ABSTRACTDecline in cognitive functioning in the workplace is a major concern for health care systems. Understanding factors associated with nighttime functioning is imperative for instituting organizational risk management policies and developing personalized countermeasures. The present study aims to identify individual factors associated with cognitive functioning during the night shift of hospital nurses working on irregular rotating-shift schedules. Ninety-two female nurses were recruited from 17 wards in two general hospitals, using convenience sampling by clusters. Inclusion criteria were working at least 28 h a week (75% of full time) and one night shift per week. Exclusion criteria were pregnancy, diagnosed sleep disorders or medical conditions that may affect sleep and/or function. Cognitive performance was measured during the middle (03:00 h) and at the end (07:00 h) of the night shift using the Digit Symbol Substitution Task (DSST) and the Letter Cancellation Task (LCT) over two night shifts. Subjective sleepiness was assessed by the Karolinska Sleepiness Scale (KSS) at the same time points. All participants completed a sociodemographic questionnaire, the Munich ChronoType Questionnaire for Shift-Workers (MCTQShift) and the Pittsburgh Sleep Quality Index (PSQI). Sleep duration 24 h before the night shift and time awake since last sleep opportunity were monitored by actigraphy. Univariate repeated measures ANOVA found main effects for clock time (p<0.001), age (p<0.05), time awake (p<0.05) and sleepiness (p<0.01) for DSST correct responses; main effects for clock time (p<0.001) and sleepiness (p<0.001) for LCT capacity; and main effects for clock time (p<0.001) and age (p<0.01) for LCT omission errors. All factors remained significant in a mixed-model analysis for DSST. Cognitive performance among hospital nurses is low during the middle of the night shift and increases at the end of the shift; decreased functioning is associated with increased subjective sleepiness, older age and prolonged time awake. Identifying factors contributing to performance during the night shift may provide a basis for the development of risk management policies and preventative interventions. 相似文献
In 2008, one of the worst public health crises occurred in the state of Nevada,
where authorities discovered up to 63,000 patients were potentially exposed to
hepatitis C infection, largely due to substandard infection control and other
negligent practices at two endoscopy clinics in Las Vegas. In the subsequent
grand jury proceedings that followed, it was discovered that several clinic
employees not only participated in these egregious practices, but doctors,
nurses, and other health care professionals witnessed yet failed to report these
incidents, largely due to fears of whistleblower retaliation. In response, the
Nevada state legislature attempted to strengthen whistleblower protection laws,
but it remains unclear if such laws actually protect employees who attempt to
report patient safety concerns. As the push for quality patient outcomes becomes
more prominent with health care reform, whistleblower concerns must be
effectively addressed to ensure that health care professionals can report
patient safety concerns without fear of retaliation. 相似文献
In the nurse plant syndrome, or nurse association, seedlings (beneficiaries) are associated with adult shrubs/trees (benefactors).
This phenomenon has been documented in several regions of the planet. Abiotic stress amelioration (one mechanism of facilitation)
is one of the causes of this association. Most of the studies addressing the nurse syndrome have been conducted on spatial
scales of a few hectares and have focused on only one or a few species. Moreover, there is an almost complete lack of studies
addressing the incidence and characteristics of the nurse phenomenon in the arid Andes of South America. We undertook a first
approximation to the study of facilitation in these ecosystems. The study was conducted at local and regional scales and involved
the assessment of the spatial distribution of juveniles (seedlings and saplings) of 51 populations of 16 shrub and 12 cactus
species in relation to shrub cover at 20 localities of the Prepuna (subtropical Andes of Bolivia and Argentina, 20–26°S).
In terms of spatial distribution, the juveniles of most of the populations of shrubs studied were distributed both under the
shrubs and in open spaces, thereby showing an apparent indifference to microhabitat. Globose and opuntioid cacti were preferentially
distributed below the canopies of shrubs and were usually more associated with the dominant shrub species, which stood out
as better potential nurses. The pattern was consistent throughout the region, including the more mesic and arid localities.
The fact that Prepuna woody species are capable of establishing in open spaces would confer this region a greater resilience.
Our findings further suggest that community dynamics in arid and semi-arid environments are more variable than previously
thought. 相似文献
Investigating the methylation status of the circadian genes may contribute to a better understanding of the shift work-related circadian disruption in individuals exposed to artificial light at night. In the present study, we determined the methylation status of the circadian genes associated with a shift work pattern among nurses and midwives participating in a cross-sectional study in Lodz, Poland.
Quantitative methylation polymerase chain reaction assays were used to assess promoter CpG methylation in PER1, PER2, PER3, CRY1, CRY2, BMAL1, CLOCK, and NPAS2 in genomic DNA from whole blood of 347 women having a rotating-shift work schedule and 363 women working days only. The percentage of methylated reference (PMR) was assessed using fluorescent probes for PER1, PER2, PER3, CRY1, and NPAS2, and the percentage of gene methylation, as the methylation index (MI), using two sets of primers for BMAL1, CLOCK, and CRY2.
We tested the possible association between current and lifetime rotating night-shift work characteristics and circadian gene methylation by using proportional odds regression model with blood DNA methylation, categorized into tertiles, and adjusted for age, current smoking status, folate intake and blood collection time. The findings indicated that CpG methylation in PER2 promoter was significantly decreased (P < 0.004) among nurses and midwives currently working rotating shifts, as compared with day-working nurses and midwives. The lower percentage of PER2 methylation was associated with a higher monthly frequency of current night duties (2–7 night shifts, and eight or more night shifts per month) (P = 0.012) and was associated at borderline significance (P = 0.092) with the lifetime duration of shift work (>10 ≤ 20 years and >20 ≤ 43 years of rotating-shift work) among nurses and midwives (N = 710). Moreover, women with a longer lifetime duration of shift work presented a lower status of PER1 methylation (P = 0.040) than did the women with up to 10 years of rotating-shift work. Long lifetime duration of shift work (> 10 years) among current rotating night-shift workers (N = 347) was associated with BMAL1 hypomethylation (P = 0.013).
Among eight of the investigated circadian genes, only PER1, PER2, and BMAL1 showed differential methylation attributable to the rotating-shift work of nurses and midwives. The findings on blood-based DNA methylation in the circadian genes may provide a better insight into the mechanistic principles underlying the possible health effects of night-shift work but these should be verified in further studies recruiting larger populations of shift workers. 相似文献
Bird assemblages are sensitive to changes in landscape composition and the environment, such as those that result from drought. In this study, the relationship between landscape composition and avian functional diversity in traditional agricultural ecosystems in the Civilian Control Zone (CCZ) of Korea was examined. In addition, the resilience of biodiversity to changes in landscape elements resulting from drought conditions was investigated. The traditional agricultural landscape (TAL) of the sites studied was divided into three types: TAL 1 had a high proportion of rice paddies, TAL 2 included large forest areas, and TAL 3 represented areas with drylands. Of these, TAL 1 showed the highest species richness and functional richness, but these measures were most vulnerable to drought. Meanwhile, TAL 2 showed that the bird communities were more tolerant under drought event. This study shows that to conserve and enhance the diversity of birds in traditional agricultural landscapes of Northeast Asia, active management of forest areas is needed to protect bird populations. In addition, commercial pressures to develop this area will require urgent biodiversity conservation plans to protect the unique biodiversity of the Korean CCZ. This study thus provides landscape management guidance for conservation planning. 相似文献
Poor sleep quality or sleep restriction is associated with sleepiness and concentration problems. Moreover, chronic sleep restriction may affect metabolism, hormone secretion patterns and inflammatory responses. Limited recent reports suggest a potential link between sleep deprivation and epigenetic effects such as changes in DNA methylation profiles. The aim of the present study was to assess the potential association between poor sleep quality or sleep duration and the levels of 5-methylcytosine in the promoter regions of PER1, PER2, PER3, BMAL1, CLOCK, CRY1 CRY2 and NPAS2 genes, taking into account rotating night work and chronotype as potential confounders or modifiers. A cross-sectional study was conducted on 710 nurses and midwives (347 working on rotating nights and 363 working only during the day) aged 40–60 years. Data from in-person interviews about sleep quality, chronotype and potential confounders were used. Sleep quality and chronotype were assessed using Pittsburgh Sleep Quality Questionnaire (PSQI) and Morningness–Eveningness Questionnaire (MEQ), respectively. Morning blood samples were collected. The methylation status of the circadian rhythm genes was determined via quantitative methylation-specific real-time PCR assays (qMSP) reactions using DNA samples derived from leucocytes. The proportional odds regression model was fitted to quantify the relationship between methylation index (MI) as the dependent variable and sleep quality or sleep duration as the explanatory variable. Analyses were carried out for the total population as well as for subgroups of women stratified by the current system of work (rotating night shift/day work) and chronotype (morning type/intermediate type/evening type). A potential modifying effect of the system of work or the chronotype was examined using the likelihood ratio test. No significant findings were observed in the total study population. Subgroup analyses revealed two statistically significant associations between a shorter sleep duration and 1) methylation level in PER2 among day workers, especially those with the morning chronotype (OR = 2.31, 95%CI:1.24–4.33), and 2) methylation level in CRY2 among subjects with the intermediate chronotype, particularly among day workers (OR = 0.52, 95%CI:0.28–0.96). The study results demonstrated a positive association between average sleep duration of less than 6 hours and the methylation level of PER2 among morning chronotype subjects, and an inverse association for CRY2 among intermediate chronotype subjects, but only among day workers. Both the system of work and the chronotype turned out to be important confounders and modifiers in a number of analyses, making it necessary to consider them as potential covariates in future research on sleep deficiency outcomes. Further studies are warranted to explore this under-investigated topic. 相似文献