BACKGROUND: The prevalence and burden of cardiovascular disease (CVD) is a concern. While CVD events will occur later in a woman’s life, modifiable risk factors for CVD occur earlier during adult years. While, there is strong evidence linking modifiable risk factors to CVD, the influence of the work environment on CVD risk is poorly understood. OBJECTIVES: The study objectives were to: 1) determine the prevalence of cardiovascular risk indicators; 2) determine the relationships between work patterns and lifestyle behaviours in female hospital workers; 3) determine the relationships between work patterns and cardiovascular risk indicators; and 4) determine the relationships between work patterns, lifestyle behaviours and cardiovascular risk while controlling for covariates. METHODS: Participants were female hospital workers (N= 466) from 2 hospital sites in Southeastern Ontario. Cardiovascular risk data were obtained through anthropometric measurements, blood sampling and self-report. Work pattern data were collected through self-report and linked with hospital administrative work data. Lifestyle behaviour data were obtained through self-report using validated questionnaires. Metabolic syndrome was classified in accordance with the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) (III) guidelines. RESULTS: Approximately 1 in 4 female participants had the metabolic syndrome, with elevated waist circumference being the most common CVD risk factor. After adjustments, the multivariate analysis found a few key significant associations between irregular work patterns, specifically extended shifts and CVD risk, specifically elevated systolic and diastolic blood pressure. However, consistent with the literature, the bivariate analyses revealed that after 6 or more years of shift work, female workers were more likely to develop the metabolic syndrome (OR 1.9, 95% CI 1.12, 3.17) and abdominally obesity (OR = 2.0, 95% CI, 1.31, 3.11). CONCLUSIONS: The findings from this study suggest that generally work patterns do not influence the development of unhealthy behaviours and cardiovascular risk factors, although a few key exceptions exist. Further research is needed to elucidate the mechanisms linking harmful and protective work pattern characteristics to CVD risk. Given the prevalence of abdominal obesity and overall CVD risk, hospital decision makers need to consider cardiovascular health within healthy workplace initiatives as the healthcare workforce is aging. / Thesis (Master, Nursing) -- Queen's University, 2009-09-24 18:39:03.718

Objective: To compare psychological work and life stress indicators among female hospital employees in both shift work (SW) and non-shift work (NSW) positions, and determine associations with demographic and vocational factors, and indicators of cardiovascular risk (CVR). Methods: Female employees from one Southeastern Ontario acute care hospital (n=212) provided fasting blood samples, demographic and work related data, and completed a physical assessment and questionnaires. Work stress was measured with the Job Content Questionnaire and Effort-Reward Balance Index (ERI). Life stress was assessed with the Derogatis Stress Profile. Metabolic Syndrome (MS) was determined based on Interim Societies Joint Guidelines. Results: SW in comparison to NSW employees reported higher mean scores in: global ERI (.70 (SD .4) vs. .58 (SD.29) p<.05), psychological job demands (21.2 (SD 4.8) vs. 19.2 (5.7) p<.01), physical job demands (13.8 (SD 2.6) vs. 10.2 (SD 3.8), skill discretion (36.5 (SD 4.4) vs. 34.7 (SD 5.4) p<.01), lower decision authority (31.6 (SD 5.8) vs. 33.5 (SD 6.5) p<.05), and lower total life stress scores (39.2 (SD 7.3) vs. 42.1 (SD 9.4) p<.05). There were no significant differences between SW and NSW group for MS or CVR factors. MS was present among 17% of all employees, 18.5% of SW, and 15.5% of NSW. In logistic regression analysis MS occurrence was associated with chronic SW exposure of 6 or more years (AOR 5.41 (95% CI, 1.84 – 15.87), decisional authority (AOR 1.09 (95% CI, 1.00 – 1.18), skill discretion (AOR 1.13 (95% CI, 1.01 – 1.26), and depression (AOR 1.26 (95% CI 1.08 – 1.46). Conclusions: Women working in SW positions experience more psychological and physical work stress, and effort-reward imbalance. The interplay between effort and reward aspects of the work environment may significantly contribute to psychological work stress and persist with increasing age among female hospital employees regardless of SW status. Among female hospital employees SW status and psychological stress measures do not appear to have an immediate effect upon CVR, as measured by the MS, but may contribute to its development with prolonged exposure. / Thesis (Master, Nursing) -- Queen's University, 2014-04-27 21:22:11.951

The implications of introducing shift work and flexible working hours into the UK clothing industry were examined, with special reference to the effects on personnel, plant utilisation and garment costs. A total of 37 garment manufacturing establishments, within 17 companies, were visited; 91 managers (for production and economic data)and 1018 supervisors and operatives, 87% female and 13% male, (for social data) were consulted. The main points arising from the survey are:- 1 . Social (i) The average age and length of service of respondents were respectively 30.4 and 7.1 for women and 40 and 13.9 for men. Nearly three fifths were married and over half of the women had children, most of them at school or pre-school stage. (ii) Over four fifths were committed to some kind of housework; 3 to 5 hours between 17.00 and 24.00 hours were usually spent on this task but about 9% spent more than 5 hours on it. (iii) Over half would be very much bothered by the inability to carry on their individual and/or group social activities. About two thirds would also be concerned by a change in the period of and time for sleep and meal times. Nearly two fifths used public transport for the journey to work. (iv) Only 15% had worked on multiple shifts previous to their present employment and 16% left their previous job because of being on shifts or unsuitable hours. About one fifth worked currently part-time and only 13% wanted to change their existing working system so that they might gain extra convenience and leisure in their working life. (v) The unsolicited personal choice of working systems were mainly shifts (13%), flexible working hours (14%) and part-time day work (30%); working only in school hours appeared to attract the choice of about 40% of the women. (vi) From the points above, it seemed that a high proportion of married female workers, mostly with dependent children and committed to housework, would probably react against shift work. The availability of part-time work together with the normal day work habit acquired would also affect the employees' attitudes towards the acceptance of even flexible working hours. 2. Production (i) The main problems involved with introducing shift work were considered to be sharing of equipment, bonus and piece rate payment and responsibility for quality failures. Dislike of sharing machines by operatives was considered to be a severe problem in sewing section and the extent of this dislike seemed higher in traditional rather than non traditional clothing areas; the operatives' age and length of service appeared to affect their attitudes. The smaller the period of time for each job then the less the problem of sharing payment and responsibility could become. (ii) Introduction of flexible working hours could create the difficulties of shortage and/or excess of supply of work within the production flow with interdependent operations; the extent of the problem could vary with the amount of work in progress and the period of time spent by each operative on the garment and/or its parts. Economic (i) Garment cost elements are material, labour, variable and fixed overheads (survey averages 50.6%, 24.9%, 8% and 16.5%), of which labour and variable overheads would be affected by introducing multiple shifts and only fixed overheads by flexible working hours. There should be a decrease in variable overheads per garment because of sharing a fixed amount of cost between shifts, an increase in labour cost due to shift premium and an increase in fixed overheads because of longer opening hours of the plant on flexible working hours. (ii) The capital employed on plant and machinery, C, could often be divided by the number of shifts so that this could help to increase profitability by a factor of 2 or 3. (iii) General formulae were established, using the most relevant variables, for calculating the profitability and profitability ratios of different working schemes. Generally, if the number of shifts are increased then the profitability of the plant could be very greatly increased. This was well illustrated from the calculated profitability ratios of about 2 and 3 respectively, when industrial survey values were used, for 2 and 3 shift systems replacing a single shift system. Profitability of flexible working hours would, theoretically, be less than that of single shift, but there might be some economic gains, such as reduced rates of labour turnover and absenteeism (which are currently high in the garment industry), arising from the introduction of flexible working hours.

Objective: To evaluate the association between shift work and blood pressure, pre-hypertension and hypertension in nursing personnel of a large general hospital. Methods: In a cross-sectional survey, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital. Hypertension was diagnosed by the mean of four automatic blood pressure readings>= 140/90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure>= 120-139 or diastolic blood pressure>= 80-89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between turns of work, defined as day or night, and by the combination of turns, and blood pressure, pre-hypertension and hypertension was explored in bivariate and multivariate analyses, controlling for risk factors for hypertension by covariance analysis and modified regression Poisson. Results: The mean age of the participants was 34.3 ± 9.4 years and 88.2% were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work (day/night and combination of turns) was not different in the bivariate analysis and after adjustment for confounding (all risk ratios = 1.0). Conclusion: Night shift work is not associated with blood pressure, hypertension and pre-hypertension in nurses and nurses assistants working in a large general hospital.

Objective: To evaluate the association between shift work and blood pressure, pre-hypertension and hypertension in nursing personnel of a large general hospital. Methods: In a cross-sectional survey, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital. Hypertension was diagnosed by the mean of four automatic blood pressure readings>= 140/90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure>= 120-139 or diastolic blood pressure>= 80-89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between turns of work, defined as day or night, and by the combination of turns, and blood pressure, pre-hypertension and hypertension was explored in bivariate and multivariate analyses, controlling for risk factors for hypertension by covariance analysis and modified regression Poisson. Results: The mean age of the participants was 34.3 ± 9.4 years and 88.2% were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work (day/night and combination of turns) was not different in the bivariate analysis and after adjustment for confounding (all risk ratios = 1.0). Conclusion: Night shift work is not associated with blood pressure, hypertension and pre-hypertension in nurses and nurses assistants working in a large general hospital.

Made available in DSpace on 2014-12-17T15:36:34Z (GMT). No. of bitstreams: 1 KatieMA.pdf: 1513045 bytes, checksum: 955957b28fd14373c71d44639284077e (MD5) Previous issue date: 2007-10-11 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / One of the largest problems of the present time resulting from the economic globalization and the modern technology, of the point of view of the biological rhytms of our organism, it is offering services and production of goods available in 24 o'clock, that it demands organized workers in several work schedules besides the hours of the day. Those schedules cause a series of biopsychosocial consequences in the worker's health, in function of circadian, homeostatic and psychosocial alterations. Accordingly, the aim of this study was to accomplish an evaluation of the effects of several works schedules in the pattern of the sleep wake cycle, anxiety, stress and in the health. We counted with a sample of 274 workers subdivided in 49 daytime worker groups and 225 workers in different shift work schedules with different speeds (rotating shift group, slower day shift group, faster day shift group). From the results analysis it is verified irregularities of the daily activities, stress and alterations in the workers' health in all schedules. It was also verified thata the workers thata presented irregularities in the daily activities were the mroe stressed. On the other hand, the shift works were considered more ansious and associated with bad sleep quality. It was verified that the workers with bad sleep quality were those presented larger levels of dispocional anxiety. There was no statistically significant correlation between bad sleep quality and irregular daily lifestyle. However, it can be affirmed thata shift work schendules doesn't are the main determinant for the circadian alterations, but the answers of the individuals to the shifts work; and that the inadequate behavioural strategies to work with the effects of the shift schedules. In conclusion, individual strategies related to the coping of the work in shift (adaptation and tolerance) should be extolled as indispensable tool in the ergonomic evaluation of the work / Um dos maiores problemas hodiernos resultante da globaliza??o econ?mica e da tecnologia moderna, do ponto de vista da ritmicidade biol?gica do nosso organismo, ? a oferta de servi?os e produ??o de bens dispon?vels 24 horas, ininterruptamente, que exige trabalhadores organizados em v?rios equemas de trabalho. Esses hor?rios causam conseq??ncias biopsicossociais na sa?de do trabalhador, em fun??o de altera??es circadianas, homeost?ticas e psicossociais. A presente pesquisa realizou uma avalia??o dos efeitos de diversos esquemas de trabalhos no padr?o do ciclo sono vig?lia, na ansiedade, no estresse e na sa?de. A amostra foi constitu?da por 274 trabalhadores subdivididos em 49 trabalhadores em esquemas diurnos fixos e 225 em diferentes esquemas em turnos com velocidades diferentes (turnos alternante, diurno alternante com rota??o lenta e diurno alternante com rota??o r?pida). Com a an?lise dos resutados, verificou-se a ocorr?ncia de irregularidades nas atividades di?rias, estresse e altera??es na sa?de dos trabalhadores em todos os esquemas. Verificou-se tamb?m que os trabalhadores que apresentavam irregularidades nas atividades di?rias eram os mais estressados. Por outro lado, os esquemas de turnos foram considerados mais ansiog?nicos e associados ? qualidade do sono ruim. Constatou-se que os trabalhadores com qualidade de sono ruim eram os que apresentavam maiores n?veis de ansiedade disposicional. N?o foi encontrada associa??o entre irregularidade e qualidade de sono ruim. Dessa forma, sugere-se que os esquemas de turno n?o s?o determinantes para as altera??es circadianas, mas as respostas dos indiv?duos aos esquemas de turnos; e que as altera??es homeost?ticas seriam moduladas pelas caracter?sticas de personalidade que levam a estrat?gias comportamentais inadequadas para lidar com os efeitos dos esquemas de turnos. Conclui-se que estrat?gias individuais relacionadas ao enfretamento dotrabalho em turno (adapta??o e toler?ncia) devem ser preconizadas como ferramenta indispens?vel na avalia??o ergon?mica do trabalho

Objective: To evaluate the association between shift work and blood pressure, pre-hypertension and hypertension in nursing personnel of a large general hospital. Methods: In a cross-sectional survey, 493 nurses, nurse technicians and assistants, were selected at random in a large general hospital. Hypertension was diagnosed by the mean of four automatic blood pressure readings>= 140/90 mmHg or use of blood pressure lowering agents, and pre-hypertension by systolic blood pressure>= 120-139 or diastolic blood pressure>= 80-89 mmHg. Risk factors for hypertension were evaluated by a standardized questionnaire and anthropometric measurements. The association between turns of work, defined as day or night, and by the combination of turns, and blood pressure, pre-hypertension and hypertension was explored in bivariate and multivariate analyses, controlling for risk factors for hypertension by covariance analysis and modified regression Poisson. Results: The mean age of the participants was 34.3 ± 9.4 years and 88.2% were women. Night shift workers were older, more frequently married or divorced, and less educated. The prevalence of hypertension in the whole sample was 16%, and 28% had pre-hypertension. Blood pressure (after adjustment for confounding) was not different in day and night shift workers. The prevalence of hypertension and pre-hypertension by shift work (day/night and combination of turns) was not different in the bivariate analysis and after adjustment for confounding (all risk ratios = 1.0). Conclusion: Night shift work is not associated with blood pressure, hypertension and pre-hypertension in nurses and nurses assistants working in a large general hospital.

Orientador: Milva Maria Figueiredo De Martino / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T01:45:46Z (GMT). No. of bitstreams: 1 Rocha_MariaCeciliaPiresda_D.pdf: 50708094 bytes, checksum: d5c98b3bb7f2cb00b66d559bc6c4a1bd (MD5) Previous issue date: 2013 / Resumo: O presente estudo baseou-se nos conhecimentos da fisiologia para entender como o estresse pode interferir no ritmo circadiano e na qualidade de sono do enfermeiro. A presença do hormônio cortisol em concentrações elevadas pode ser um dos indicadores de estresse e qualidade de sono ruim. Objetivo: avaliar a concentração salivar de cortisol, como índice fisiológico indicativo do grau de estresse, relacionando-o com o resultado da avaliação psicológica do estresse e verificar a presença do ritmo circadiano na análise da concentração de cortisol salivar. Método: este estudo foi quantitativo, transversal e comparativo, realizado numa instituição hospitalar governamental da cidade de Campinas, São Paulo, Brasil. Utilizamos para a coleta de dados; uma ficha de identificação; o Inventário de Estresse em Enfermeiros (IEE); o Questionário Índice de Qualidade do Sono de Pittsburgh Brasil (PSQI-BR); o Questionário para identificação de indivíduos matutinos e vespertinos adaptado de Horne e Östeberg (1976) para o Brasil por Benedito-Silva et al. (1990) e a dosagem do cortisol salivar. Participaram 57 enfermeiros dos turnos da manhã, tarde e noite. As coletas de saliva foram efetuadas pelo próprio trabalhador, em quatro horários e sempre antes das refeições: das 6h00 às 7h00 min; das 12h00 às 13h00 min, das 19h00 às 20h00 min e das 22h00 às 23h00 min. Este procedimento foi realizado em um dia de trabalho e num dia de folga. Resultados: observou-se predomínio de sujeitos do sexo feminino (80,7%), com 37,07 anos de idade (dp¿8,49). Encontrou-se correlação negativa e significativa entre a área sob a curva dos valores de cortisol salivar e a idade dos enfermeiros, no dia de trabalho (Correlação de Spearman; r= -0,27579; p= 0,0435), sendo que, quanto maior a idade menor a área do cortisol. Observou-se que nos turnos diurnos houve ajuste nos parâmetros do ritmo circadiano do cortisol salivar, no período de 24 horas, enquanto que, para os enfermeiros do turno noturno,não houve ajuste ao modelo cosinor. No dia de folga os turnos se ajustaram ao modelo cosinor. Do total de enfermeiros, 25% apresentaram estresse, e 74% dos enfermeiros mostraram qualidade de sono ruim. Os principais estressores apontados foram: trabalhar com pessoas despreparadas, falta de recursos humanos, administrar ou supervisionar o trabalho de outras pessoas e falta de material necessário ao trabalho. Houve correlação negativa e significativa entre os valores de cortisol salivar e o cronotipo dos enfermeiros, no dia de trabalho (Correlação de Spearman; r= -0,30246; p= 0,0262), mostrando, quanto maior o escore do cronotipo menor a área do cortisol. Conclusão: os resultados das medidas de cortisol salivar nos enfermeiros do noturno demonstrou ausência de ritmo de 24 horas no dia de trabalho. Foi demonstrada a interferência do turno de trabalho na ritmicidade circadiana e na produção diária de cortisol salivar. A análise do cosinor das 24 horas do dia de folga mostrou resultados significativos para os valores de cortisol salivar para os turnos diurno e noturno, e confirma a importância do dia de folga para a normalização de ajuste do ritmo circadiano com a recuperação dos índices de cortisol / Abstract: This study was based on the knowledge of physiology to understand how stress can interfere with the circadian rhythm and sleep quality of nurses. The presence of the hormone cortisol can be an indicator of stress and poor sleep quality. Objective: to evaluate the concentration of salivary cortisol as an index indicative of the degree of physiological stress, linking it with the result of psychological stress and verify the presence of circadian rhythm. Method: this was quantitative, comparative and cross-sectional study in a government hospital in the city of Campinas, São Paulo, Brazil. Used to collect data, an identification charge; Inventory Stress in Nurses (IEE), Quality Index Questionnaire Pittsburgh Sleep Brazil (PSQI-BR), the Questionnaire for identifying individuals morning and evening adapted from Östeberg and Horne (1976) for Brazil by Benedito-Silva et al. (1990) and salivary cortisol. 57 RN nurses participated from morning, afternoon and evening shifts. The samples of saliva were made by the worker himself four times and always before meals: from 6:00 am to 7:00 a.m., from 12:00 to 13:00 a.m., from 7:00 to 8:00 p.m. and from 10:00 to 11:000 p.m. This procedure was performed on a workday and a day off. Results: 80.7% was female, with 37.07 years old (SD = 8.49). It was found significant negative correlation between the area under curve for salivary cortisol and age of nurses in the work day (Spearman correlation, r = -0.27579, p = 0.0435), and, as and the higher the age smaller the area of cortisol. It was observed that the day shifts were setting the parameters of the circadian rhythm of salivary cortisol in 24-hour period, while for the night shift nurses, no adjustment to Cosinor model. 25% of RN nurses had stress, and 74% of showed poor sleep quality. The stressors mentioned were: working with people unprepared, lack of human resources, manage or supervise the work of others and lack of material required to work. We found a significant correlation between the area under the curve values for salivary cortisol and age of nurses in the work day (Spearman correlation, r = -0.27579, p = 0.0435). There was a correlation between the values of salivary cortisol and chronotype of nurses at work day (Spearman correlation, r = -0.30246, p = 0.0262), showing the higher the score the lower the chronotype area cortisol. Conclusion: the results of the measures of salivary cortisol in the evening nurses demonstrated the absence of 24 hours in the work day in and day off, and was demonstrated interference shift in daily rhythmicity of salivary cortisol. Analysis of Cosinor of 24 hours on days off results showed significant values for salivary cortisol for day and night shifts, and confirms the importance of the day off for the normalization adjustment of circadian rhythms to the recovery of the cortisol indices / Doutorado / Enfermagem e Trabalho / Doutora em Enfermagem

Orientador: Bruno Geloneze Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T12:17:34Z (GMT). No. of bitstreams: 1 Cardozo_DanielaSchiavo_D.pdf: 1355414 bytes, checksum: 3c91c18e1699608cf367e306cda835af (MD5) Previous issue date: 2012 / Resumo: Devido ao aumento considerável de trabalhadores noturnos é importante o estudo dos efeitos deste tipo de trabalho na saúde do trabalhador. Estudos atuais demonstram que trabalhos em turno e noturno favorecem transtornos digestivos relacionados a diferenças no hábito alimentar, tanto no valor calórico total, como no horário e número de refeições. Além disso, há aumento dos fatores de risco cardiovasculares, tais como: altos níveis de triglicérides e colesterol séricos, obesidade abdominal, resistência à insulina e outros marcadores da síndrome metabólica. Estes fenômenos estão relacionados a um ganho e redistribuição do peso corporal, em parte atribuível a diferenças no padrão de fome e saciedade. Trabalhadores do turno noturno podem apresentar perturbação no ritmo biológico endógeno em função do conflito temporal entre o relógio biológico endógeno e a estrutura de funcionamento das atividades sociais. Esta dessincronização pode produzir transtornos intensos e persistentes na fisiologia do sono. Foram selecionados 12 trabalhadoras de turno noturno e 12 do diurno do HC-UNICAMP, com IMC entre 25 e 29.9 (sobrepeso). O objetivo deste trabalho foi comparar uma população trabalhadora de turno noturno com uma população trabalhadora diurna, em relação a componentes bioquímicos e antropométricos da síndrome metabólica. Além disso, a caracterização das respostas de hormônios reguladores da fome e saciedade foi acessada a partir de um teste de refeição padrão, com dosagens de grelina, (hormônio orexigênico), oxintomodulina, xenina, glucagon-like peptide 1 (GLP-1) e PYY3-36 (hormônios anorexigênicos). A resistência à insulina foi avaliada por índices que relacionam a produção de insulina com a curva glicêmica durante o teste de refeição (Metabolic Clearance Rate, ou índice de Stumvoll). Estes mesmos voluntários foram avaliados quanto à qualidade de sono, ao cronótipo e ao estado inflamatório sub-clínico (avaliado pelos níveis circulantes de interleucina 6, TNF-?, adiponectina e proteína C-reativa). Na avaliação quanto ao cronótipo, a maior proporção de indivíduos indiferentes foram encontrados no grupo do turno noturno. A qualidade de sono avaliada pelo score de Pittsburgh não demonstrou diferença significante entre os grupos estudados. Os trabalhadores de turno noturno demonstraram valores maiores para disfunção diurna, demonstrando sonolência excessiva diurna. O principal achado foi a caracterização de uma resposta de produção do hormônio orexigênico - grelina - aumentada no período pós-prandial das voluntárias de trabalho noturno e uma resposta reduzida de xenina (um hormônio anorexígeno e de fonte estomacal). Assim este fato pode ser responsável pela mudança do comportamento alimentar e consequente ganho de peso destas trabalhadoras de turno noturno. / Abstract: Due to the considerable increase of night shift workers it is important the study of its effects on worker health. Recent studies reveal that work in shifts and night shift work propitiate digestive disorders related to differences in dietary habits, in the total caloric content, as well as in the timing and number of meals. Moreover, it is noticed an increase in cardiovascular risk factors such as high levels of triglycerides and cholesterol, and abdominal obesity, insulin resistance and markers of metabolic syndrome. These phenomena are related to gain and redistribution of body weight, in part attributable to changes in the pattern of hunger and satiety. Night shift workers may have endogenous biological rhythm disturbance as a result of the temporal conflict between the endogenous biological clock and the functioning structure of social activities. This asynchronization may produce intense and persistent disorders in sleep physiology. We selected 12 night shift workers and 12 day workers of the HC-UNICAMP, with BMI between 25 and 29.9 (overweight). The objective of this study was to compare a population of night shift workers with a daytime working population in relation to anthropometric and biochemical components of the metabolic syndrome. Besides that, the characterization of the responses of hormones regulating hunger and satiety was accessed by means of a standard meal test , with dosages of ghrelin, oxyntomodulin, xenin, glucagon-like peptide 1 (GLP-1) and PYY3-36. Insulin resistance was evaluated by indexes relating the production of insulin during the glycemic test meal (Stumvol index). These same volunteers were evaluated for the quality of sleep, the chronotype and sub-clinical inflammatory state (assessed by circulating levels of interleukin-6, TNF-?, adiponectin and protein C-reactive). In the assessment for the chronotype, the highest proportion of indifferent individuals were found in the group of night shift. The quality of sleep assessed by pittsburgh score showed no significant difference between groups. The night shift workers showed higher values for daytime dysfunction, demonstrating excessive daytime sleepiness. The main finding was the characterization of a increased response in production of hormone - ghrelin - in the postprandial period of night shift workers and reduced response of xenina (an anorectic hormone source and stomach). As a conclusion, this fact may be responsible for the weight gain observed for those night shift workers. / Doutorado / Clinica Medica / Doutora em Clínica Médica

The research problem is the increasing numbers of overweight and obese nurses working the night shift. Study on overweight and obesity among female Filipino nurses has not been conducted. It was important to conduct a research study among female Filipino nurses to find out if there are statistically significant associations between night shift work and weight gain. The purpose of this correlational and cross-sectional study was to determine if there are statistically significant associations between insufficient sleep, abnormal eating patterns, working 12-hour shifts, years of working night shift, age, stress, marital status, nursing units, decreased physical activity, and level of weight gain among female Filipino nurses working the night shift in the hospital. The theoretical base of this study was the locate evidence, evaluate evidence, assess evidence, and informed decision model. The survey questionnaire was constructed and an online survey through Survey Monkey was used to access nurses via a convenience sampling. Data were analyzed using Spearman correlation, multiple regression, and ANOVA. According to study findings, there were significant associations between insufficient sleep, abnormal eating patterns, marital status, 12-hour shifts, number of years working on night shift, and increased in body mass index. The implications for social change include information that nurses can use to better understand the negative implications of night shift work on health. At the organizational level, this study provides information for administrators and nursing leaders that might facilitate change in policies by improving working conditions for nurses.