Purpose
The purpose of the present study was to compare neonatal morbidity between night and the rest of day and investigate potential differences of birth outcomes during the internal night.
Methods
...We conducted a retrospective study based on maternal and neonatal data of period 2004–2007, enrolling exclusively spontaneous deliveries of term (≥37 weeks), singleton pregnancies with cephalic presentation that were in labor. Time of day was divided into the night-shift period, from 11.00 p.m. to 7.00 a.m. (period 1) and the rest-of-day period, from 7.00 a.m. to 11.00 p.m. (period 2). The night-shift period was further sub-divided into period 1a (11.00 p.m.–3.00 a.m.) and period 1b (3.00 a.m.–7.00 a.m.). Epidemiological and obstetric characteristics as well as neonatal outcomes were initially compared between periods 1 and 2 and thereafter between sub-periods 1a and 1b.
Results
There were 3,055 cases with complete data meeting our inclusion criteria, of which 871 (28.5%) were delivered during period 1 and 2,184 (71.5%) during period 2. Furthermore, 51.3% of night-born infants were delivered during period 1a and the remaining 48.7% during period 1b. All examined parameters were not significantly different between periods 1 and 2. Analyzing night internally, the rate of emergent CS was significantly higher for period 1a (13.2%), compared with period 1b (4%). Furthermore, incidence of NICU admission was significantly higher for the first half of the night-shift period (2.7%) compared to the relative of the second half (0.5%).
Conclusions
Neonatal morbidity was comparable between night-shift and rest-of-day periods, but the rates of emergent CS and NICU admission were significantly increased in the first half of the night-shift period (11.00 p.m.–3.00 a.m.).
Background Care workers in nursing homes are at high risk of developing musculoskeletal disorders (MSDs). Many care workers work in shifts, which may compromise both the quality of care they give and ...their working life. Taking a nap during night shifts has been proposed to ameliorate shift work-related problems, but its relationship with MSDs is not clear. Aims To explore how MSD pain differs according to frequency of night-shift naps. Methods A questionnaire study was conducted on 111 care workers at three nursing homes. Of 98 respondents, data from 66 shift workers (54 women) were analysed. Data on self-rated pain in multiple sites (neck, shoulder, arm, leg and low back), naps during night shifts and relevant variables were collected. Participants were categorized into three groups on the basis of frequency of night-shift naps taken during the previous month: non-nappers, <50% nappers and ≥50% nappers. Results Pain at all sites, with the exception of low back pain, differed significantly among the three groups. Pain scores were lowest at the arm and leg for the ≥50% nappers. Neck and shoulder pain was lower for the ≥50% nappers and the non-nappers compared to the <50% nappers. Conclusions Reduced pain in the arm and leg was associated with taking a nap at least once every two night shifts among the nursing home care workers. No association was found between low back pain and night-shift naps in this sample.
Objective: This paper reports findings as a replicated qualitative study (McKenna and French 2010) that investigated experiences and value of night duty; with the variance that the students' were ...undergraduate enrolled nurse students as opposed to undergraduate registered nurse student nurses'. Design: Enrolled nurse students' from one private Registered Training Organisation (RTO) were invited to participate in a two week night shift placement as their preparation for practice in an acute care facility. A qualitative approach involving focus groups with students and ward nurses, prior to, and following that clinical placements was used. In addition, individual interviews were conducted with other key stakeholders from the RTO and Health Care Service. Setting: The study was conducted in one regional public hospital in Victoria, Australia. A clinical teacher, who was also the clinical co ordinator, was employed by the RTO to provide student supervision during the placement. Subjects: Thirty eight enrolled nursing students, six permanent night staff from the hospital and four key personnel representing the education provider and hospital perspectives consented to participate. Main Outcome measures: All transcripts were thematically analysed together with the context of placement value and experiences. Results: Four themes emerged from pre placement interviews: coping with travelling, nature of night shift, preparing to be a graduate, and change and adjustment. Post placement interviews revealed four themes of; time to learn and time to teach, adjusting, continuity and preparing to be a graduate and night duty as a recommended clinical placement for the enrolled nurse student. Conclusions: This replication study has added evidentiary support that night duty is a highly appropriate model of professional clinical practice for the enrolled nurse. Within a collaborative model it has enabled the student enrolled nurse to consolidate theory to practice, exposure to reality of nursing as a twenty four hour continuity of care and met professional and education competency standards. It also demonstrated that with visionary partnerships new models of clinical experience for the enrolled nurse can be developed that meet today's challenges to provide flexible models of clinical experience.
Summary Objective We assessed the effects of Saam (traditional Korean) acupuncture on the autonomic nervous system in night-shift nurses using power-spectral heart-rate variability (HRV) analysis. ...Methods This study had a 2 × 4 cross-over design with a series of six ( n = 1) controlled trials. Six night-shift nurses were randomly divided into two groups, and each nurse received four acupuncture treatments on the third day of night-shift work. One group started with Saam acupuncture (gallbladder jeonggyeok), while the other started with sham acupuncture. Saam acupuncture and sham acupuncture were applied in turn. HRV was measured before and after treatment. For statistical analysis, the results of the two groups were combined, and a Bayesian model was used to compare the changes in HRV values before and after treatment, between Saam and sham acupuncture. Results As the ratio of low- to high-frequency power (LF/HF) for HRV increased on the third day of night-shift work in the pilot study, HRV measurements were made on the third day. Compared with sham acupuncture, Saam acupuncture reduced sympathetic activity; the overall median treatment effect estimate in LF normalised units decreased by −17.4 (confidence interval (CI): −26.67, −8.725) and that for LF/HF decreased by −1.691 (CI: −3.222, −0.3789). The overall median treatment effect estimate in HF normalised units increased by 17.41 (CI: 6.393, 27.13) with Saam acupuncture, suggesting an increase in parasympathetic activity. Conclusion Saam acupuncture may attenuate the imbalance between sympathetic and parasympathetic activities induced by night-shift work in nurses.
The use of a short (< 1 h) nap in improving alertness during the early morning hours in the first night shift was examined under laboratory conditions. The study contained four experimental, ...non‐consecutive night shifts with a nap of either 50 or 30 min at 01.00 or 04.00 hours. An experimental night shift without a nap served as a control condition. Each experimental shift was followed by daytime sleep. Fourteen experienced male shift workers went through all of the experimental conditions. The results showed that the naps improved the ability to respond to visual signals during the second half of the night shift. Physiological sleepiness was alleviated by the early naps, as measured 50 min after awakening, but not at the end of the shift. Subjective sleepiness was somewhat decreased by the naps. The naps produced sleep inertia which lasted for about 10–15 min. Daytime sleep was somewhat impaired by the 50 min naps. The study shows that a nap shorter than 1 h is able to improve alertness to a certain extent during the first night shift.
Objectives: “Regular visiting/on-demand response type long-term care” has recently been established. This will lead to a decrease in the burden on the family, but an increase in the burden of the ...care personnel who provide this kind of long-term care. The objectives of this study were to clarify the fatigue symptoms of long-term care workers in facilities that provide this kind of long-term care, and examine the related factors in the workplace. Methods: An anonymous questionnaire survey was conducted with 96 workers engaged in long-term care in facilities. The questionnaire was composed of cumulative fatigue symptoms index, work situation, supports in the workplace, and the attributes. The subjects were divided into two groups: those who had night shift between PM 6 to AM 8 with or without day shift (night shift group), and those who had only day shift (day shift group). The relationships between the fatigue symptom levels and work situation etc. were compared between the two groups. Results: The night shift group consisted of 47 workers, whose mean age was 42.3 years and whose mean working experience was 6.0 years. The median number of persons they had visited in the previous month was 9. The day shift group consisted of 49 workers, whose mean age was 44.6 years and whose mean working experience was 5.9 years. The median number of persons they visited in the previous month was 9.5. Age and sex distributions showed no difference between the two groups. There was no difference in the work situations and the supports in the workplace, except for working time and the details of care the subjects were providing. The fatigue symptom levels were high in both groups, but in the night shift group the level of physical disorders was higher than in the day shift group. Satisfaction with work, education and training for mental health and consideration for traffic safety when making home visits were negatively related to fatigue symptom levels in both groups. Learning care during the previous year, and the ease of receiving paid holiday were not related to the fatigue symptom levels in the night shift group. This was different in the day shift group. Conclusions: Measures of fatigue symptoms should be performed for both groups. It is desirable that supports, additional to that given in the workplace to the day shift group, be given to the night shift group, and its efficacy be researched.
Prolactin - a hormone secreted in a circadian rhythm acts as a regulator of growth and development of the mammary glands. It has been observed that working at night increases breast cancer risk in ...women. Night shift work, probably carcinogenic to humans (Group 2A IARC), can disrupt a circadian rhythm, and thus potentially alter the rhythm of prolactin secretion. The aim of our work was to review epidemiological evidence on the association between prolactin and the risk of breast cancer and the influence of work at night on prolactin secretion. Search was done in the Medline database by keywords (shift work, work at night, risk of breast cancer and prolactin). 'The increased proliferation of breast cells activated by prolactin can promote the development of cancer. The results of the largest epidemiological prospective studies suggest the association between prolactin levels and the risk of breast cancer in women. So far, only seven studies have investigated the association between work at night and prolactin secretion. In three studies lower concentrations of prolactin have been observed in night shift workers. No relationship between the night shift work duration and prolactin level in women have been reported. Night shift work can modify the profile of prolactin secretion in night workers, probably decreasing the secretion of this hormone at night. It is therefore unlikely that prolactin plays an important role in the development of breast cancer in women working at night. This conclusion is based on the results of a few epidemiological studies.
Objective: To examine the factors related to fatigue accumulation by irregular shift workers after the late-night shift. Method: We studied employees of a company in the transportation industry in ...Fukushima prefecture. The company transports passengers, and many employees, including the crew, engage in irregular shift work. We performed the investigation by using a self-administered questionnaire which was sent to 89 employees in October, 2011. Of the 89 who were given the survey, 84 replied, and 52 of those employees had worked the late-night shift (straddling midnight) at least once during September. In answer to the question “How long does it take you to recover after working the late-night-shift?” choices were “I don’t feel tired “, “I recover the next day”, “I recover in two or three days”, and “It takes more than three days”. We classified the choices into two groups of: 1) “I don’t feel tired” and “I recover the next day”, and 2) “I recover in two or three days” and “It takes more than three days”. Other questions were asked about age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shift, risk of lifestyle-related diseases (hypertension, dyslipidemia, and diabetes), awareness of life stress accumulation, and exercise habits. Results: Thirty-two employees answered that they recovered from the late-night shift by the next day, whereas 20 employees answered that it took more than 2 days to recover after the late-night-shift. The group who answered that recovery time after the late-night shift took more than 2 days significantly (p=0.035) felt that their stress management was insufficient. Age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shifts, risk of lifestyle-related diseases, and exercise habits showed no significant association with fatigue accumulation. The group who answered that their stress management was insufficient significantly chose liquor (p=0.045) and cigarettes (p=0.030) for stress reduction. Discussion: In this study, a relationship was recognized between degree of awareness of daily stress relief and fatigue recovery period. In addition, various means of stress relief had different effects, suggesting the need for individualized mental health care.
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