SLEEP OF NIGHT WORKERS: EEG RECORDINGS

Ten hospital corpsmen working the 11 p.m. to 7 a.m. shift were selected for a study of night workers. Each completed a questionnaire describing his experiences with night work, and each slept in the laboratory for several days, while continuous EEG recordings were made. Although the quantity and distribution of the EEG sleep stages was not greatly different from that found in night sleep periods, there were some irregularities in the progression of EEG patterns, particularly interruptions in Stage REM sleep. It appeared that Ss slept better, worked better, and felt better after several weeks of assignment to night shift work.     

开环状态下调节的暗焦点研究进展△

正常情况下,人眼调节系统可利用闭环负反馈系统进行精确的调节反应,而在缺乏足够的视觉刺激时,反馈回路被打破,在开环状态下的调节系统趋向于返回其 “静息”位置(暗焦点),导致人眼的屈光状态趋于近视。目前有研究认为近距离用眼后暗焦点会发生变化,可能与长时间近距离工作引发的近视相关。本文结合相关文献报道,对暗焦点的测量技术、自身特点及其在近视防控中的应用前景等方面进行综述,以期为临床工作及相关研究提供参考。     

Disorders of arousal and sleep-related bruxism among Japanese adolescents: a nationwide representative survey

ObjectiveThe main objective of our study was to clarify the prevalence of disorders of arousal (confusional arousals, sleepwalking, sleep terrors) and sleep-related bruxism (teeth grinding) and their associated factors among Japanese adolescents.MethodsOur study was designed as a cross-sectional sampling survey. The targets were students attending junior and senior high schools throughout Japan. The questionnaire asked for personal data and information on lifestyle, depressive state, and sleep status including the frequency of experiencing disorders of arousal and sleep-related bruxism.ResultsA total of 99,416 adolescents responded. The overall response rate was 63.7%, and 98,411 questionnaires were subjected to analysis. The prevalence of disorders of arousal was 7.1% (95% confidence interval [CI], 6.9–7.3%) among boys and 7.7% (95% CI, 7.5–7.9%) among girls. The prevalence of sleep-related bruxism was 2.3% (95% CI, 2.2–2.4%) among boys and 3.0% (95% CI, 2.8–3.2%) among girls. The factors associated with disorders of arousal were the grade in school, smoking habit, alcohol consumption, naptime (min), breakfast habit, participation in club activities, sleep duration, difficulty initiating sleep, nocturnal awakening, early morning awakening, subjective sleep assessment, snoring, decrease in positive feelings, and depression (all p < .001). The factors associated with sleep-related bruxism were gender, smoking habit, nocturnal awakening, snoring, early morning awakening, decrease in positive feelings, and depressive feelings (all p < .001).ConclusionsIf disorders of arousal or sleep-related bruxism are observed in an adolescent, his or her smoking habit, alcohol consumption, sleep status, and depressive state should be considered.     

The Hot Flush Beliefs and Behaviour Scale for Men (HFBBS-Men) undergoing treatment for prostate cancer

Objective

Hot flushes and night sweats (HFNS) are commonly experienced by men receiving treatment for prostate cancer. Cognitive behavioural therapy (CBT) has been found to be an effective treatment for HFNS in women, but cognitions and behavioural reactions to HFNS in men are under-researched. This study describes the development of the HFNS beliefs and behaviour scale for men.

Methods

HFNS beliefs and behaviour items were generated from a qualitative study, from pilot interviews with men with prostate cancer and HFNS, and from scales used for women. 118 men with prostate cancer, aged above 18, English-speaking, who had minimum of seven HFNS weekly for at least 1 month, completed the initial measure, and measures of HFNS frequency, problem rating, anxiety and depression (HADS). Principal components analyses with orthogonal rotation determined the most coherent solution.

Results

Exploratory factor analysis culminated in a 17-item HFNS beliefs and behaviour scale for men (HFBBS-Men) with three subscales: (1) HFNS social context and sleep, (2) Calm/Acceptance, (3) Humour/Openness. The subscales had reasonable internal consistency (Cronbach alpha 0.56–0.83). Validity was supported, by correlations between subscale 1, HFNS frequency, problem-rating and mood; men with locally advanced cancer more likely to adopt Calm/Acceptance and those with metastatic cancer Humour/Openness.

Conclusions

Preliminary analysis of the HFBBS-Men suggests that it is a psychometrically sound instrument, grounded in men's experiences. As a measure of cognitive and behavioural reactions to HF/NS, the HFBBS-Men should increase understanding of the mediators of outcomes of psychological interventions, such as CBT.     

Zinc therapy for night blindness in cystic fibrosis

This is the first report of a supplemented CF patient presenting with clinical vitamin A deficiency to be successfully treated with zinc therapy alone. Therefore in addition to retinol supplementation, normalizing serum zinc levels may be important in maintaining the vitamin A status of CF patients. The interactions and synergistic effects between the two micronutrients are discussed.     

Association of musculoskeletal disorders and workload with work schedule and job satisfaction among emergency nurses

BackgroundThe emergency department is a highly demanding work environment, considered by high workload and stress. The impact of work-related factors on musculoskeletal disorders (MSDs) in emergency nurses (ENs) are not yet well understood. We investigated the association of MSDs and workload with work schedule (permanent day and night work) and job satisfaction in ENs.MethodData were collected through a questionnaire including individual and work-related factors, workload (National Aeronautics and Space Administration-Task Load Index [NASA-TLX]) and MSDs (Standardized Nordic Questionnaire) from 380 ENs in five hospitals.ResultsThe findings revealed that work schedule and job satisfaction levels were significantly associated with the MSDs in different body regions. Work schedule was significantly related to physical demand, performance, frustration, and overall workload, whereas it was not to the mental and temporal demands and effort. Job satisfaction level was negatively associated with mental demand and frustration. A high prevalence of musculoskeletal problems, particularly in knees, upper back, lower back, neck and shoulders were found.ConclusionMSDs are highly prevalent among ENs involved in night work and with low job satisfaction levels. The results are discussed in terms of their implications for emergency hospital nurses. The findings can help to better understand the working conditions and emphasize the need for ergonomic interventions in order to reduce MSDs and workload. Also, the study findings highlight the importance of mental aspects of workload in this occupational group.     

Night shift work experiences among Iranian nurses: a qualitative study

Aim:  To describe the perceptions held by Iranian registered nurses (IRNs) concerning their night shift work experiences.
Background:  Due to the nature of nursing work and the need for 24-h coverage every day, the majority of nurses work night shifts in their professional practice. Evidence from several studies indicates that night working is a challenge for most nurses. This situation can cause many forms of physical and emotional stress.
Methods:  A qualitative design was used with purposeful sampling. Eighteen IRNs from four different general educational hospitals in Iran took part in the study. Data were collected via semi-structured interviews and analysed according to qualitative content analysis.
Findings:  Three main themes were identified from the data: (a) socio-cultural impacts of night work, (b) health-related impacts of night work, and (c) night work as an opportunity for gaining more clinical experiences and learning more.
Conclusion:  The impact of shift work on nurses' daily professional behaviour and adverse health outcomes related to shift work should be well understood and considered when organizing healthcare systems. We need to identify ways to support nurses who work nights and also give attention to the caregiver's needs.     

轮值夜班护士焦虑状况调查与对策

目的探讨轮值夜班护士的焦虑状况，分析引起焦虑的原因，并制定相应的应对措施，以减少护士的负性情绪，促进护士的身心健康。方法应用焦虑自评量表（SAS）对广东某三甲医院有轮值夜班经历的护士进行随机调查分析。结果轮值夜班护士的焦虑水平明显高于非夜班护士（P〈0．01）；轮值夜班护理人员的焦虑水平与工作年限呈正相关关系，工作1年以下的轮值夜班护士的焦虑水平明显增高；不同科室护理人员的焦虑水平排列为：ICU〉儿科〉急诊科〉内科〉外科〉妇产科〉手术室，其中内科、外科、妇产科之间无显著性差异（P〉0．05）；夜班频率越高焦虑评分越高（P〈0．01），单人轮值夜班比双人轮值夜班的焦虑水平高（P〉0．01）。结论轮值夜班护士的焦虑状况应引起医院管理者的高度注意，制定行之有效的措施，降低轮值夜班护士负性的心理感受，提高其心理适应水平。     

护士夜班排班方式对增加直接护理时数及护理质量的影响

目的探索增加直接护理时数及提高护理质量的护士夜班排班方式。方法根据病房工作量的分类方法,对临床内外科护士三班倒换制、全夜制夜班的间接、直接护理时数统计,比较不同夜班排班方式对直接护理时数及护理质量的影响。结果全夜制夜班对比倒换制夜班护士每24h可增加直接护理时数66min,折算为1.06h,P<0.001;全夜制夜班夜间护理病人综合满意度为95.67%;病区夜间护理质量达标率100%。结论全夜制夜班可减少护士频繁交接班而增加直接护理时数,有利于提高护理效率及护理质量。     

Effect of caffeine on physiological sleep tendency and ability to sustain wakefulness at night

Marked sleepiness occurs during typical night shift work hours and this reduced alertness is associated with marked performance deficits. The effect of caffeine (versus placebo) upon sleepiness at night was studied using objective measures of physiological sleep tendency and ability to sustain wakefulness. Both measures show caffeine to reduce sleepiness at a single dose roughly the equivalent of two to four cups of coffee. Despite impressive objective differences in alertness with caffeine, subjects did not consistently differentiate between drug conditions on subjective alertness assessments. The use of CNS stimulants to promote alertness during night shift hours should be considered, particularly for occupations for which alertness is critical.