population (non-shift workers, university students, retirees, unemployed individuals) and shift work population. Participants attended two face-to-face/virtual sessions and completed the CNQ and food/sleep/work diaries. Outcomes included subjective chronotype, wake/sleep/mid-sleep time, sleep duration, meal/snack regularity, meal/snack/total frequency, times of first/last/largest eating occasions (EO), main meal (MM) 1/2/3, and duration of eating window (DEW). 116 participants enrolled (44.5 ± 16.5 years, BMI: 27.3 ± 5.8 kg/m2, 73% female, 52% general population); 105 completed the study. Reliability was acceptable for chronotype, sleep, and all temporal eating patterns except on night shifts. Convergent validity was good for chronotype and sleep except for certain shift/shift-free days. Generally, meal/snack regularity and frequency, and times of first/last EO showed good validity for the general population but not shift workers. Validity was good for DEW (except work-free days and afternoon shifts) and times of MM 1/2/3 (except afternoon and night shifts), while time of largest EO had poor validity. The CNQ has good test-retest reliability and acceptable convergent validity for the general and shift work population, although it will benefit from further validation, especially regarding regularity, frequency, and times of first and last eating occasions across more days amongst a larger sample size of shift workers. Use of the CNQ by researchers will expand our current understanding of chrononutrition as relationships between timing of food intake and the multitude of health outcomes are examined.

Dim light at night shifts microglia to a pro-inflammatory state after cerebral ischemia, altering stroke outcome in mice

Circadian rhythms are endogenous biological cycles that regulate physiology and behavior and are set to precisely 24-h by light exposure. Light at night (LAN) dysregulates physiology and function including immune response; a critical component that contributes to stroke pathophysiological progression of neuronal injury and may impair recovery from injury. The goal of this study is to explore the effects of dim LAN (dLAN) in a murine model of ischemic stroke to assess how nighttime lighting from hospital settings can affect stroke outcome. Further, this study sought to identify mechanisms underlying pathophysiological changes to immune response after circadian disruption. Male and female adult Swiss Webster (CFW) mice were subjected to transient or permanent focal cerebral ischemia, then were subsequently placed into either dark night conditions (LD) or one night of dLAN (5 lx). 24 h post-stroke, sensorimotor impairments and infarct sizes were quantified. A single night of dLAN following MCAO increased infarct size and sensorimotor deficits across both sexes and reduced survival in males after 24 h. Flow cytometry was performed to assess microglial phenotypes after MCAO, and revealed that dLAN altered the percentage of microglia that express pro-inflammatory markers (MHC II+ and IL-6) and microglia that express CD206 and IL-10 that likely contributed to poor ischemic outcomes. Following these results, microglia were reduced in the brain using Plexxikon 5622 (PLX 5622) a CSFR1 inhibitor, then the mice received an MCAO and were exposed to LD or dLAN conditions for 24 h. Microglial depletion by PLX5622 resulted in infarct sizes that were comparable between lighting conditions. This study provides supporting evidence that environmental lighting exacerbates ischemic injury and post-stroke mortality by a biological mechanism that exposure to dLAN causes a fundamental shift of activated microglial phenotypes from beneficial to detrimental at an early time point after stroke, resulting in irreversible neuronal death.

Evaluation of noise levels and noise sources in an Irish neonatal intensive care unit.

This study: (i) quantified the typical noise levels in an Irish neonatal intensive care unit (NICU) and compared the values to recommendations by the American Academy of Paediatrics (AAP) and the European Standards for Care for Newborn Health (EFCNI) and to occupational exposure limit value and exposure action values; and (ii) qualified the perception of noise levels and the sources of noise across the various stakeholders within a typical NICU. A noise survey was conducted in an Irish NICU. Observations identified practices and behaviours in the NICU that potentially had an impact on noise levels. Noise levels were compared to occupational exposure limits and AAP and EFCNI standards. A noise perception survey was conducted to identify noise sources and awareness of noise levels in the NICU. Results were analysed using SPSS Statistics to determine statistical significance. Noise levels recorded were consistent with previous similar studies and in all cases, the average noise levels recorded exceeded the 45 dBA as recommended by the AAP and EFCNI. There was a statistically significant difference (P < 0.01) between noise levels recorded on the day shift compared to the night shift. The perception of noise levels reported by nurses versus parents was found to be statistically significant (P = 0.001). 38.3% of all respondents reported having received no information or training with regard to noise in the NICU. There was a statistically significant difference in the perception of who is most likely to be affected by noise in the NICU, with nurses reporting those most likely to be affected by noise were patients, and parents reporting those most likely to be affected were staff (P = 0.003). This study supports the hypothesis that noise levels within the NICU are of concern and require regular assessment and monitoring. Training and awareness programmes are an important component to ensuring all persons in the NICU recognise their potential impact on noise levels in the NICU and in reducing the risk for patients and staff.

Nurses' level of sleepiness during night shift.

This study aimed to determine the peak hours of sleepiness and the factors affecting the sleepiness levels of nurses. Sleepiness is commonly seen in individuals working night shifts. However, in case of nurses, this sleepiness can be a major threat to patient and staff safety. This was a prospective cross-sectional study. Data were collected between July and September 2023, and a stratified sampling method was used according to the departments in which the nurses worked. Data were collected using the Personal Information Form and Visual Analog Scale. Nurses reported their sleepiness levels at the beginning of each hour between midnight and 8:00 am. The study adhered to the STROBE checklist for reporting. The mean sleepiness levels of emergency department nurses, intensive care nurses, internal or surgical clinic nurses, and all nurses were 59.75±15.50, 43.53±20.49, 44.67±18.88, and 49.15±19.67, respectively. The highest sleepiness level of the nurses was at 05:00 am. A significant correlation was found between the variables of age, gender, marital status, sleep quality, number of patients cared, working style and satisfaction with working in the department, and sleepiness level (P<0.05). Nurses working night shifts experience sleepiness (highest at 5:00 am). In addition, the sleepiness levels of nurses are affected by some personal and clinical factors. Based on the results, there is a need for necessary policies regarding nurses' working hours and working conditions. To protect patient and employee safety, necessary strategies should be devised regarding the hours when nurses experience the highest sleepiness and the factors affecting sleepiness levels.

Effects of Time of Arrival on Trauma Patient Outcomes.

Arriving during "off hours" to the hospital can put patients at greater risk of complications or mortality given lesser staff. Our goal was to investigate this in trauma patients with an Injury Severity Score (ISS) of >15. We hypothesized that the patients admitted late at night and/or during the weekend, would have worse outcomes, delays to the operating room (OR), and longer lengths of stay (LOS) compared to those who arrive on a weekday during the day. We performed a retrospective study from 8/1/2019 to 8/1/2022 of all trauma patients with an ISS >15 at our Level 1 Trauma Center. Patients <18years, dead on arrival, or transferred out were excluded. Univariate and multivariable analysis were performed comparing weekday vs weekend arrivals, day vs night shift arrivals, and with patients grouped as weekday day, weekday night, weekend day, and weekend night. The primary outcome was mortality. 953 patients met inclusion criteria. The patients that arrived on the weekend and at night were significantly younger than their counterparts. A significantly greater percentage of Black patients arrived during night shift. Mortality, hospital LOS, and ICU LOS did not differ based on day or time of arrival. Contrary to our hypothesis, our study did not find a significant difference in outcomes when evaluating based on a patient's time of arrival. This gives credence that our mature trauma center can provide the same level of care despite the time of a severely injured patient's time of arrival.