Narratives,memorable cases and metaphors of night nursing: findings from an interpretative phenomenological study

The aim of the study was to explore the experiences of night nurses. An interpretative phenomenological study was undertaken, and 35 nurses working in Italian medical, surgical and intensive care units were purposely recruited. Data were gathered in 2010 by semi‐structured interviews, collecting nurses' narratives, memorable cases and metaphors, aimed at summarising the essence of work as a nurse during the night. The experience of night nursing is based on four interconnected themes: (i) working in a state of alert, (ii) growing by expanding autonomy and responsibility, (iii) assuring sensitive surveillance and (iv) experiencing deep intimacy. Memorable episodes were polarised along (i) expected/unexpected events; (ii) positive/negative epilogues; and (iii) life/death issues. Many of the emergent metaphors described working during the night as being in the middle of a space where an apparent calm scene takes place, but unpredictable factors may suddenly change the order of events and the outcomes, creating chaos. Working during the night alerts nurses, who increase autonomy, expanding their role and assuming more responsibility with respect to that assumed during daily shifts. The nurses' clinical reasoning is based on data they carefully listen to, and on the meaning that nurses give time by time to different noises and silence. While in the past a sense of companionships was reported, a loneliness or a ‘neutral’ experience concerning the relationships with colleagues seems to prevail during night nursing. Working night shifts is a complex task, and specific training must be assured to students/novices.     

Night shift work,chronotype and prostate cancer risk in the MCC‐Spain case‐control study

Night shift work has been classified as a probable human carcinogen based on experimental studies and limited human evidence on breast cancer. Evidence on other common cancers, such as prostate cancer, is scarce. Chronotype is an individual characteristic that may relate to night work adaptation. We evaluated night shift work with relation to prostate cancer, taking into account chronotype and disease severity in a population based case‐control study in Spain. We included 1,095 prostate cancer cases and 1,388 randomly selected population controls. We collected detailed information on shift schedules (permanent vs. rotating, time schedules, duration, frequency), using lifetime occupational history. Sociodemographic and lifestyle factors were assessed by face‐to‐face interviews and chronotype through a validated questionnaire. We used unconditional logistic regression analysis adjusting for potential confounders. Subjects who had worked at least for one year in night shift work had a slightly higher prostate cancer risk [Odds Ratio (OR) 1.14; 95%CI 0.94, 1.37] compared with never night workers; this risk increased with longer duration of exposure (≥28 years: OR 1.37; 95%CI 1.05, 1.81; p‐trend = 0.047). Risks were more pronounced for high risk tumors [D'Amico classification, Relative Risk Ratio (RRR) 1.40; 95%CI 1.05, 1.86], particularly among subjects with longer duration of exposure (≥28 years: RRR 1.63; 95%CI 1.08, 2.45; p‐trend = 0.027). Overall risk was higher among subjects with an evening chronotype, but also increased in morning chronotypes after long‐term night work. In this large population based study, we found an association between night shift work and prostate cancer particularly for tumors with worse prognosis.     

粪便无害化处理控制土壤中土源性线虫卵污染的效果分析

目的探讨粪便无害化处理控制土壤中土源性线虫卵污染的效果。方法选择进贤县三里乡4个自然村，以3个改厕村作处理村，1个不改厕村作对照，观察粪便无害化处理前后土壤中土源性线虫卵污染及人群感染情况的变化。结果实施粪便无害化处理1年后，处理村土壤中土源性线虫卵污染率下降36．62％（P〈0．01），村民庭院、客厅、厕所、菜园4处场所蛔虫卵污染率分别下降66．63％（P〈0．01）、49．98％（P〈0．05）、33．33％（P〉0．05）和53．50％（P〈0．01），鞭虫卵污染率下降82．98％（P〈0．01）、75．00％（P〈0．01）、72．73％（P〈0．01）和67．24％（P〈0．01），土源性线虫卵污染度（EPG）分别下降94．29％、92．19％、91．20％和90．71％，死虫卵率均达68．66％以上。人群蛔虫感染率下降40．81％（P〈0．01），鞭虫感染率下降33．75％（P〈0．01），土源性线虫总感染率下降36．33％（P〈0．01）。对照村土壤中土源性线虫卵污染率和污染度的变化无显著性（P〉0．05），人群土源性线虫感染率亦无显著性变化（P〉0．05）。结论粪便无害化处理可有效降低土壤中土源性线虫卵的污染率和污染度，并可取得显著降低人群感染的效果。     

The night float system of resident on call

In 1989, the internal medicine residency training program at St. John’s Episcopal Hospital changed from a standard one-in-four on-call system to a night float system of resident on call. Using a confidential questionnaire that assessed the opinions of medical nurses, the nurses were asked which system they preferred, and how the change to a night float system of resident on call affected medical resident performance. A significant majority of the nurses preferred night float over a standard system of resident on call. Most nurses responded that because night float allows residents to get more rest, residents make fewer mistakes and are easier to work with. Residents on night float were not considered to be more knowledgeable. The responders indicated that night float did not create confusion about which resident to call for a patient problem. Presented at the 16th annual spring meeting of the Association of Program Directors in Internal Medicine, April 18– 20, 1994, Miami, Florida.     

动态心电图监测昼夜心律失常与自主神经功能的关系

2 0 0 0例病人 HOL TER监测发现白天出现的无症状短阵房速与夜间出现的 °( 型 )房室传导阻滞均具有规律性 ,发生机理与自主神经的功能有关。当白天交感神经占优势时易出现短阵房速 ,中午达峰值 ,午夜为低谷。活动状态发生的短阵房速是睡眠状态的二倍 ,当夜间迷走神经占优势时 ,可引起 °( 型 )房室传导阻滞 ,且睡眠时发生醒时消失。多见于植物神经功能紊乱的病人 ,这种房室传导阻滞系功能性改变     

Effects of nicotine on the exploratory locomotion patterns of female Roman high- and low-avoidance rats

Utilizing an automated, Dashiell-type hexagonal maze, it was demonstrated that RHA rats: 1) were more active, 2) reversed direction more often, 3) entered radial (blind) alleys less often, and 4) displayed shorter latencies than did RLA rats. Direction reversals (U-turns) tended to increase from day to day with the RHA rats, whereas the opposite was true for the RLA rats. Nicotine injections (0.2 mg/kg) increased activity and the number of U-turns, shortened the latencies and lessened the likelihood of entering radial alleys for both strains. The RHA rats were more sensitive to nicotine than were the RLA rats in all of these measurements, which varied, depending upon alley length and structural complexity, among the maze configurations.     

Risk of Breast Cancer After Night- and Shift Work: Current Evidence and Ongoing Studies in Denmark

Breast cancer is the most frequent cancer among women, and the number is increasing worldwide. This tumour is strongly associated with Western lifestyle, but the specific risk factors behind this observation are not well known. Exposure to light-at-night, including disturbance of the circadian rhythm, possibly mediated via the melatonin synthesis and clock genes, has been suggested as a contributing cause of breast cancer. Since shift- and night-time work is prevalent and increasing in modern societies, this exposure may be of public health concern, and contribute to the continuing elevation in breast cancer risk. Until now only few epidemiological studies have evaluated breast cancer risk after shift- and night- work. Although these studies are all suffering from methodological problems, especially concerning assessment of light exposure, results have consistently shown an increase in risk associated with night- and shift work. Good opportunities for epidemiological cancer research exist in Denmark, and several studies on different aspects of breast cancer, work schedules, light exposure and melatonin levels are ongoing in order to further examine different aspects of this issue.