暂无摘要。

Delivering 24 h healthcare requires rotational shift work from doctors and the medical imaging team, while contributing to safe and timely care of patients. Additional service pressure and staff shortfall leads to workload pressures, adjusted shift patterns and risk of burnout. Evidence should be sought to the effects of this work on staff.
This systematic review followed PRISMA reporting guidelines, using a convergent mixed methods approach according to Guidance from Joanna Briggs International. Quantitative trends and results were qualified in order to thematically analyse in conjunction with qualitative data and discussed together in context. Following initial searching, returned articles were screened by title and abstract. A team of 3 reviewers undertook blinded critical appraisal of those suitable, with quality assurance from a 4th team member. Papers passing a threshold of 75% on JBI appraisal tools were accepted for synthesis. Data extraction of appropriate articles retrieved was undertaken in parallel.
Following screening and critical appraisal, 13 studies were returned focusing exclusively on Non Consultant Doctors. No studies investigated diagnostic radiographers. 85% (n = 11) reported negative association between shift work and the three themes of sleep/fatigue, burnout and wellbeing: including after the introduction of shift pattern control or adjusted shift patterns. The remainder showed no change, or any improvement nullified by countermeasures to maintain service delivery.
Current working practices and shift plans in the target population showed detrimental effects on the participants - this can be suggested that Diagnostic Radiographers may suffer fatigue, burnout and poor mental health from stretched shift working patterns.
Further study into the effects of shift work on Diagnostic Radiographers and other allied health professionals is indicated - relating to the above themes in the context of errors and patient safety. Additional research into Non Consultant Doctors, shift work effects and the context of wider service delivery required; with suitable interventions and education to maximise understanding of legal working practices, monitoring and self-management of symptoms.

BACKGROUND: The association between shift/night work and the risk of stroke is not supported by strong evidence.
OBJECTIVE: This study aimed to obtain evidence of a potential relationship between shift/night shift work and the risk of stroke.
METHODS: We searched PubMed, Embase, the Cochrane Library and Web of science databases for eligible studies from inception to January 19, 2024. We followed the statement in the Preferred Reporting Items for Systematic Evaluations and Meta-Analysis (PRISMA). STATA 14.0 software was used for meta-analysis.
RESULTS: A total of five studies involving 700,742 subjects were included in this meta-analysis. We found that shift/night workers had a 1.08 times higher risk of stroke than non-shift/night workers (RR: 1.08; 95 % CI: 1.05-1.10; P < 0.001).
CONCLUSIONS: Shift/night work may be a risk factor for stroke. More objective prospective studies are needed to further support this result.

BACKGROUND: Coronary artery disease (CAD) prevention in shift workers (SWs) poses a significant challenge worldwide, as CAD remains a major cause of mortality and disability. In the past, SWs were found at higher risk of CAD than non-s SWs. Nevertheless, the pathogenic mechanism between shift work and CAD to date is unclear. This systematic review aims to enhance understanding of the risk of CAD occurrence in SWs.
METHODS: A systematic literature review was conducted from January 2013 to December 2023. MEDLINE/Pubmed databases were used initially, and additional relevant studies were searched from references. Shift work was defined as any schedule outside traditional shifts, including the night shift.
RESULTS: Fifteen pertinent papers were categorized into risk assessment or risk management. Findings demonstrated an increased risk of CAD among SWs compared to non-SWs, with an increased CAD risk observed for both shift work and night shift work.
CONCLUSIONS: Duration-response associations indicate that greater shift exposure is linked to higher CAD risk. SWs incur an increased risk of CAD through the atherosclerotic process. As shift work duration increases as the risk of atherosclerosis is higher, workers demonstrate a higher prevalence and severity of coronary artery plaques.
CONCLUSIONS: The evidence-based results underscore the increased risk of CAD in SWs and are sufficient for proposing guidelines aimed at reducing the risk of CAD in SWs and at managing people with CAD in return to work characterized by disrupted circadian rhythms.

This systematic review and meta-analysis (PROSPERO registration CRD42022309827) aimed to describe how shift work impacts new workers\' sleep, mental health, and physical health during the transition to shift work and to consolidate information regarding predictors of shift work tolerance (SWT) during this transition period. Inclusion criteria included: new shift workers; sleep, mental health, or physical health outcomes; prospective study design with the first timepoint assessing workers within three months of starting shift work; and written in English. Searches from six databases returned 12,172 articles as of August 2023. The final sample included 48 papers. Publication quality and risk of bias was assessed using the critical appraisal skills program. Forty-five studies investigated longitudinal changes in sleep, mental health, or physical health outcomes and 29 studies investigated predictors of SWT (i.e., better sleep, mental and physical health). Sleep and mental health outcomes worsened following the onset of shift work, while physical health did not significantly change. Pre-shift work mental health, sleep, and work characteristics predicted SWT later in workers\' careers. Shift work adversely impacts new workers\' sleep and mental health early in their career, and interventions before beginning shift work are needed to promote better SWT.

BACKGROUND: Hypertension, a major public health problem worldwide, has been linked to lifestyle factors and work conditions, with conflicting evidence on the association between long work hours and risk of hypertension.
METHODS: We conducted a systematic review and meta-analysis of observational studies to investigate the relationship between working hours and hypertension or blood pressure, assessed the risk of bias and performed subgroup analyses. The protocol was registered with the International Prospective Register of Systematic Reviews.
RESULTS: The pooled OR for the association between long working hours and risk of hypertension was 1.09 (95% CI: 0.88 to 1.35) in the 15 studies that used hypertension as the outcome. In the three studies that used blood pressure as the outcome, diastolic blood pressure was higher among those with long working hours compared with those with non-long working hours (1.24 mm Hg, 95% CI: 0.19 to 2.29). In subgroup analysis, the pooled OR for the association between long working hours and risk of hypertension was 1.28 (95% CI: 1.14 to 1.44) and 1.00 (95% CI: 0.64 to 1.56) in women and men, respectively.
CONCLUSIONS: Although this study could not clearly confirm the relationship between long working hours and hypertension, the subgroup analysis suggests that long working hours may be associated with hypertension, particularly among women. More reliable research is needed to establish causality.
UNASSIGNED: CRD42023406961.

Shift work involves working outside the standard working hours of 9 am to 5 pm Monday to Friday and may include working evening, night, weekend, or rotating shift patterns. Since shift workers sleep less and their circadian rhythms are disrupted, they are reported to have higher body weight than day workers.
This meta-analysis aims to determine whether shift workers (SW) are more prone to higher body mass index (BMI) than their day workers (DW) counterparts. It also addresses the question of whether the duration of shift work exposure, sex, or occupational type affect BMI value.
Four databases that is PubMed, EBSCO Host, Scopus, and Web of Science were searched for reports published up to October 2023.
Sixty-three studies involving a total of 693 449 participants met our inclusion criteria. Meta-analyses showed a significant effect of shift work on BMI value (standard mean difference; SMD: 0.10 kg/m2 [95% confidence interval; 95% CI: 0.07; 0.13; p < .001]) as compared with non-shift counterparts. Subgroup analysis revealed that shift work significantly increased BMI for studies where male working on this job schedule (SMD: 0.10 kg/m2 [95% CI: 0.04; 0.17; p = .0018]) for studies where shift workers worked ≥13 years (calculated as the median of shift work experience; SMD: 0.14 kg/m2 [95% CI: 0.10; 0.18; p < .001]) as well as for studies where industrial (SMD: 0.12 kg/m2 [95% CI: 0.05; 0.19; p = .0012]) and other type of occupations were dominated (0.12 kg/m2 [95% CI: 0.07; 0.16; p < .001]).
We found that in general working on a shift schedule increases BMI as compared with day workers, especially in case of male employed in this job schedule, for shift workers working for long periods of time (≥13 years), and for shift workers employed in industry and other type of occupations(e.g., airline workers, firefighters, police officers, blue collar, security personnel, bus drivers, garbage collectors, railway workers, postal, oil and gas workers).

OBJECTIVE: The aim was to conduct a systematic review and meta-analysis to study the association between night work and the development of prostate cancer.
METHODS: A systematic literature search was conducted in CINAHL, Embase, MEDLINE, and Web of Science. Studies were included based on a PECOS; the population included men in/above the working age, exposure defined as night work, outcome defined as prostate cancer, and study design restricted to cohort studies. The exclusion of articles, risk-of-bias assessment, and data extraction were performed by two reviewers. A meta-analysis was conducted using a random-effects model, including a sensitivity analysis stratified based on the risk-of-bias assessment. We evaluated publication bias using a funnel plot and Egger´s test, and the level of evidence was assessed using GRADE.
RESULTS: A total of 528 articles were identified, and eight cohort studies were included. Three studies had a moderate risk of bias, while five studies had a high risk of bias. The meta-analysis showed a pooled hazard ratio (HR) of 1.0 (95% CI 0.6-1.7). In the sensitivity analysis, moderate vs. high risk-of-bias studies showed a pooled HR of 1.2 (95% CI 0.3-4.1) and 0.9 (95% CI 0.6-1.3), respectively. Based on GRADE, the level of evidence was rated low.
CONCLUSIONS: We found no association between night work and the development of prostate cancer. The evidence was assessed as limited and inconsistent. Future studies encompassing consistent definitions of night work, including objective exposure data, are highly warranted.

OBJECTIVE: to analyze sleep quality of nurses who worked coping with COVID-19 in scientific evidence.
METHODS: an integrative review, carried out in seven databases, including studies between December 2021 and June 2022, without language restrictions. The sample consisted of 15 primary studies.
RESULTS: nurses working in hospital, intensive care, outpatient care and teaching institutions constitute a vulnerable group for sleep disorders: latency, duration, efficiency and quality. The disorders identified involved insomnia at varying levels of severity: daytime dysfunction and morning sleepiness. Night work and low capacity for self-care were determinants of impaired sleep patterns.
CONCLUSIONS: the COVID-19 pandemic contributed to greater vulnerability of nurses to changes in sleep, requiring strategies for risk management and well-being promotion.

We examined the breadth and depth of the current evidence investigating napping/sleeping during night shift work and its impact on non-invasive measures of endothelial function. We used a scoping review study design and searched five databases: Ovid Medline, EMBASE, Ovid APA PsycInfo, Web of Science Core Collection, and EBSCO CINAHL. We limited our search to English language and publications from January 1980 to September 2022. Our reporting adhered to the PRISMA-ScR guidance for scoping reviews. Our search strategy yielded 1949 records (titles and abstracts) after deduplication, of which 36 were retained for full-text review. Five articles were retained, describing three observational and two experimental research studies with a total sample of 110 individuals, which examined the non-invasive indicators of endothelial function in relation to the exposure to night shift work. While there is some evidence of an effect of night shift work on the non-invasive indicators of endothelial function, this evidence is incomplete, limited to a small samples of shift workers, and is mostly restricted to one measurement technique for assessing endothelial function with diverse protocols. In addition, there is no identifiable research investigating the potential benefits of napping during night shift work on non-invasive measures of endothelial function.