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Background: For many years, occupational physicians have debated whether there is a link between working the night shift and depression and other co-occurring mental health issues, with an emphasis on work-related, biological, individual, and environmental factors. We performed this systematic review and meta-analysis to estimate the overall association between sleep deprivation and depression among nurses working night shifts. Methods: A systematic search as carried out across the electronic databases PubMed, Scopus, and Web of Science from inception to 30 September 2022, for studies that reported a relationship between estimated night shift work and depression in nurses. The outcomes were measured using the odds ratio (OR) and matching 95% confidence interval (CI). The I2 statistic was used to assess heterogeneity. The Grading of Recommendations Assessment, Development and Evaluation technique was used to evaluate the quality of the evidence, and the Newcastle–Ottawa Scale was utilized to assess the methodological quality of each of the included studies. We determined the overall relationship between working nights and the onset of depression. Results: A total of 20 studies were included in the systematic review. Furthermore, 8 studies were included in the meta-analysis due to their common use of the OR as an effect measure. The 8 studies gave an overall estimate indicating a statistically significant association between night shift work and depression among nurses (OR = 1.49 95% CI: 1.26, 1.76). The prediction interval for the overall estimate was (0.995, 2.231). This implies that the true OR in a future study would most likely fall within this range, with a 95% certainty. Conclusions: The outcome of this systematic review and meta-analysis showed a significant association between night shift work, the circadian and sleep disruption it causes, and the risk of depression in nurses. This demonstrates that nurses who work night shifts are at risk of developing depression. publishedVersion

The objective of this study was to evaluate the relia-bility and validity of the lifestyle (Miller-Smith) and life expectancy (Schneider) questionnaires in the Italian setting in order to make this instrument available for the determination of lifestyle and hope level in the different domains of everyday life.Before testing their psychometric properties, the original versions of the two questionnaires, lifestyle (Miller-Smith) and life expectancy (Schneider), were translated into the Italian language. We tested the instrument's psychometric properties on a sample of 18 patients over 60 years old with Alzheimer's disease in the Sapienza University of Rome teaching hospital, policlinico Umberto 1. Internal consistency was considered to assess the reliability of the results across items within the adopted scale by using Cronbach's α coefficient. Using Kolmogorov-Smirnov's test, the normality distribution was evaluated to guarantee the applicability of a parametric or non-parametric test. The software used to analyze data was SPSS version 26 for Windows.According to the outcome of our statistical analysis, the lifestyle scale showed high overall internal consistency, and the Cron-bach's α coefficient for the total 20-item scale was 0.80 in the Italian population. On the other hand, using the 12-item questionnaire about life expectancy resulted in a high overall internal consistency of 0.93, according to the Cronbach's alpha test.The outcome of our study shows that the Italian versions of the lifestyle (Miller-Smith) and life expectancy (Schneider) questionnaires demonstrated good psychometric properties and good characteristics of factorial validity for future epidemiological studies aimed at evaluating lifestyle and lifestyle expectancy in the Italian population and can as well be used in clinical practice and research.

Nurses working rotating shifts (RS) are at risk of circadian rhythm disruption, which can affect sleep quality and can lead to emotional stress, anxiety, and depression. Aerobic exercise is a type of repetitive and structured physical activity that involves the metabolic system, which utilizes oxygen to produce energy and has been demonstrated to improve shift-workers' health and well-being. The main purpose of engaging in regular moderate-intensity aerobic exercise is to improve cardiopulmonary fitness and functional capacity. When engaging in moderate-intensity aerobic exercise, the increase in arterial pressure is accompanied by a simultaneous increase in heart rate, which signifi-cantly contributes to the rise in blood pressure, which is reversed after exercise due to an increase in parasympathetic activity and a decrease in sympathetic activity. Moderate-intensity aerobic exercise includes walking at a moderate pace, water aerobics, dancing, recreational swimming, gardening, table tennis, and stair climbing at a moderate pace and represents a cost-effective health promotion strategy for im-proving sleep quality and duration. Adherence to a moderate-intensity aerobic exercise program may increase both sleep quality and duration by improving melatonin concentrations, endocrine activities, heart rate and slow wave sleep among nurses working RS. Occupational medicine practitioners should consider creating a workplace health promotion program that incorporates moderate-intensity aerobic exercise for RS-nurses to minimize the impact of shift work on their sleep quality.