Correlates shift work with increased risk of gastrointestinal complaints or frequency of gastritis or peptic ulcer in H. pylori-infected shift workers?

Physical and psychological health in intern paramedics commencing shift work: Protocol for an exploratory longitudinal study

BACKGROUND

Paramedics are routinely exposed to shift work. Existing research shows that shift work exposure is associated with adverse mental and physical health outcomes. However, the current understanding of the impact of commencing shift work in a paramedic role on health is limited. This can be addressed by recruiting new paramedics before they commence shift work, and conducting regular follow-ups of potential biological, psychological and social changes. The present study aimed to examine changes in biological, psychological and social factors relative to pre-shift work baseline in a cohort of paramedics commencing intern employment with an Australian ambulance service.

METHOD AND ANALYSIS

This observational, mixed-methods, longitudinal study aims to recruit 40 interns from one Australian ambulance service. Data collection will occur at baseline (standard day schedule for initial training), and subsequently at three months, six months, nine months and twelve months, to measure biological, psychological and social changes relative to baseline measurements. Changes in cardiometabolic markers (cholesterol, triglycerides, fasting glucose), microbiome (self-collected stool samples), sleep and physical activity (actigraphy) will be measured. Interns will also complete a battery of self-report questionnaires, sleep diaries and qualitative interviews to explore various psychological and social variables over time. Statistical analyses will be conducted using mixed effects regression, specifying a random effect of subject on the intercept, allowing participants to vary according to individual baseline levels, as well as tracking progress over time, appropriately accounting for serial correlation. Qualitative study components will be analysed via coding and thematic analysis procedures.

DISCUSSION

The present study protocol is a comprehensive outline of the observational study planned. The study will allow for greater knowledge of any changes in biological, psychological and social factors during a 12-month transition to shift work. The findings from the proposed study will have implications for the development of strategies to support early-career shift workers.

The Short-Day Cycle Induces Intestinal Epithelial Purine Metabolism Imbalance and Hepatic Disfunctions in Antibiotic-Mediated Gut Microbiota Perturbation Mice

Intestinal microbiota dysbiosis is related to many metabolic diseases in human health. Meanwhile, as an irregular environmental light–dark (LD) cycle, short day (SD) may induce host circadian rhythm disturbances and worsen the risks of gut dysbiosis. Herein, we investigated how LD cycles regulate intestinal metabolism upon the destruction of gut microbes with antibiotic treatments. The growth indices, serum parameters, concentrations of short-chain fatty acids (SCFAs), and relative abundance of intestinal microbes were measured after euthanasia; intestinal contents, epithelial metabolomics, and hepatic transcriptome sequencing were also assessed. Compared with a normal LD cycle (NLD), SD increased the body weight, spleen weight, and serum concentration of aspartate aminotransferase, while it decreased high-density lipoprotein. Meanwhile, SD increased the relative abundance of the Bacteroidetes phylum while it decreased the Firmicutes phylum in the gut of ABX mice, thus leading to a disorder of SCFA metabolism. Metabolomics data revealed that SD exposure altered gut microbial metabolism in ABX mice, which also displayed more serious alterations in the gut epithelium. In addition, most differentially expressed metabolites were decreased, especially the purine metabolism pathway in epithelial tissue. This response was mainly due to the down-regulation of adenine, inosine, deoxyguanosine, adenylsuccinic acid, hypoxanthine, GDP, IMP, GMP, and AMP. Finally, the transcriptome data also indicated that SD has some negative effects on hepatic metabolism and endocrine, digestive, and disease processes. Overall, SD induced an epithelial and hepatic purine metabolism pathway imbalance in ABX mice, as well as the gut microbes and their metabolites, all of which could contribute to host metabolism and digestion, endocrine system disorders, and may even cause diseases in the host.

The Interaction Effects of Burnout and Job Support on Peptic Ulcer Disease (PUD) among Firefighters and Policemen

Policemen and firefighters encounter numerous emergency events that frequently lead to high burnout and low job support, resulting in adverse health effects. A number of studies reported the correlation between job characteristics and the risk of peptic ulcer diseases (PUD) across various industries. However, there is very little research on evaluating the interaction effects of burnout and job support on the prevalence of PUD among firefighters and policemen. The objective of this study was to assess the interactional effects between burnout and job support on the prevalence of PUD among firefighters and policemen. This was a cross-sectional quantitative study. Registered, full-time police officers and firefighters in Taiwan were anonymously interviewed by a mail-delivered questionnaire. All female workers were excluded due to different job characteristics and a limited sample size. A total of 9328 firefighters and 42,798 policemen completed the questionnaire, with a response rate of 78.7%. Overall, prevalence rates of self-reported and self-reports of physician-diagnosed PUD were 8.3% and 6.5% for policemen and 7.1% and 5.5% for firefighters, respectively. There was a 22% reduced odds ratio of PUD as diagnosed by physicians for the group with low burnout and high job support, but an increased odds ratio of 53% for the group with high burnout and low job support, after adjusting for lifestyle and demographic variables. There must be an increase of job support and reduction of burnout through the modification of work structure and setting up of counseling services to reduce workplace stress and the prevalence of PUD among policemen and firefighters.

Circadian rhythms: a regulator of gastrointestinal health and dysfunction

Circadian rhythms regulate much of gastrointestinal physiology including cell proliferation, motility, digestion, absorption, and electrolyte balance. Disruption of circadian rhythms can have adverse consequences including the promotion of and/or exacerbation of a wide variety of gastrointestinal disorders and diseases. Areas covered: In this review, we evaluate some of the many gastrointestinal functions that are regulated by circadian rhythms and how dysregulation of these functions may contribute to disease. This review also discusses some common gastrointestinal disorders that are known to be influenced by circadian rhythms as well as speculation about the mechanisms by which circadian rhythm disruption promotes dysfunction and disease pathogenesis. We discuss how knowledge of circadian rhythms and the advent of chrono-nutrition, chrono-pharmacology, and chrono-therapeutics might influence clinical practice. Expert opinion: As our knowledge of circadian biology increases, it may be possible to incorporate strategies that take advantage of circadian rhythms and chronotherapy to prevent and/or treat disease.

Deregulated expression of circadian clock genes in gastric cancer

BACKGROUND

Gastric cancer (GC), an aggressive malignant tumor of the alimentary tract, is a leading cause of cancer-related death. Circadian rhythm exhibits a 24-hour variation in physiological processes and behavior, such as hormone levels, metabolism, gene expression, sleep and wakefulness, and appetite. Disruption of circadian rhythm has been associated with various cancers, including chronic myeloid leukemia, head and neck squamous cell carcinoma, hepatocellular carcinoma, endometrial carcinoma, and breast cancer. However, the expression of circadian clock genes in GC remains unexplored.

METHODS

In this study, the expression profiles of eight circadian clock genes (PER1, PER2, PER3, CRY1, CRY2, CKIϵ, CLOCK, and BMAL1) of cancerous and noncancerous tissues from 29 GC patients were investigated using real-time quantitative reverse-transcriptase polymerase chain reaction and validated through immunohistochemical analysis.

RESULTS

We found that PER2 was significantly up-regulated in cancer tissues (p < 0.005). Up-regulated CRY1 expression was significantly correlated with more advanced stages (stage III and IV) (p < 0.05).

CONCLUSIONS

Our results suggest deregulated expressions of circadian clock genes exist in GC and circadian rhythm disturbance may be associated with the development of GC.

The impact of shiftwork on health: a literature review

AIMS AND OBJECTIVES

To identify the impact of shiftwork on individuals and their lives and to discuss the implications this has for nurses and nursing.

BACKGROUND

The context of shiftwork in the early 21st century is changing rapidly, and those involved in or required to work shiftwork are now spread over many different sectors of the community. In the Australian community, 16% of workers regularly work shiftwork. Most nurses undertake shiftwork at some time in their career, and health services could not operate without a shiftworking nursing workforce.

DESIGN

Narrative literature review.

METHODS

A narrative review of journal articles was conducted. Databases searched were CINAHL, EBSCO Host, JSTOR, Medline/PubMed and Google Scholar. Search terms used were 'shiftwork' and 'shift work'. Limitations included 'English language', 'published between 1980-2013' and 'human'.

RESULTS

Reviewed for this paper were 118 studies that met the inclusion criteria. Results were categorised using thematic analysis. Themes that emerged were physical and psychosocial health, and sleep. Findings will be explored under these themes.

CONCLUSIONS

Shiftwork research has mainly focussed on the physiological and psychosocial health and sleep effects. Absent from the literature are studies focussing on the personal experience of the shiftworker and how workers mediate the effects of shiftwork and how shiftwork fits into the rest of their lives. Therefore, it is difficult to draw conclusions about how people 'manage' their shiftwork, and further research needs to be undertaken in this area.

RELEVANCE TO CLINICAL PRACTICE

Working shifts for nurses is a reality that comes with the profession. While there is a significant body of research on shiftwork, little of this has been specifically applied to nursing, and the implications for individual nurses needing to care for their own health have not been drawn.

Prevalence of depression and its relationship with work characteristics in a sample of public workers

Occupation is a fundamental right, enabling social interaction and financial support for the individual. However, it is an undeniable source of stress, with consequences for physical and mental health. The prevalence of depression and somatic complaints were assessed in 1,013 public workers using the Beck Depression Inventory and a questionnaire investigating for the presence of somatic problems designed by the research team. The results were related to demographic characteristics, history of previous depressive episodes, work schedule (day work, night and day rotating shift work, day rotating shift work), and duration of current work schedule. There were more cases of moderate depression in the day rotating shift workers (84%) than in those working at night (83%). More women had mild or moderate depression than men (22% and 4% versus 10% and 3%, respectively). Severe depression was found only in men. Nearly 10% of depressed individuals reported previous depressive episodes. A link between depression and somatic complaints was also found. In particular, 59% of depressed subjects reported gastrointestinal complaints and 41% did not (P<0.001). In conclusion, the occurrence of depressive symptoms could be facilitated by occupation. A history of depressive symptoms should not be neglected, given the risk of recurrence. Somatic complaints could represent a "wake-up call" regarding depression. Global assessment and effective support are fundamental for promotion of a better quality of life in the at-risk category of workers.

Shift work, light at night, and the risk of breast cancer

Studies of the effect of shift work have identified several negative health outcomes, most notably breast cancer. Disruption of circadian rhythm by exposure to light at night has been identified as the mechanism likely responsible for this outcome. This article recommends that health care institutions work with occupational health nurses to develop and implement hazard communication and policies concerning shift work, exposure to light at night, and increased risk for negative health outcomes, particularly breast cancer.