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This study aims to explore the possibilities and potential value creation of a large-scale implementation of shift work within the construction sector, allowing production ongoing more than 40 hours per week. This is not a novel concept in construction, however it is not a standardised way of working and today often brings many obstacles. Previous research within construction management has focused on the traditional approaches in measuring success from metrics like time, cost and quality. A general research statement is that the construction industry is stagnant and calls for development. As there is an increased recognition in the need of looking beyond these traditional measures, this thesis has therefore delved into both the intangible and direct values, regarding social and financial aspects of implementing shift work in the production phase. The work is done through a qualitative method, including semistructured interviews with respondents holding experience in the field and that previously have worked in shift work projects. The interviews are conducted with personnel of the contractor, as well as with three different client organisations in order to gather a diverse picture and opinions. The empirical data suggests that implementing shift work as a standardised way to schedule would not be appropriate as of today. Firstly, the management knowledge is not existent at the time and needs to be developed in order to implement shift work in a more extensive way. However, this managerial progress would be well received as it would be beneficial in all types of projects. It is seen that today, there are potential social and financial values that are unutilised regarding personal flexibility, cost savings and competitive development. Nevertheless, there are still obstacles that need to be considered. Resistance to change within the construction industry is holding back potential innovation and development, health aspects need to be further treated and finding motiva, Denna studie syftar till att undersöka möjligheterna och det potentiella värdeskapandet av att införa skiftarbete inom byggsektorn, vilket möjliggör produktion som pågår mer än 40 timmar per vecka. Detta är inte ett nytt koncept inom byggbranschen men det är inte heller ett standardiserat arbetssätt och som idag ofta medför många hinder. Tidigare forskning inom byggbranschen har fokuserat på de traditionella metoderna för att mäta framgång med hjälp av aspekterna: tid, kostnad och kvalitet. Ett generellt forskningssynpunkt är att byggbranschen är stagnerad och kräver utveckling. Eftersom det finns ett ökat erkännande av behovet av att se bortom dessa traditionella mått har denna uppsats därför fördjupat sig i både de indirekta och direkta värdena, med avseende på sociala och ekonomiska aspekter av att implementera skiftarbete i produktionsfasen. Arbetet genomförs med en kvalitativ metod med semistrukturerade intervjuer med respondenter som har erfarenhet inom området och som arbetat i projekt med skiftarbete. Intervjuerna görs med anställda från entreprenören samt med tre olika kunder för att få ett flersidigt perspektiv. Den empiriska datan tyder på att det i dagsläget inte är lämpligt att införa skiftarbete som ett standardiserat sätt att schemalägga byggprojekt. För det första finns inte tillräcklig kunskap som krävs för att genomföra detta och som måste utvecklas för att införa skiftarbete på ett storskaligt sätt. Denna utveckling av projektledning skulle dock vara fördelaktig eftersom den skulle vara till nytta i alla typer av framtida byggprojekt. Vi har sett att det idag finns potentiella sociala och ekonomiska värden som inte utnyttjas inom industrin och att det finns vissa hinder som måste tas i beaktning. Motstånd till förändring inom byggbranschen hindrar idag potentiell innovation och utveckling, vidare behöver hälsoaspekterna noggrannare beaktas och det är idag svårt att hitta motiverade medarbetare. Det rekommenderade sättet att arbeta är åtta timmars

Introduction: Cognitive functions play a crucial role in individual’s life since they represent the mental abilities necessary to perform any activity. During working life, having healthy cognitive functioning is essential for the proper performance of work, but it is especially crucial for preserving cognitive abilities and thus ensuring healthy cognitive aging after retirement. The aim of this paper was to systematically review the scientific literature related to the effects of work on cognitive functions to assess which work-related factors most adversely affect them. Method: We queried the PubMed and Scopus electronic databases, in February 2023, according to the PRISMA guidelines (PROSPERO ID number = CRD42023439172), and articles were included if they met all the inclusion criteria and survived a quality assessment. From an initial pool of 61,781 papers, we retained a final sample of 64 articles, which were divided into 5 categories based on work-related factors: shift work (n = 39), sedentary work (n = 7), occupational stress (n = 12), prolonged working hours (n = 3), and expertise (n = 3). Results: The results showed that shift work, occupational stress, and, probably, prolonged working hours have detrimental effects on cognitive functioning; instead, results related to sedentary work and expertise on cognitive functions are inconclusive and extremely miscellaneous. Discussion: Therefore, workplace health and well-being promotion should consider reducing or rescheduling night shift, the creation of less demanding and more resourceful work environments and the use of micro-breaks to preserve workers’ cognitive functioning both before and after retirement. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439172, identifier CRD42023439172.

Objective: 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. Methods: 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. Results: 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. Conclusion: 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.

Shift work (SW) demands increased with modern world and its physical and psychological outcomes have been studied a lot. Its impact on brain structures alteration in the older population using structural Magnetic resonance imaging (sMRI) is still scarce in available literature. This 5-years follow-up study examined the association between SW and volume of brain regions in older people, and also the role of physical activity and sleep health (such as chronotype and insomnia) in this relationship. Total participants with job involve SW were 1966 from UK Biobank (UKB). UKB is a population-based and large-scale database whichrecruited participants in 2006-2010 from all over the UK. UKB used Ace touchscreen questionnaire to assess SW and volumes of brain structures were measured using sMRI.Results from linear regression model after adjusted for age, gender, education and comparative body size at age 10 showed that individuals who usually do SW had an increase in left amygdala volume (ß = 34.65, 95% CI = 0.94, 68.36) compare to individuals who never do SW (ß = 65.11, 95% CI = -15.47, 145.69). Individuals who sometimes do SW had a decrease in left thalamus volume (ß = -20.32, 95% CI = -41.71, 1.07) compare to individuals who never do SW (ß = 154.98, 95% CI = 78.85, 231.10). The associations are not supported for hippocampus and frontal medial cortex. The influence of physical activity, chronotype,insomnia and SW on volumes of brain regions are also of smaller extent. The findings add to literature on SW and brain volume changes as findings gives insight to understand the impact of SW on brain volume among older people but more research is needed to examine this association more intensively other than UK population.

This study aims to explore the possibilities and potential value creation of a large-scale implementation of shift work within the construction sector, allowing production ongoing more than 40 hours per week. This is not a novel concept in construction, however it is not a standardised way of working and today often brings many obstacles. Previous research within construction management has focused on the traditional approaches in measuring success from metrics like time, cost and quality. A general research statement is that the construction industry is stagnant and calls for development. As there is an increased recognition in the need of looking beyond these traditional measures, this thesis has therefore delved into both the intangible and direct values, regarding social and financial aspects of implementing shift work in the production phase. The work is done through a qualitative method, including semistructured interviews with respondents holding experience in the field and that previously have worked in shift work projects. The interviews are conducted with personnel of the contractor, as well as with three different client organisations in order to gather a diverse picture and opinions. The empirical data suggests that implementing shift work as a standardised way to schedule would not be appropriate as of today. Firstly, the management knowledge is not existent at the time and needs to be developed in order to implement shift work in a more extensive way. However, this managerial progress would be well received as it would be beneficial in all types of projects. It is seen that today, there are potential social and financial values that are unutilised regarding personal flexibility, cost savings and competitive development. Nevertheless, there are still obstacles that need to be considered. Resistance to change within the construction industry is holding back potential innovation and development, health aspects need to be further treated and finding motiva, Denna studie syftar till att undersöka möjligheterna och det potentiella värdeskapandet av att införa skiftarbete inom byggsektorn, vilket möjliggör produktion som pågår mer än 40 timmar per vecka. Detta är inte ett nytt koncept inom byggbranschen men det är inte heller ett standardiserat arbetssätt och som idag ofta medför många hinder. Tidigare forskning inom byggbranschen har fokuserat på de traditionella metoderna för att mäta framgång med hjälp av aspekterna: tid, kostnad och kvalitet. Ett generellt forskningssynpunkt är att byggbranschen är stagnerad och kräver utveckling. Eftersom det finns ett ökat erkännande av behovet av att se bortom dessa traditionella mått har denna uppsats därför fördjupat sig i både de indirekta och direkta värdena, med avseende på sociala och ekonomiska aspekter av att implementera skiftarbete i produktionsfasen. Arbetet genomförs med en kvalitativ metod med semistrukturerade intervjuer med respondenter som har erfarenhet inom området och som arbetat i projekt med skiftarbete. Intervjuerna görs med anställda från entreprenören samt med tre olika kunder för att få ett flersidigt perspektiv. Den empiriska datan tyder på att det i dagsläget inte är lämpligt att införa skiftarbete som ett standardiserat sätt att schemalägga byggprojekt. För det första finns inte tillräcklig kunskap som krävs för att genomföra detta och som måste utvecklas för att införa skiftarbete på ett storskaligt sätt. Denna utveckling av projektledning skulle dock vara fördelaktig eftersom den skulle vara till nytta i alla typer av framtida byggprojekt. Vi har sett att det idag finns potentiella sociala och ekonomiska värden som inte utnyttjas inom industrin och att det finns vissa hinder som måste tas i beaktning. Motstånd till förändring inom byggbranschen hindrar idag potentiell innovation och utveckling, vidare behöver hälsoaspekterna noggrannare beaktas och det är idag svårt att hitta motiverade medarbetare. Det rekommenderade sättet att arbeta är åtta timmars

Under hösten 2023 infördes ett nytt direktiv gällande 11 timmars sammanhängande dygnsvilaför anställda inom Sveriges kommuner och regioner. Direktivet har förändratarbetsförutsättningarna för vårdpersonal, en yrkesgrupp som ofta arbetar skift. Syftet medstudien var därför att undersöka vårdpersonals upplevelse av work-life balance vid skiftarbetesedan det nya direktivet trädde i kraft. För att undersöka detta genomfördes en kvalitativstudie bestående av åtta semistrukturerade intervjuer med undersköterskor och sjuksköterskor,vilka analyserades med en induktiv tematisk analys. Resultatet visade att respondenternalägger stor vikt vid att försöka separera arbetslivet från privatlivet för att på så sätt skapabalans i livet. Trots detta upplevde dock majoriteten av respondenterna att arbetet går ut överprivatlivet. Resultatet tyder på att det nya direktivet gällande 11 timmars sammanhängandedygnsvila har haft en negativ inverkan på respondenternas work-life balance, During the autumn of 2023, the new directive regarding 11 hours of continuous daily rest foremployees within Sweden's municipalities and regions was introduced. The directive haschanged the working conditions for healthcare staff, a professional group that often works inshifts. The purpose of the study was therefore to investigate the healthcare workers'experience of work-life balance during shift work since the new directive came into effect. Toexamine this, a qualitative study was performed in which eight semi-structured interviewswere conducted with assistant nurses and nurses, which were analyzed using inductivethematic analysis. The results showed that the respondents put a lot of emphasis on trying toseparate work life from private life in order to create balance in life. Despite this, however,the majority of respondents felt that work overrides private life. The results indicate that thenew directive regarding 11 hours of continuous daily rest have had a negative impact on therespondents' work-life balance.

Under hösten 2023 infördes ett nytt direktiv gällande 11 timmars sammanhängande dygnsvilaför anställda inom Sveriges kommuner och regioner. Direktivet har förändratarbetsförutsättningarna för vårdpersonal, en yrkesgrupp som ofta arbetar skift. Syftet medstudien var därför att undersöka vårdpersonals upplevelse av work-life balance vid skiftarbetesedan det nya direktivet trädde i kraft. För att undersöka detta genomfördes en kvalitativstudie bestående av åtta semistrukturerade intervjuer med undersköterskor och sjuksköterskor,vilka analyserades med en induktiv tematisk analys. Resultatet visade att respondenternalägger stor vikt vid att försöka separera arbetslivet från privatlivet för att på så sätt skapabalans i livet. Trots detta upplevde dock majoriteten av respondenterna att arbetet går ut överprivatlivet. Resultatet tyder på att det nya direktivet gällande 11 timmars sammanhängandedygnsvila har haft en negativ inverkan på respondenternas work-life balance, During the autumn of 2023, the new directive regarding 11 hours of continuous daily rest foremployees within Sweden's municipalities and regions was introduced. The directive haschanged the working conditions for healthcare staff, a professional group that often works inshifts. The purpose of the study was therefore to investigate the healthcare workers'experience of work-life balance during shift work since the new directive came into effect. Toexamine this, a qualitative study was performed in which eight semi-structured interviewswere conducted with assistant nurses and nurses, which were analyzed using inductivethematic analysis. The results showed that the respondents put a lot of emphasis on trying toseparate work life from private life in order to create balance in life. Despite this, however,the majority of respondents felt that work overrides private life. The results indicate that thenew directive regarding 11 hours of continuous daily rest have had a negative impact on therespondents' work-life balance.

Background and Objective: Melatonin in breast milk exhibits a 24-hour circadian rhythm, present in nighttime breast milk but nearly undetectable in daytime breast milk. Shift work can disrupt the circadian timing of individuals, evident in changes in melatonin in saliva and urine samples. However, it is unknown whether these changes are also reflected in breast milk from a shift working mother. The aim of this study was to investigate whether maternal circadian rhythm disturbance from shift work impacts the melatonin concentration in breast milk. Materials and Methods: Breast milk and saliva samples were collected from 11 shift working mothers at four timepoints across five consecutive days. This included during their day shift or nonworkdays to act as a control, night shift, subsequent night shifts and postnight shift. Where possible, pre- and postfeed collections were also undertaken. Samples were grouped into four-time intervals: 12–6:30 am, 7–11:30 am, 12–6:30 pm, 7–11:30 pm, and melatonin levels (picogram per milliliter) in the breast milk and saliva samples were analyzed. Results: There was a significant decrease in breast milk melatonin (p = 0.026) at the 12–6:30 am time interval on subsequent night shifts, compared with control days. However, there was no overall time and shift type interaction effect (p = 0.70). In addition, no observed difference in melatonin levels was found in saliva samples, or when comparing pre- and postfeed breast milk. Breast milk melatonin however was found to be significantly higher compared with saliva (p > 0.001), at all but one time interval. Conclusion: The findings suggest that there is a potential effect of maternal circadian rhythm disruption from shift work on breast milk melatonin levels. This is an important step in exploring the role of maternal circadian timing and the effect on breast milk composition. Expansion of this research and exploration of other circadian rhythm misalignment sleep disorders on breast mil

Objectives: To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. Design: A cross-sectional study. Setting: An anonymous online survey of healthcare shift workers in Australia. Participants: A total of 403 nurses, midwives and paramedics completed the survey. Main outcome measures: Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. Results: Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. Conclusion: Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.

Aims: To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift work. Design: A single case study with embedded units. Methods: Twenty-seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022. Results: Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long-term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations. Conclusion: This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients. Implications for the Profession and/or Patient Care: Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessar

Objectives: To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. Design: A cross-sectional study. Setting: An anonymous online survey of healthcare shift workers in Australia. Participants: A total of 403 nurses, midwives and paramedics completed the survey. Main outcome measures: Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. Results: Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. Conclusion: Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.

Aims: To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift work. Design: A single case study with embedded units. Methods: Twenty-seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022. Results: Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long-term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations. Conclusion: This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients. Implications for the Profession and/or Patient Care: Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessar

Epidemiological studies associate night shift work with increased breast cancer risk. However, the underlying mechanisms are not clearly understood. To better understand these mechanisms, animal models that mimic the human situation of different aspects of shift work are needed. In this study, we used "timed sleep restriction" (TSR) cages to simulate clockwise and counterclockwise rotating shift work schedules and investigated predicted sleep patterns and mammary tumor development in breast tumor-prone female p53R270H©/+WAPCre mice. We show that TSR cages are effective in disturbing normal activity and estimated sleep patterns. Although circadian rhythms were not shifted, we observed effects of the rotating schedules on sleep timing and sleep duration. Sleep loss during a simulated shift was partly compensated after the shift and also partly during the free days. No effects were observed on body weight gain and latency time of breast cancer development. In summary, our study shows that the TSR cages can be used to model shift work in mice and affect patterns of activity and sleep. The effect of disturbing sleep patterns on carcinogenesis needs to be further investigated.

Nightshift work disturbs the circadian rhythm, which might contribute to the development of cardio-metabolic disorders. In this cross-sectional study, we aimed to gain insight into perturbations of disease relevant metabolic pathways due to nightshift work. We characterized the metabolic profiles of 237 female nurses and paramedic staff participating in the Klokwerk study using the Nightingale Health platform. We performed analyses on plasma levels of 225 metabolites, including cholesterol, triglycerides, fatty acids, and amino acids. Using both principal component- and univariate-regression, we compared metabolic profiles of nightshift workers to metabolic profiles from workers that did not work night shifts (defined as day workers). We also assessed whether differential effects were observed between recently started versus more experienced workers. Within the group of nightshift workers, we compared metabolic profiles measured right after a nightshift with metabolic profiles measured on a day when no nightshift work was conducted. We observed evidence for an impact of nightshift work on the presence of unfavorable fatty acid profiles in blood. Amongst the fatty acids, effects were most prominent for PUFA/FA ratios (consistently decreased) and SFA/FA ratios (consistently elevated). This pattern of less favorable fatty acid profiles was also observed in samples collected directly after a night shift. Amino acid levels (histidine, glutamine, isoleucine, and leucine) and lipoproteins (especially HDL-cholesterol, VLDL-cholesterol, and triglycerides) were elevated when comparing nightshift workers with day workers. Amino acid levels were decreased in the samples that were collected directly after working a nightshift (compared to levels in samples that were collected during a non-nightshift period). The observed effects were generally more pronounced in samples collected directly after the nightshift and among recently started compared to more experienced nightshift

Shift work is a common occupational exposure, however, few studies have examined aspects of shift work beyond night work and long hours, such as rotational patterns or weekend work, which may contribute to poor health through disruption of the bodys circadian rhythms. In this manuscript, we calculated the prevalence of working hour characteristics using algorithms for type (e.g., day), duration, intensity, rotational direction, and social aspects (e.g., weekend work) in a nationwide cohort of American manufacturing workers (N = 23,044) between 2003 and 2014. Distributions of working hour characteristics were examined by schedules (e.g., permanent day, day/night) and demographics, and were cross-classified in a matrix to examine co-occurrence. Approximately 55% of shifts may cause circadian rhythm disruption as they were non-day shifts or day shifts with a quick return or rotation, or were 13 h or longer. Older workers, female workers, and White workers worked permanent day shifts most often, while workers of color worked more day/night schedules. Night and evening shifts had more frequent shift rotations, quick returns, and longer hours than day shifts. Yet, day shifts, which are presumed to have little negative circadian impact, may cause circadian rhythm disruption as long hours, quick returns and rotations also occurred within day shifts.

Circadian clock dysregulation has been implicated in various types of cancer and represents an area of growing research. However, the role of the circadian clock in prostate cancer has been relatively unexplored. This literature review will highlight the potential role of circadian clock dysregulation in prostate cancer by examining molecular, epidemiologic, and clinical data. The influence of melatonin, light, night shift work, chronotherapy, and androgen independence are discussed as they relate to the existing literature on their role in prostate cancer.

Prior epidemiological research has established that sleep disturbances and depression are associated. However, notable methodological limitations exist across past studies, including the heavy use of between-person analyses that are often based on sleep and depression measured at a single point in time, use of general “sleep disturbance” over well-defined facets of sleep, overreliance on self-reported sleep, and lack of attention to within-person relationships and their interactions with group-level characteristics (e.g., shiftwork). To address these limitations, the current study examined relationships between multiple sleep facets and depression across various types of measurement (i.e., single time-point, daily; self-report, actigraphy) and moderators (i.e., shiftwork, intraindividual variability of sleep midpoint) in nurses. Participants were 349 nurses (90.83% female; 76.50% White; 89.20% non-Hispanic/Latinx; Mage = 39.13 years) who completed baseline measures of insomnia and depression. Participants then completed daily diaries assessing sleep and depression for 14 days, during which they also wore an Actiwatch (Phillips Respironics, Andover, MA). Simple linear regression was used to examine the relationship between insomnia and depression at a single point in time, while multilevel modeling was used to examine daily, bidirectional relationships between depression and sleep facets (i.e., sleep efficiency, quality, duration, midpoint) across self-report and actigraphy measures. Shiftwork and intraindividual standard deviation (iSD) of sleep midpoint were included as moderators in models. Results revealed higher insomnia severity was significantly associated with higher depression severity (b = -0.35, SE = 0.01, p < .001) at a single point in time, even after covarying for age, gender, race, ethnicity, shiftwork, and midpoint iSD. Daily depression and subjective sleep quality and efficiency were bidirectionally associated (all p’s <.05), even after adding in cov

Shift work in the mining industry is a risk factor for sleep loss leading to impaired alertness, which may adversely impact health and safety risks. This risk is being increasingly recognised by leaders and shift workers in the mining industry, however, there is limited knowledge available on the extent of sleep loss and other potential contributing factors. Furthermore, knowledge of the efficacy of individual interventions to assist shift workers to improve their sleep, and the management of risk at an organisational level is scarce. This PhD thesis involved three studies. The first two studies involved the recruitment of 88 shift workers on a fly-in, fly-out (FIFO) mining operation in Western Australia (WA), undertaken within a business-as-usual model. The third study develops a diagnostic tool to support the systematic assessment of an organisation's Fatigue Risk Management System (FRMS). Study 1 (Chapter 4) investigated sleep behaviours, the prevalence of risk of sleep disorders and the predicted impact on alertness across the roster schedule. Sleep was objectively measured using wrist-activity monitors for the 21-day study period and biomathematical modelling was used to predict alertness across the roster schedule. The prevalence of risk for sleep problems and disorders was determined using scientifically validated sleep questionnaires. We found sleep loss was significantly greater following days shift and night shift compared to days off, which resulted in a 20% reduced alertness across the 14 consecutive shifts at the mining operation. Shift workers reported a high prevalence of risk for sleep disorders including shift work disorder (44%), obstructive sleep apnoea (OSA) (31%) and insomnia (8%); a high proportion of shift workers were obese with a body mass index (BMI) > 30kg/m2 (23%) and consumed hazardous levels of alcohol (36%). All of which may have contributed to sleep loss. In addition, the design of shifts and rosters, specifically, early morning shift

Background: Working night shifts is associated with higher safety risks due to shift work-related fatigue. Nutrition, especially certain (macro) nutrient compositions, has been suggested to reduce fatigue, however, results of studies are contradictory. This could be explained by differences in the time interval investigated between the consumption of a meal and measurement of cognitive performance. Therefore, this observational study investigated the association between macronutrient intake and objective alertness at different time intervals during the night shift in nurses. Methods: 128 nurses, aged 20–61 years, completed an alertness test (Psychomotor Vigilance Task) during the night shift and a 24-h dietary recall after the night shift. This was repeated three times, always on the first night shift in a night shift series. The associations between macronutrient intake 0 to 1, 1 to 2, and 2 to 3 h before the PVT with alertness during the night shift were analyzed through Linear Mixed Models. The basic model was adjusted for age and gender and the adjusted model additionally for BMI, start time of PVT and energy and caffeine intake during the relevant time interval. Results: Protein intake was not associated with objective alertness levels, while fat and carbohydrates intake had opposite associations with objective alertness levels over similar time intervals. Fat intake up to 1 h prior to the PVT was borderline associated with a longer median reaction time (RT) (ß = 9.00 ms/10 g fat, 95% CI: −0.21, 18.20), while a higher carbohydrate intake up to 1 h prior to the PVT was borderline associated with shorter median RTs (ß = −3.89, 95% CI: −7.85, 0.06). A higher fat intake 2 to 3 h prior to the PVT was associated with less lapses (log transformed ß = −0.16; 95% CI: −0.31, −0.02), while a higher carbohydrate intake 2 to 3 h prior to the PVT was associated with more lapses (ß = 0.06, 95% CI: 0.01, 0.12). Conclusion: Our results contribute to understanding the associatio

Abstract Background A large proportion of staff working in hospital settings are overweight or obese, have poor dietary habits and low physical activity levels. The workplace is a priority setting for health promotion. This systematic review will describe dietary and physical activity workplace interventions that have aimed to improve the health of staff in hospital settings; and the barriers and enablers of implementing these interventions. Methods A systematic search retrieved 551 studies from 2004 to 2020 using the following databases CINAHL Complete, MEDLINE Complete, Academic Search Complete, Global Health, Health Source Nursing/Academic Edition and PsycINFO. Studies were included if they: (1) took place in a hospital setting; (2) employed a physical activity or dietary intervention to improve the well-being of staff; (3) the intervention duration was 12 weeks or over; (4) used a control group. The Integrated quality Criteria for the Review of Multiple Study designs (ICROMS) and National Institute of Health’s National Heart Lung and Blood Institute Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies tools were used to assess quality of included studies. A narrative review was conducted. Results Quality analysis identified six studies of high quality, nine moderate quality, and three low quality. Of these 18 studies, 15 reported at least one positive health outcome. The evidence revealed that multi-component strategies, financial incentives and motivational strategies were the most effective approaches to improve health behaviours of hospital staff. Conclusion Hospital-based dietary and physical activity workplace interventions show promise as an effective strateg

Denna studies syfte var att undersöka skiftarbetares psykiska välbefinnande utifrån faktorerna socialt stöd från familj, vänner och andra speciella personer samt möjligheten att utföra ens fritidsaktiviteter. För att utforska detta genomfördes genom en enkätundersökning (n=32) där deltagarna bestod av skiftarbetare som arbetar olika slags skiftscheman på ett industriföretag i Sverige. Enkäten bestod av frågor gällande socialt stöd, utförande av fritidsaktiviteter, psykiskt välbefinnande samt demografisk information. Ett problem som uppstod under processen av insamling av data var att responsen från urvalsgruppen var låg, vilket resulterade i ett litet deltagarantal. Det insamlade datamaterialet hanterades utifrån deskriptiva och statistiska analyser som korrelationsanalys, linjär regressionsanalys, chi-två test samt frekvensanalys. Trots det låga deltagarantalet gav analyserna relevanta statistiskt signifikanta resultat. Resultaten tydde på ett positivt samband mellan socialt stöd och psykiskt välbefinnande samt mellan möjlighet att utföra sina fritidsaktiviteter till önskad mängd och psykiskt välbefinnande, vilket gick i enlighet med vad tidigare forskning på området visat. Enkätens låga deltagande försvårade möjligheten till att dra generaliserande slutsatser. Förslag till vidare forskning är att replikera denna studie på en större urvalsgrupp för att möjliggöra generaliseringar., The aim of this study was to investigate the mental well-being of shift workers based on the factors of social support from family, friends and significant others, and the possibility to participate in one’s leisure activities. A survey was conducted (n=32), and the participants were shift workers, working different types of shift schedules, at a Swedish industrial company. The survey was constructed of items regarding social support, participation in leisure activities, psychological well-being and demographic information. An issue that occurred during the process of collecting data was that the response from the sample group was low, which resulted in a low participation rate. The collected data material was handled based on descriptive and statistical analyzes such as correlation analysis, linear regression analysis, chi-square tests and frequency analysis. The analyzes gave relevant statistical significant results despite the low participation rate. The results indicated a positive correlation between social support and psychological well-being as well as between the opportunity to participate in one's leisure activities to the desired amount and psychological well-being. The results were in line with what previous research in the field has found. The low participation rate of the survey makes it difficult to draw any generalizing conclusions. Suggestions for future research are to replicate this study with a larger sample group to enable generalizations.

Purpose: Faroese fishers have four times more accidents than workers on land. The aim was to understand fishers’ fatigue better and how their work and sleep patterns influenced their sleepiness levels and cognitive performance. Materials and Methods: A total of 157 Faroese fishers wore wrist-worn actigraphs at sea and one week on land and filled in sleep and sleepiness diaries during the trip. Furthermore, a 3-minute simple reaction time (SRT) test was completed at the beginning and end of the trip. The ship’s movement and noise were also logged. The actiwatch results were analysed with mixed methods repeated measures. The sleepiness registrations and performance on the SRT-test were analysed with paired t-test. The ship movements (Pitch and roll) were divided into approximately three same-sized groups (lowest 1/3, medium 1/3, and highest 1/3) and compared against the Karolinska Sleepiness Scores (KSS ranging from 1– 9) ≥ 7 and physical tiredness (ranging from 1– 9) scores ≥ 7. Chi-square tests were used to determine the significance of these differences. Mean sleepiness scores at sea, and the proportion of sleepiness scores ≥ 7 were calculated, as well as sleepiness scores as a function of the time of day. Results: While at sea, fishers had more split sleep, slept less, and had lower sleep efficiency than onshore. Sleepiness was higher at the end of the trip, and cognitive decline was found. The number of major lapses was higher at the end of the trip, but with no significant difference between the median reaction times. Conclusion: The crew on-board the freezer longliner, who worked 8– 8 shifts, slept the most, had the longest continuous sleep periods, the highest sleep efficiency, the lowest sleepiness levels, and the highest noise exposure during their time off.

Problemformulering: År 2020 arbetade ungefär var femte anställd skift eller annan typ av schema med arbetstid som förlagts under olika tider på dygnet. Det mest förekommande problemet med skiftarbete handlar om sömn och det är vanligt förekommande med störd sömn, sömnbrist och trötthet hos skiftarbetare. Tidigare forskning har visat att bristande sömnvanor bland skiftarbetare kan ha negativa konsekvenser för den fysiska och psykiska hälsan. Goda sömnvanor kan däremot minska risken för olika typer av sjukdomar. Många arbeten kräver bemanning dygnet runt, trots att det finns forskning som visar på att skiftarbete kan ha negativa konsekvenser på hälsan är det omöjligt att slopa alla skift. Denna studie kan bidra med kunskap till arbetstagare och arbetsgivare kring hur goda sömnvanor kan upprätthållas trotts skiftarbete. Syfte: Syftet med denna kvalitativa studie är att beskriva skiftarbetares olika upplevelser av goda sömnvanor. Metod: Kvalitativ intervjustudie med semistrukturerad intervjuguide. Insamlade data analyserades genom fenomenografisk analysmetod. Resultat: Ett huvudtema, fyra kategorier och tio subkategorier identifierades. Huvudtemat för den fenomenorafiska analysen är att god sömn är en process med olika möjligheter. Kategorierna, med tillhörande subkategorier, sträcker sig över fyra olika delar av dygnet. Resultatet visar vad skiftarbetare upplever som god sömn och vad som bidrar till god sömn. Slutsats: Denna studie visar att god sömn är en process med olika möjligheter som sträcker sig över hela dygnet. Resultatet belyser möjligheterna till goda sömnvanor bland skiftarbetare och lyfter fram deltagarnas egna upplevelser. Resultatet bidrar till det hälsofrämjande perspektivet genom att medvetandegöra de faktorer som främjar en god sömn. Detta gör det möjligt att skapa stödjande miljöer och tillhandahålla kunskap för att på vis och underlättar att göra hälsosamma val gällande sömnen., Aim: The purpose of this qualitative study is to describe shift workers' different experiences of good sleeping habits. Method: Qualitative interview study with a semi-structured interview guide. Collected data were analyzed by phenomenographic analysis method. Results: One main theme, four categories and ten subcategories were identified. The main theme of the phenomenographic analysis is that good sleep is a process with different possibilities. The categories, with associated subcategories, extend over four different parts of the day. The results show what shift workers experience as good sleep and what contributes to good sleep. Conclusion: The results of this study show that good sleep is a process with different possibilities that extends throughout the day. The results highlight the opportunities for good sleeping habits among shift workers and highlight the participants' own experiences. The results contribute to the health-promoting perspective by raising awareness of the factors that promote good sleep. This makes it possible to create supportive environments and provide knowledge to make healthy choices regarding sleep.

Objective Shift work is associated with impaired health and safety but there is a lack of systematic knowledge of shift workers attitude to their shift systems. This may be important for the ability to retain valuable personnel in the company/organization, and to attract new employees. The purpose of the present study was to investigate: the prevalence of shift characteristics (nights, long shifts, short rest, etc.) in traditional shift systems, the workers’ attitude to their shift systems, if combinations of problematic shift characteristics are associated with the workers’ attitude, and if work stress and poor sleep, fatigue, or social difficulties are associated with attitudes to shift systems. Methods A representative sample of 3,500 individuals with non-day work in the general population of Sweden were asked to participate in the study. A total of 1965 workers remained after drop-outs. The material was analyzed by Chi2 analysis and hierarchical multiple regression. Results The results showed that traditional shift systems included many more shift characteristics than those constituting the core of the systems. All included day work, for example. 90.2% of those with roster work had shifts > 10 h at least once a month. 66.9% of those with roster work without nights had < 11 h rest between shifts at least once a month. Less than 25% of the respondents had a rather or very negative attitude to their shift system, with the lowest level for those who work either fixed days or nights (7.6 and 5.7%, respectively) and highest for three-shift work (21.2%) and roster work without night work (24.4%). Shiftwork or roster work with nights had highest levels (> 50%) of sleep problems and fatigue. The difference across shift systems was significant at p < .001 in all cases. Combinations of the most problematic shift characteristics were associated with some increase in negative attitude to the shift schedule. Among schedule characteristics, only long weeks turned o

The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) >= 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND >= 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.

As the demand for a 24-hour world increases so does the need for more shift workers. To maintain the standard expected of them, shift workers often work long hours, including night work where their main opportunity for sleep is during the day. Research has found that shift workers experience fatigue, difficulties in cognition and impaired wellbeing after working shifts like these. Despite this, minimal research has been conducted to explore how many days of recovery should be rostered after one night shift. This study aimed to find evidence to guide workplaces on how many days of rest employees should be rostered to recuperate from one night of sleep loss. A sample of 39 night shift (n=22) and day shift workers (n=17) completed a five day experiment from pre-night shift to rest day three (or five consecutive days for controls) and were assessed in tasks of prospective memory, sustained vigilance, self-reported fatigue levels and self-reported affect to measure well-being. The results indicated that while there was no significant change in vigilant attention or prospective remembering across the five days that self-reported fatigue and positive affect experienced significant changes. These findings indicate that night shift workers may need two to three days of rest to recover from some of the effects from a night of sleep deprivation. However this study repeated with a larger sample size and stricter conditions could yield different results.

PurposeOptimal cognitive performance might prevent vehicle accidents. Identifying time-related circadian and homeostatic parameters having an impact on cognitive performance of drivers may be crucial to optimize drivers' performance.MethodsIn this prospective study conducted on bus drivers, two drivers alternated driving during a 24-h round trip and were accompanied by an interviewer. Each driver was tested using Karolinska Sleepiness Scale (KSS) and the reversed digit span Wechsler Working Memory test before the start of his shift and then every 6 h during a "work/driving" day. Psychomotor Vigilance Task (PVT) was assessed before and after the journey. Linear mixed model was used to explore the factors affecting cognitive performance and sleepiness in univariate and multivariate analysis.ResultsAmong 35 bus drivers, the effect of time of day on working memories was statistically significant (p = 0.001), with the lowest working memory scores at 04:00 am (± 1). The highest score of subjective sleepiness was also at 04:00 am (± 1). The time on task parameter affected sleepiness significantly (p = 0.024) and sleepiness was significantly associated with decreased working memory. Psychomotor Vigilance Task reaction time mean and the number of minor lapses were significantly increased after the journey, which suggested decreased vigilance. In multivariable analysis, a longer interval between the beginning of working hours and testing time (B (95% CI) = 15.25 (0.49 to 30), p = 0.043) was associated with higher (i.e., slower) PVT reaction time mean.ConclusionsThese results suggest that optimizing bus drivers' working schedules may improve drivers' sleepiness and cognitive performance and thus increase road safety.

Adequate pain management is one of the biggest challenges of the modern healthcare system. Physician perception of patient subjective pain, which is crucial to pain management, is susceptible to a host of potential biases. Here we explore the timing of physicians' work as a previously unrecognized source of systematic bias in pain management. We hypothesized that during night shifts, sleep deprivation, fatigue, and stress would reduce physicians' empathy for others' pain, leading to underprescription of analgesics for patient pain relief. In study 1, 67 resident physicians, either following a night shift or not, performed empathy for pain assessment tasks and simulated patient scenarios in laboratory conditions. As predicted, following a night shift, physicians showed reduced empathy for pain. In study 2, we explored this phenomenon in medical decisions in the field. We analyzed three emergency department datasets from Israel and the United States that included discharge notes of patients arriving with pain complaints during 2013 to 2020 (n = 13,482). Across all datasets, physicians were less likely to prescribe an analgesic during night shifts (compared to daytime shifts) and prescribed fewer analgesics than generally recommended by the World Health Organization. This effect remained significant after adjusting for patient, physician, type of complaint, and emergency department characteristics. Underprescription for pain during night shifts was particularly prominent for opioids. We conclude that night shift work is an important and previously unrecognized source of bias in pain management, likely stemming from impaired perception of pain. We consider the implications for hospitals and other organizations employing night shifts.

Problemformulering: År 2020 arbetade ungefär var femte anställd skift eller annan typ av schema med arbetstid som förlagts under olika tider på dygnet. Det mest förekommande problemet med skiftarbete handlar om sömn och det är vanligt förekommande med störd sömn, sömnbrist och trötthet hos skiftarbetare. Tidigare forskning har visat att bristande sömnvanor bland skiftarbetare kan ha negativa konsekvenser för den fysiska och psykiska hälsan. Goda sömnvanor kan däremot minska risken för olika typer av sjukdomar. Många arbeten kräver bemanning dygnet runt, trots att det finns forskning som visar på att skiftarbete kan ha negativa konsekvenser på hälsan är det omöjligt att slopa alla skift. Denna studie kan bidra med kunskap till arbetstagare och arbetsgivare kring hur goda sömnvanor kan upprätthållas trotts skiftarbete. Syfte: Syftet med denna kvalitativa studie är att beskriva skiftarbetares olika upplevelser av goda sömnvanor. Metod: Kvalitativ intervjustudie med semistrukturerad intervjuguide. Insamlade data analyserades genom fenomenografisk analysmetod. Resultat: Ett huvudtema, fyra kategorier och tio subkategorier identifierades. Huvudtemat för den fenomenorafiska analysen är att god sömn är en process med olika möjligheter. Kategorierna, med tillhörande subkategorier, sträcker sig över fyra olika delar av dygnet. Resultatet visar vad skiftarbetare upplever som god sömn och vad som bidrar till god sömn. Slutsats: Denna studie visar att god sömn är en process med olika möjligheter som sträcker sig över hela dygnet. Resultatet belyser möjligheterna till goda sömnvanor bland skiftarbetare och lyfter fram deltagarnas egna upplevelser. Resultatet bidrar till det hälsofrämjande perspektivet genom att medvetandegöra de faktorer som främjar en god sömn. Detta gör det möjligt att skapa stödjande miljöer och tillhandahålla kunskap för att på vis och underlättar att göra hälsosamma val gällande sömnen., Aim: The purpose of this qualitative study is to describe shift workers' different experiences of good sleeping habits. Method: Qualitative interview study with a semi-structured interview guide. Collected data were analyzed by phenomenographic analysis method. Results: One main theme, four categories and ten subcategories were identified. The main theme of the phenomenographic analysis is that good sleep is a process with different possibilities. The categories, with associated subcategories, extend over four different parts of the day. The results show what shift workers experience as good sleep and what contributes to good sleep. Conclusion: The results of this study show that good sleep is a process with different possibilities that extends throughout the day. The results highlight the opportunities for good sleeping habits among shift workers and highlight the participants' own experiences. The results contribute to the health-promoting perspective by raising awareness of the factors that promote good sleep. This makes it possible to create supportive environments and provide knowledge to make healthy choices regarding sleep.

Over a quarter of the workforce in industrialized countries does shift work, which increases the risk for cardiometabolic disease. Yet shift workers are often excluded from lifestyle intervention studies to reduce this risk. In a randomized control trial with 137 firefighters who work 24-h shifts (23-59 years old, 9% female), 12 weeks of 10-h time-restricted eating (TRE) was feasible, with TRE participants decreasing their eating window (baseline, mean 14.13 h, 95% CI 13.78-14.47 h; intervention, 11.13 h, 95% CI 10.73-11.54 h, p = 3.29E-17) with no adverse effects, and improved quality of life assessed via SF-36 (ClinicalTrials.gov: NCT03533023). Compared to the standard of care (SOC) arm, TRE significantly decreased VLDL particle size. In participants with elevated cardiometabolic risks at baseline, there were significant reductions in TRE compared to SOC in glycated hemoglobin A1C and diastolic blood pressure. For individuals working a 24-h shift schedule, TRE is feasible and can improve cardiometabolic health, especially for individuals with increased risk. VIDEO ABSTRACT.

For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) >= 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND >= 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.

For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) >= 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND >= 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.

The purpose of this study is to explore the safety challenges managing shift work in the Swedish forest industry. There are several factors that can affect safety in working life. In general, previous research shows that managerial and leadership behaviours affect safety and well-being regardless of the type of industry. A leadership with a focus on safety affects the safety climate and the outcome in the form of accidents in an organisation. The interaction between managers and employees regarding safety issues also has a positive effect on safety. Leaders who are instead passive regarding safety issues have significant negative effects on safety, contribute to an increased number of accidents and reduce safety-related behaviour in the organisation. This means that employees with passive leaders themselves become less interested in engaging in safety activities. Shift work has also been shown to affect the health and safety of employees. For example, studies show that higher sickness absence is associated with three-shift rotation compared to two-shift rotation and that fatigue and insomnia may be an effect of shift work. Further, research also shows a link between fatigue and a higher frequency of accidents. In this paper, we use a co-creation approach to capture the safety challenges related to shift work. The overall methodological approach in this study is action-oriented research. The empirical data is collected with interviews and focus groups which altogether include 56 respondents with more than 700 years of joint work experiences from shift work in the forest industry. Preliminary results show the importance of creating a safety culture where both the management and the employees take active part and responsibility in solutions. The managers have the formal responsibility, including law and regulation related to safety aspects. The employees in turn have the responsibility for their own choices and behaviours not least related to food, sleep, and training.

Denna studies syfte var att undersöka skiftarbetares psykiska välbefinnande utifrån faktorerna socialt stöd från familj, vänner och andra speciella personer samt möjligheten att utföra ens fritidsaktiviteter. För att utforska detta genomfördes genom en enkätundersökning (n=32) där deltagarna bestod av skiftarbetare som arbetar olika slags skiftscheman på ett industriföretag i Sverige. Enkäten bestod av frågor gällande socialt stöd, utförande av fritidsaktiviteter, psykiskt välbefinnande samt demografisk information. Ett problem som uppstod under processen av insamling av data var att responsen från urvalsgruppen var låg, vilket resulterade i ett litet deltagarantal. Det insamlade datamaterialet hanterades utifrån deskriptiva och statistiska analyser som korrelationsanalys, linjär regressionsanalys, chi-två test samt frekvensanalys. Trots det låga deltagarantalet gav analyserna relevanta statistiskt signifikanta resultat. Resultaten tydde på ett positivt samband mellan socialt stöd och psykiskt välbefinnande samt mellan möjlighet att utföra sina fritidsaktiviteter till önskad mängd och psykiskt välbefinnande, vilket gick i enlighet med vad tidigare forskning på området visat. Enkätens låga deltagande försvårade möjligheten till att dra generaliserande slutsatser. Förslag till vidare forskning är att replikera denna studie på en större urvalsgrupp för att möjliggöra generaliseringar., The aim of this study was to investigate the mental well-being of shift workers based on the factors of social support from family, friends and significant others, and the possibility to participate in one’s leisure activities. A survey was conducted (n=32), and the participants were shift workers, working different types of shift schedules, at a Swedish industrial company. The survey was constructed of items regarding social support, participation in leisure activities, psychological well-being and demographic information. An issue that occurred during the process of collecting data was that the response from the sample group was low, which resulted in a low participation rate. The collected data material was handled based on descriptive and statistical analyzes such as correlation analysis, linear regression analysis, chi-square tests and frequency analysis. The analyzes gave relevant statistical significant results despite the low participation rate. The results indicated a positive correlation between social support and psychological well-being as well as between the opportunity to participate in one's leisure activities to the desired amount and psychological well-being. The results were in line with what previous research in the field has found. The low participation rate of the survey makes it difficult to draw any generalizing conclusions. Suggestions for future research are to replicate this study with a larger sample group to enable generalizations.

We investigated the association of the number of eating occasions and energy intake with alertness and gastrointestinal (GI) complaints in nurses during their night shift. During this observational study we collected data on anthropometrics and demographics, eating frequency, energy intake, alertness and GI complaints in 118 healthy female nurses, aged 20 to 61 years. Nurses completed an alertness test (psychomotor vigilance task) during the night shift and a 24-hr dietary recall and a questionnaire about GI complaints after the night shift. This was repeated three times, always on the first night shift in a night shift series. The number of eating occasions during the night shift was negatively associated with reaction times (β = −4.81 ms, 95% confidence interval [CI] −9.14 to −0.48; p =.030), and number of lapses (β = −0.04, 95% CI −0.07 to −0.00; p =.030). However, the number of eating occasions was not associated with subjective alertness and GI complaints. Energy intake during the night shift was not associated with objective or subjective alertness or with GI complaints. These associations were independent of caffeine intake, age, body mass index and dependence among the repeated measurements. The present study showed that eating frequency was positively associated with objectively measured alertness levels in female nurses during the night shift. The results need to be confirmed in an intervention study, where also timing, size and composition of the meal will be taken into account. In practice, optimising nutritional guidelines on these aspects could lead to faster responses, less (medical) errors, and a better wellbeing of night shift workers.

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses’ health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.

Background and aims: The objective of the present work was to determine to what extent sleep quality may mediate the association between chronodisruption (CD) and metabolic syndrome (MS), and between CD and body composition (BC). Methodology: Cross-sectional study which included 300 adult health workers, 150 of whom were night shift workers and thereby exposed to CD. Diagnosis of MS was made based on Adult Treatment Panel III criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Body mass index (BMI), fat mass percentage, and visceral fat percentage were meas

Shift work that involves circadian disruption has been highlighted as a likely carcinogenic factor for breast cancer in humans. Also, unhealthy lifestyle habits observed in night work nurses could be causally related to an increase in the incidence of estrogen-positive breast tumours in this population. Assessing baseline risk of breast cancer in nurses is essential. The objective of this study was to analyze the risk of breast cancer that nurses had in relation to their lifestyle and labour factors related to shift work. A cross-sectional descriptive study through a questionnaire about sociodemographic variables, self-perception of health, and working life was designed. The sample consisted of 966 nurses. The relationship between variables was tested. A binary logistic regression and a classification and regression tree were performed. The most significant labour variables in relation to the risk of breast cancer were the number of years worked (more than 16 years; p < 0.01; OR = 8.733, 95% CI = 2.811, 27.134) and the total years performing more than 3 nights per month (10 or more years; p < 0.05; OR = 2.294, 95% CI = 1.008, 5.220). Also, the nights worked throughout life (over 500; OR = 4.190, 95% CI = 2.118, 8.287) were significant in the analysis. Nurses who had or ever had breast cancer valued their self-perceived health more negatively (p < 0.001) and referred a lower quality of sleep (p < 0.001) than the non-cases nurses. The occupational factors derived from night work could have several impacts on nurses’ health and their family-work balance. Promoting healthy lifestyles, informing about shift work risks, and adjusting shift work schedules are critical methods to decrease the possible effects of circadian disruption in nurses.

Background: New graduate nurses entering the workforce experience numerous barriers to maintaining a healthy lifestyle including shift work, the high cost of healthy foods at the workplace and high levels of exhaustion which reduce motivation to participate in regular physical activity. Research has documented unhealthy lifestyles among nurses across the profession. However, few studies focus on graduates' experiences during their transition into their careers. Aim: To investigate the barriers and enablers to healthy eating and participation in physical activity for new graduate nurses during their first year of clinical practice, and to explore attitudes to participation in workplace health promotion programs. Methods: Semi-structured interviews informed by the socioecological model were conducted with 24 new graduate nurses and analysed using thematic analysis. Findings: Four key themes emerged as barriers to healthy eating and physical activity: time, shift work, work environment, and work culture. Participants indicated a high interest in workplace health promotion programs. Discussion: Limited time and shift work impact on the eating and physical activity behaviours of new graduate nurses which leads to unhealthy snacking to maintain energy, as does high levels of exhaustion, reduced motivation to eat healthy foods, and decreased participation in physical activity. The work culture and environment also influence eating behaviours. Inadequate breaks lead to consumption of foods that are quick to eat but often low in nutrients. Conclusion: New graduate nurses experience the same difficulties in maintaining healthy lifestyles as more experienced nurses. Understanding the barriers which influence their dietary and physical activity behaviours can help inform strategies to improve the health of nurses at a critical time when they enter the nursing workforce.

Nightshift work can negatively impact sleep, performance, and health. Careful manipulation of light exposure patterns can help reduce these negative effects but is challenging in conditions of rapidly rotating shiftwork and due to individual differences. As chronotype is related to shiftwork tolerance, we explored patterns of sleep , sleepiness, and light exposure during the first day of nightshift work between earlier and later chronotypes, based on data from an observational field study among rapidly rotating hospital nurses. Due to the limited sample size, only descriptive analyses and visual inspection were conducted. In line with findings of lower shiftwork tolerance, earlier chronotypes (N=6) seemed to be sleepier during work and sleep less than later types (N=7). Differences were also observed in light exposure patterns, revealing potential for light exposure interventions, and suggesting a contribution to shiftwork tolerance. For future intervention studies in aiming to identify a light exposure strategy, our findings highlight the importance of investigating light exposure relative to the individual circadian phase

The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease.

The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease.

Data from the European Working Conditions Surveys from 2005, 2010, and 2015 for 29 European countries show that the prevalence of nonstandard work schedules (evenings, nights, weekends, and rotating shifts) differs markedly across European regions with different public policies. Working nonstandard schedules also differs by education, gender, and parental status across Europe.

Background: Shift work may impact women more negatively than men due to the increased burden of coping with demanding work schedules while also undertaking more of the domestic chores, including childcare. Aims: To examine whether the combination of shift working and caring for children affects the sleep, fatigue and work–family conflict experienced by women more than it affects men. Methods: Using data from a survey of the Swedish working population, mixed linear regression models examined work schedule (daywork, shift work with nights, shift work without nights), gender and presence of children <13 years at home as predictors of sleep insufficiency, sleep disturbance, fatigue and work–family conflict, over up to three successive measurement occasions. Adjustments were made for age, education, full/part-time working and baseline year. Results: In fully adjusted models (N = 8938), shift work was associated with insufficient sleep (P < 0.01), disturbed sleep (P < 0.01), fatigue (P < 0.05) and work–family conflict (P < 0.001). Interactions in the analyses of sleep disturbance (P < 0.001) and work–family interference (P < 0.05) indicated that among participants with no children, females reported more disturbed sleep and more work–family conflict than their male counterparts, irrespective of schedule; while among participants with children, female dayworkers reported more disturbed sleep than their male counterparts, and females working shifts without nights reported more work–family interference. Conclusions: Having young children did not exacerbate negative effects of shift work, in either men or women. This may reflect high levels of gender equality and childcare provision in Sweden., This work was supported by the Swedish Research Council for Health, Working Life and Welfare under grant 2016-07150 and NordForsk Nordic Program on Health and Welfare under grant 74809.

Having to work working outside the normal ‘9-5’ (e.g. due to shift work, long weekly work hours or flexible working) can affect men and women differently. For example, women’s health is often reported to be more negatively affected by shift working than men, although the evidence of such a gender divide is mixed. Similarly, while some studies suggest that women benefit more from high work-time control, others report women experiencing negative effects of greater work-time control. In reviewing the evidence, we will examine whether women and men have different experiences of working different types of non-standard work hours, and consider what factors might account for those gender differences.

Bakgrund: Nattarbete utgör en hälsorisk ur flera aspekter och har flera konsekvenser liknande de som ohälsosamma matvanor har. Bland lastbilschaufförer förekommer långa körningar där hälsosamma matvanor inte främjas. När arbetet sker under natten förskjuts sömnen och enligt dygnsrytmen infaller en naturlig trötthet vilket kan orsaka problem i form av olyckor. Dygnsrytmen styr även hunger och ämnesomsättning. Syfte: Att undersöka arbetsmåltider och det möjliga sambandet med upplevd trötthet hos lastbilschaufförer under både dagkörningar och nattkörningar. Metod: En webbaserad enkät delades ut på ett företag samt i en Facebookgrupp och besvarades av 43 lastbilschaufförer. Resultat: Resultaten visade att det var kaffe, vatten, smörgåsar och sötsaker som intogs i högst utsträckning. Majoriteten av måltider intogs i lastbilen under körning och under nattkörningen intogs måltider främst vid kl. 20 samt 02. För att motverka trötthet intogs koffein. Samband visade att den upplevda tröttheten ökade när intaget av mat och dryck i lastbilen under körning ökade. Samband visade också att den upplevda tröttheten ökade när intag av mat och dryck vid kl. 00-02 minskade. Ytterligare samband visade att den upplevda tröttheten ökade när möjligheten att själv kunna bestämma tid för mat och dryck minskade. Slutsats: Chaufförers möjligheter att lämna lastbilen samt att själv välja när de vill äta och dricka är relevant att förbättra då det finns ett samband mellan detta och den trötthet chaufförerna upplever under sina körningar, både under dag och natt. Arbetsgivare har möjlighet att utforma arbetsorganisationen så att förbättringar kan underlättas., Aim: To investigate work meals and the possible correlation to sleepiness among truck drivers during both day driving and night driving. Method: A web-based survey was distributed at a company and in a Facebook group. 43 truck drivers responded. Results: The results showed that the most common intake was coffee, water, sandwiches, and sweets. Most of the foods and drinks were consumed inside the truck, while driving. During the night drive foods and drinks were consumed mostly at 8 pm and 2 am. Caffeine was used to counteract sleepiness. Self-reported sleepiness increased as eating or drinking inside the truck, while driving, increased. Sleepiness also increased as eating or drinking at 12 pm-2 am decreased. Another association showed that sleepiness increased as having the option to choose when to eat or drink decreased. Conclusion: Because of the associations found, it is highly relevant to improve truck driver’s opportunities to leave the truck and to have better options in choosing when to eat or drink. Employers have the possibility to make organisational changes to make improvements easier.

Die gesundheitlichen Auswirkungen von Schichtarbeit werden intensiv erforscht, jedoch gibt es Defizite in der Untersuchung sozialer Auswirkungen, die als eine Ursache für Gesundheitsfolgen von Schichtarbeit diskutiert werden. In der vorliegenden Studie wird der Zusammenhang zwischen der Vereinbarkeit von Arbeit und Privatleben und dem Gesundheitszustand von Schichtarbeitern im Vergleich zu Beschäftigten mit Normalarbeitszeiten in einer Mediationsanalyse untersucht. Dazu werden Daten der für Deutschland repräsentativen BIBB/BAuA-Erwerbstätigenbefragung 2018 genutzt. Beschäftigte in Schichtarbeit sind häufiger von erschwerter Vereinbarkeit und psychosomatischen Beschwerden betroffen als Beschäftigte in Normalarbeitszeit. Es wird gezeigt, dass die Vereinbarkeit von Arbeit und Privatleben als Mediator in der Beziehung zwischen Schichtarbeit und psychosomatischen Beschwerden agiert. Dies gilt für Frauen und für Männer. Die Ergebnisse bestätigen die Bedeutung sozialer Auswirkungen von Schichtarbeit als mögliche Ursache für gesundheitliche Beschwerden. Praktische Relevanz: Beschäftigten in Schichtarbeit gelingt es seltener Anforderungen der Lebensbereiche Arbeit und Familie auszubalancieren. Dieser Konflikt geht mit einem gesundheitlichen Risiko einher. Das Wissen um dieses Risiko ist von praktischer Relevanz, da Betriebe die Vereinbarkeit von Arbeit und Privatleben explizit in Maßnahmen betrieblicher Gesundheitsförderung oder bei der regulären Arbeitszeitgestaltung berücksichtigen können. Führungskräfte und Beschäftigte in Schichtarbeit sollten darüber hinaus wissen, dass Probleme in der Vereinbarkeit von Arbeit und Privatleben einen bedeutenden Stressor darstellen., Health consequences of shift work have been investigated intensively, while there is a lack of research on social consequences of shift work, although social consequences have been discussed as a reason for health consequences of shift work. In this present study, we investigate the association between compatibility of work and private life and health status of shift workers compared to employees with regular working hours in a mediation analyses. To do so, we applied data from the German representative BIBB/BAuA employment survey 2018. Employees in shift work showed more often difficulties in the compatibility of work and private life and psychosomatic complaints than employees with regular working hours. The compatibility of work and private life partially mediated the relationship between shift work and psychosomatic complaints. This was the case for men and women. Our results support the importance of social consequences of shift work, one of the possible causes for negative health consequences of shift work. Practical Relevance: Shift workers face more often difficulties in balancing the demands of the areas of work and family life. This conflict has health consequences. The knowledge of this risk is of practical relevance, because companies could explicitly target the compatibility of work and private life in interventions of workplace health promotion or in the regular organization of working time. Leaders and shift workers should be aware that difficulties in the compatibility of work and private life are an important stressor.