Extending a model of shift-work tolerance

The present study contributes to theory and practice through the development of a model of shift-work tolerance with the potential to indicate interventions that reduce nurses' intention toward turnover and increase job satisfaction in hospital-based settings. Survey data from 1257 nurses were used to conduct structural equation modeling that examine the direct and indirect effects of supervisor and colleague support, team identity, team climate, and control over working environment on time-based work/life conflict, psychological well-being, physical symptoms, job satisfaction, and turnover intention. The analysis of the proposed model revealed a good fit The chi-square difference test was non-significant (χ2(26)=338.56), the fit indices were high (CFI=.923, NFI=.918, and NNFI=.868), the distribution of residuals was symmetric and approached zero, the average standardized residual was low (AASR=.04), and the standardized RMR was .072. In terms of the predictor variable, the final model explained 48% of the variance in turnover intention. The data revealed considerable evidence of both direct effects on adjustment and complex indirect links between levels of adjustment and work-related social support, team identity, team climate, and control. Nurses with high supervisor and coworker support experienced more positive team climates, identified more strongly with their team, and increased their perceptions of control over their work environment. This in turn lowered their appraisals of their time-based work/life conflict, which consequently increased their psychological well-being and job satisfaction and reduced their physical health symptoms and turnover intention. The type of shift schedule worked by the nurses influenced levels of turnover intention, control over work environment, time-based work/life conflict, and physical symptoms.

Horário por turnos : análise do seu efeito numa empresa do sector industrial

O presente estudo teve por objetivo analisar os possíveis efeitos do trabalho por turnos, incluindo o turno noturno, a nível da saúde, vida familiar e social, numa empresa do sector da indústria. Foi construído um questionário que abordava questões relativas aos dados sociodemográficos, organização temporal do trabalho, qualidade do sono, exigências da tarefa e envolvimento, saúde, vida familiar e social, e posteriormente foi aplicado a uma amostra de 24 trabalhadores com idades entre os 29 e os 52 anos (41,58±5,79 anos). Os resultados mostram uma tendência para doenças como a obesidade, colesterol elevado e manifestação de sintomas relacionados com problemas digestivos nos trabalhadores que trabalham por turnos à [sic] mais anos. Antes do primeiro turno noturno o tempo de sono é bastante reduzido e fica aquém do tempo que os trabalhadores sentem que necessitam dormir para se sentirem bem. O turno da tarde é o que permite os trabalhadores ficarem com um tempo de sono mais próximo desse “ideal”. Em relação à idade, todos os trabalhadores do grupo etário mais velho manifestam interrupções do sono diurno. Também se verifica um maior descontentamento destes trabalhadores com o tempo livre para realizar atividades que tragam bem-estar. Este estudo contribui para o conhecimento da realidade do trabalho por turnos na indústria e espera-se que desperte a procura de soluções que otimizem a vida destes trabalhadores.

Les stratégies de soutien des infirmières novices travaillant le soir et la nuit en centre hospitalier

Travail dirigé présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en sciences infirmières option administration des services infirmiers

Riesgo cardiovascular de trabajadores de una empresa de hidrocarburos. 2014

Objetivo: Determinar el riesgo cardiovascular de los trabajadores de una empresa de hidrocarburos (E.H) mediante la aplicación de la escala Framingham REGICOR durante el año 2014. Métodos: Se realizó un estudio descriptivo tipo corte transversal a partir de los registros de 700 trabajadores de una empresa de hidrocarburos que tenían una historia clínica laboral con información completa. Resultados: La edad promedio fue de 33,6 años (σ 9,1). Se encontró una prevalencia de HTA (1,4%), tabaquismo (5,7%), hábito de tomar licor (66,4%) y exceso de peso (61,6%). La prevalencia de hipertensión arterial y tabaquismo fue de 1.71% y 5.7% respectivamente, de hipercolesterolemia el 39,00%, de hipertrigliceridemia del 30,14% y el 20,00% de los trabajadores son obesos. El 3,00% (21) de los trabajadores fueron clasificados como de riesgo moderado de sufrir un evento isquémico o hemorrágico en un periodo de 10 años. A pesar que ningún trabajador fue clasificado como riesgo alto, se recomienda se realicen actividades tendientes a que a los trabajadores generen conciencia sobre los riesgos de desarrollar un evento cardiovascular si no se modifican los estilos de vida.

Association between sleep quality and quality of life in nursing professionals working rotating shifts

Objective: To analyze the association between sleep quality and quality of life of nursing professionals according to their work schedules. Methods: A prospective, cross-sectional, observational study was conducted between January and December 2010, with 264 nursing professionals, drawn from 989 subjects at Botucatu General Hospital and stratified by professional category. The Pittsburg Sleep Quality Index and the WHOQOL-bref were administered to evaluate sleep quality and quality of life, respectively. Self-reported demographic data were collected with a standard form. Continuous variables were reported as means and standard deviations, and categorical variables were expressed as proportions. Associations were evaluated using Spearman's correlation coefficient. The association of night-shift work and gender with sleep disturbance was evaluated by logistic regression analysis using a model adjusted for age and considering sleep disturbance the dependent variable. The level of significance was p < 0.05. Results: Night-shift work was associated with severe worsening of at least one component of sleep quality in the model adjusted for age (OR = 1.91; 95% CI 1.04; 3.50; p = 0.036). Female gender was associated with sleep disturbance (OR = 3.40; 95% CI 1.37; 8.40; p = 0.008). Quality of life and quality of sleep were closely correlated (R = -0.56; p < 0.001). Conclusions: Characteristics of the nursing profession affect sleep quality and quality of life, and these two variables are associated.

Job satisfaction and discrepancies between social and biological timing

The discrepancies between social and biological timing are reflected in shift workers' well-being. The aim of this study was to verify the association between job satisfaction and chronotype among day and night nursing personnel. Several variables, including seniority at the hospital and, in the same shift, sleep duration, quality of sleep, sleepiness and willingness to change sleep timing were also analyzed. Chronotype was calculated by using the morningness-eveningness questionnaire. We studied 514 nursing professionals from a public university hospital. Among the day workers, the higher the morningness, the more the workers were satisfied with their job. In contrast, among night workers, job satisfaction was associated with sleep quality and seniority at the hospital but not with chronotype. Our results suggest that an agreement between work schedule and chronotype may help to increase job satisfaction among diurnal workers.

Trabajo nocturno e índice de masa corporal en los trabajadores de la salud : una revisión de la literatura

Introducción: Se considera el trabajo rotativo nocturno como aquel que se lleva a cabo fuera de las horas laborales diurnas. Se ha planteado que el trabajo en horas nocturnas podría estar relacionado con diversos desordenes, dentro de ellos un incremento en el índice de masa corporal con el consecuente desarrollo de sobrepeso y obesidad. El objetivo de este estudio es realizar una revisión de la literatura existente, acerca del trabajo rotativo nocturno y su relación con el índice de masa corporal (IMC) en trabajadores de la salud. Métodos: Se realizó una revisión sistemática de información publicada en los últimos 10 años en la base de datos PUBMED y se seleccionaron únicamente los artículos de texto completo relacionados con este tema en los idiomas inglés, español e italiano. Resultados: A través de la búsqueda se encontraron 10 artículos que cumplieron los criterios de inclusión definidos. Predominantemente se obtuvieron estudios de diseño transversal. Tres de estos estudios encontraron una asociación entre trabajo rotativo nocturno actual e incremento en el IMC y por el contrario dos estudios no hallaron esta asociación. Por otro lado, seis estudios coinciden en una asociación positiva entre mayor tiempo acumulado en trabajo rotativo nocturno y un incremento en el IMC. Conclusiones: Los hallazgos encontrados en los estudios analizados apuntan a la existencia de una estrecha relación entre el aumento del Índice de Masa Corporal (IMC) con los turnos nocturnos (o rotativos que incluyen este horario) llevados a cabo de manera prolongada, en los trabajadores de la salud, en comparación con los trabajadores que realizan turnos diurnos regulares.

Sleep, ageing and night work

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Weight gain in relation to night work among nurses

Objective: To investigate the relationship between working at night and increased body weight in nursing. In addition, we evaluated the differences in the proportion of variables sociodemographic, work and health, according to the work shift and their association with body mass index. Methods: Based on questionnaires, we obtained data from 446 nursing professionals about aspects of their job, health and lifestyle. We performed linear and logistic regression analysis. Results: Working at night is associated with a weight gain greater than (beta=0.24 kg/m(2)) working during the day (beta=0.15 kg/m(2)), as well as with aging (beta=0.16 kg/m(2)) and duration of working in nursing (beta=0.18 kg/m(2)). Night workers have a higher educational level, have been working for more years in nursing and also in the current shift, do not have diabetes and have reported longer sleep than day workers. There are also a higher number of smokers among the night workers than day workers. Logistic regression analysis also showed the more time to work in nursing and as an assistant was more likely to develop overweight/obesity. Conclusion: Working at the night contributes to more weight gain than the day shift, aging and duration of working in nursing.

Towards Night

Sixty artists explore the nocturnal. Curated by Tom Hammick. The evening hour too gives us the irresponsibility which darkness and lamplight bestow. We are no longer quite ourselves. – Virginia Woolf, Street Haunting: A London Adventure, 1930 Towards Night is an exhibition exploring the nocturnal through paintings, prints and drawings by over sixty artists. Drawing on the nineteenth century European Romantic tradition, the show surveys contemporary and historical connections to wonderment and dystopia at dusk, twilight, night and dawn. Towards Night juxtaposes key paintings and prints by Constable, Friedrich, Munch, Nolde, Palmer and Turner, some of the best known visionaries of the Romantic tradition with contemporary artists who work with the transformative aspects of nightfall to convey emotional responses of awe, anxiety and solitude, love and loss, revelry, insomnia, and journey’s end. The exhibition opens with direct and positive responses to the natural world; Marc Chagall’s exotic dreamlike evening in The Poet Reclining (1915) sits close to eighteenth century Indian miniatures depicting brightly painted figures offset against darkening monsoon clouds, and William Crozier’s Balcony at Night, Antibes (2007), of a plant, blue and iridescent against the cool night sky. As the exhibition progresses, the dystopias become darker and more disturbing, and the connections between artists and works intensify: Emma Stibbon’s Rome Aqueduct (2011) takes on a heightened sense of pathos alongside Caspar David Friedrich’s Winter Landscape (1811); Peter Doig’s cinematic Echo Lake (1998) conjures up an increased sense of contemporary angst; and Prunella Clough’s False Flower (1993), a magical tree defying brutalism by growing out of concrete, becomes more miraculous near Night Shift (2015) Nick Carrick’s tomblike high rise. Tom Hammick’s Violetta Alone (2015) and Michael Craig Martin’s Ash Tray (2015), reinforce hedonistic aspects of night-time revelry alongside Four AM, Betsy Dadd’s young woman drinking in the early hours of the morning and L.S. Lowry’s drunken people in a pub in The Crowd (1922). In the final room, a cluster of works explores dreams and insomnia, from Louise Bourgeois’ Spirals (2010) to Munch’s lovers embracing in The Kiss (1902). Tom Hammick, curator of the show said “This exhibition has grown way beyond its original conception, to become a magnificent survey of painting and printmaking from over two hundred years based around the central tenet of night. The exhibition is a kind of painterly response to the way figurative artists use their artistic heroes as starting points for their own work, both compositionally and emotionally.” Artists featured in Towards Night: Christiane Baumgarter, Michael Craig-Martin, Julian Opie, Will Gill, Merlin James, Howard Hodgkin, WillIam Scott, Patrick Caulfield, George Shaw, Stephen Chambers, Basil Beattie, Betsy Dadd, Christopher Le Brun, L.S Lowry, Andrew Cranston, David Willetts, James Fisher, Emma Stibbon, Vija Celmins, William Blake, William Crozier, Tom Hammick, Georgia Keeling, Helen Turner, Humphrey Ocean, Julian Bell, Craigie Aitchison, Mark Wright, Ken Kiff, Matthew Burrows, Andrzej Jackowski, Sarah Raphael, Nick Bodimeade, Nick Carrick, Mary Newcomb, Hurvin Anderson, Peter Doig, Phoebe Unwin, Danny Markey, Sara Lee, Simon Burton, Susie Hamilton, Marc Chagall, Alfred Wallis, Emil Nolde, J.M.W. Turner, Prunella Clough, Samuel Palmer, Louise Bourgeois, Caspar David Friedrich, Alex Katz, Ewan Gibbs, Susie Hamilton, Andrzej Jackowski, Amanda Vesey, Edward Stott, Gertrude Hermes, Rose Wylie, Sidney Nolan, John Constable, J.M.W. Turner, Emil Nolde, Hiroshige, Edvard Munch, Samuel Palmer, Eileen Cooper, Charles Neame-Spencer, Samantha Cary.

Sketching the temporal landscape : The case of night nursing

We take for granted that we exist in dimensions of time and space. We accept that time passes and that space extends as a matter of course. Just as our personal space is important to us, so is time of our own. The individual is capable of developing a variety of time perspectives or orientations, each applicable to a different aspect of life, for instance, home, leisure, economic, political and organisational. Our temporal perspective influences a wide range of psychological processes, from motivation, emotions and spontaneity to risk-taking creativity and problem-solving. Our temporal landscapes are made up of recognisable domains, with permeable borders – private time and public time, home time and work time, past, present and future time, cyclical time. Just as a geography of space contains recognisable natural features – rivers, deserts, mountains – and features created by human beings – canals, roads, skyscrapers – so our temporal landscape contains natural features – day and night, the seasons – and features created by us – the ordering of social, economic, legal, and organisational time into, among others, the practices of family life, financial periods, prison sentences and workloads. This paper views the temporal landscapes of night nurses, and is based on longitudinal ethnographic research. It highlights areas such as shift work, workload, and the temporal aspects of caring. The result is the production of a map, albeit a rough one, of the temporal landscape inhabited by night nurses as they go about their working lives.

Melatonin synthesis : a possible indicator of intolerance to shiftwork

Hypothesis Melatonin synthesis, which is directly controlled by the central circadian pacemaker indicates the circadian phase better than rectal temperature. Methods: Thirty four men (16-32 years, 7 morning, 13 neither, 14 evening types) performed a constant routine (24-26-hr bedrest, < 30 lux, 18-20°C, hourly isocaloric diet). Salivary melatonin level was determined hourly and rectal temperature was continuously recorded. Results: The nadir of rectal temperature occurred 1.5 hr (P = 0.017), the onset of melatonin synthesis 3 hr earlier (P < 0.0001) in morning than in evening types. Morningness was not related to the quantitative but significantly to the temporal parameters, closer to those of melatonin than of rectal temperature. Conclusions: The melatonin onset is a more reliable indicator of the diurnal type than the nadir of rectal temperature. As morningness has been associated with intolerance to shiftwork, melatonin profiling provides a suitable basis for the establishment of directed preventive measures.

Circadian Rhythm Disruptions and Health

The doctoral thesis defined connections between circadian rhythm disruptions and health problems. Sleep debt, jet-lag, shift work, as well as transitions into and out of the daylight saving time may lead to circadian rhythm disruptions. Disturbed circadian rhythm causes sleep deprivation and decrease of mood and these effects may lead to higher accident rates and trigger mental illnesses. Circadian clock genes are involved in the regulation of the cell cycle and metabolism and thus unstable circadian rhythmicity may also lead to cancer development. In publications I-III it was explored how transitions into and out of the daylight saving time impact the sleep efficiency and the rest-activity cycles of healthy individuals. Also it was explored whether the effect of transition is different in fall as compared to spring, and whether there are subgroup specific differences in the adjustment to transitions into and out of daylight saving time. The healthy participants of studies I-III used actigraphs before and after the transitions and filled in the morningness-eveningness and seasonal pattern assessment questionnaires. In publication IV the incidence of hospital-treated accidents and manic episodes was explored two weeks before and two weeks after the transitions into and out of the daylight saving time in years 1987-2003. In publication V the relationship between circadian rhythm disruption and the prevalence of Non-Hodgkin lymphoma was studied. The study V consisted of all working aged Finns who participated in the national population census in 1970. For our study, all the cancers diagnosed during the years 1971-1995 were extracted from the Finnish Cancer Register and linked with the 1970 census files. In studies I-III it was noticed that transitions into and out of the daylight saving time disturbs the sleep-wake cycle and the sleep efficiency of the healthy participants. We also noticed that short sleepers were more sensitive than long sleepers for sudden changes in the circadian rhythm. Our results also indicated that adaptation to changes in the circadian rhythm is potentially sex, age and chronotype-specific. In study IV no significant increase in the occurrence of hospital treated accidents or manic episodes was noticed. However, interesting observations about the seasonal fluctuation of the occurrence rates of accidents and manic episodes were made. Study V revealed that there might be close relationship between circadian rhythm disruption and cancer. The prevalence of Non-Hodgkin lymphoma was the highest among night workers. The five publications included in this thesis together point out that disturbed circadian rhythms may have adverse effect on health. Disturbed circadian rhythms decrease the quality of sleep and weaken the sleep-wake cycle. A continuous circadian rhythm disruption may also predispose individuals to cancer development. Since circadian rhythm disruptions are common in modern society they might have a remarkable impact on the public health. Thus it is important to continue circadian rhythm research so that better prevention and treatment methods can be developed. Keywords: Circadian rhythm, daylight saving time, manic episodes, accidents, Non-Hodgkin lymphoma 11

Programa de Reflexões e Debates para a Consciência Negra uma experiência d implementação da Lei n. 10.639 de 2003

O Programa de Reflexões e Debates para a Consciência Negra é um projeto político-pedagógico que desenvolveu uma metodologia de implementação da Lei n. 10.639 de 2003 em todas as disciplinas que compõem o currículo escolar do ensino médio. Esse projeto é realizado em uma unidade escolar de formação de ensino médio, situada no bairro de Quintino Bocaiúva, zona norte, da cidade do Rio de Janeiro, entre os anos de 2004 e 2008, especificamente no turno da noite. A promulgação dessa lei criou a obrigatoriedade de inserção dos conteúdos de História Africana e Cultura Afro-brasileira, nos currículos escolares em âmbito nacional. A partir da metodologia desenvolvida pelo Programa de Reflexões e Debates para a Consciência Negra, investigam-se, no presente trabalho, os sujeitos educativos, as práticas pedagógicas, a cultura escolar e as tensões e negociações cotidianas que ocorreram no processo de realização dessa nova proposta curricular. Para a realização desta análise foram utilizadas como aporte teórico-metodológicos teorias de Análise de Discurso (AD), estudos culturais sobre currículo e estudos etnográficos dos espaços educativos, para se compreender o contexto escolar e suas (re)configurações. As análises revelaram que a implementação da lei provocou a construção e reconstrução interna de estratégias e metodologias de trabalho. E que estas ações institucionalizaram internamente esta prposta curricular como missão institucional escolar, e ao mesmo tempo, a projetou para fora dos muros escolares criando diálogos e parcerias com demais setores da sociedade.

Consequências do trabalho por turnos e nocturno em profissionais de enfermagem (estudo realizado em dois hospitais do norte de Portugal)

Dissertação de Mestrado apresentada à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Psicologia.