This study examined the effects of rotating shift work on the sleep quality and duration of nurses in Malawi. Twenty-four nurses who worked rotating shifts (day shifts, night shifts, days off) completed questionnaires on their sleep. Their sleep was compared to 22 nurses who did not work nights. Rotating shift work was associated with significantly less total sleep during night shifts and lower perceived sleep quality during night shifts and days off compared to day shift workers. Night shift work also resulted in less nighttime sleep compared to days off. These findings suggest that rotating shift work impairs nurses' sleep in Malawi.
A study to assess the effectiveness of paced breathing versus back massage fo...pharmaindexing
The document summarizes a study that assessed the effectiveness of paced breathing versus back massage for managing labor pain in antenatal mothers. 200 mothers in labor were divided into 2 groups - Group I received paced breathing training and Group II received back massages. Pain levels were measured before and after the interventions using a visual analog scale. Both interventions significantly reduced reported pain levels from before to after. However, the reductions in pain levels were not significantly different between the two groups. Therefore, the study concluded that both paced breathing and back massage are effective non-pharmacological methods for relieving labor pain.
Effect of Structured Progressive Exercise Protocol on Management of Chronic C...ijtsrd
INTRODUCTION Neck pain is a common degenerative condition which is associated with poor posture and advanced age related to wear and tear. It is the one of the causes of dysfunction, like low back pain. Neck pain is one of the most common conditions for referral management by a physical therapist. The most commonly intervention for the management of neck pain are exercise and rest followed by analgesics. Despite the prevalence of neck pain, there is a lack of evidence for commonly used rehabilitation interventions. OBJECTIVE To find out the effect of structured progressive exercise protocol for patients suffering from chronic cervical spine pain. METHODOLOGY A quantitative experimental research approach with pre test post test control group design was conducted in CIRS, Bhubaneswar, Odisha. The sample comprised of 60 patients suffering from chronic cervical spine pain. The samples were purposively selected and conveniently assigned to 30 in each experimental and control group. The background data were taken through structured interview schedule. Followed by assessment of cervical pain through structured pain assessment proforma, visual analog scale and the neck disability index. The data were analysed by descriptive and inferential statistics in terms of frequency, percentage, mean, median, and “t” test. RESULTS The significant findings of the study were that, the mean post test Pain as well as NDI scores were significantly lower than the mean pre test scores of the experimental group and control group. Mean post test mean 3.3 , SD 1.93 of level of cervical pain were significantly reduced than the pretest mean 4.8 , SD 1.27 as evident from the‘t’ test was 3.70. df, 28 at 0.05 level of significance. Similarly, the post test mean 5.48 and SD 0.62 of neck disability index in cervical pain were significantly reduced than the pretest mean 7.11 and SD 0.28 as evident from the‘t’ test was 3.01at df, 28 differed significantly at 0.05 level of significance. CONCLUSION Findings of the study revealed that structured exercise protocol would be very helpful in alleviating chronic cervical spine pain and found to be more effective in experimental group than the control group. Punyashloka Nayak | Debajani Nayak "Effect of Structured Progressive Exercise Protocol on Management of Chronic Cervical Spine Pain" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33332.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33332/effect-of-structured-progressive-exercise-protocol-on-management-of-chronic-cervical-spine-pain/punyashloka-nayak
This study examined whether early improvement in neck function predicted overall response to a cervical strengthening program for chronic neck pain. 214 patients completed a 3-week strengthening program and were assessed for changes in neck disability index (NDI) scores. Patients with a positive change in NDI scores after 3 weeks had a 25 times greater odds of overall improvement. Early improvement likely reflects motor skill acquisition rather than muscle hypertrophy. While early responders saw small additional gains, continued strengthening may provide further benefits like reduced muscle co-activation.
Efficacy of classification-based_cft_in_nsclbpMeziat
Artigo (6) importante para a preparação para o curso de dor lombar crônica. "Eficácia da Terapia Cognitiva Funcional em pacientes com dor lombar crônica inespecífica: ensaio clínico randomizado controlado."
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
This study evaluated the effectiveness of a Global Postural Reeducation (GPR) program compared to a Stabilization Exercise (SE) program for patients with persistent low back pain. 100 patients were assigned to either the GPR group or SE group. Outcome measures including disability questionnaires and pain/mobility scales were measured at baseline and 3 and 6 month follow-ups. Results showed significantly greater improvements in all outcome measures in the GPR group compared to the SE group at both short-term and mid-term follow-ups. The GPR intervention was found to be more effective for reducing pain and disability in patients with persistent low back pain.
Short-term effects of teriparatide versus placebo on bone biomarkers, structu...Ellen Almirol
This pilot study evaluated the effects of 8 weeks of teriparatide (TPTD) versus placebo treatment on bone biomarkers, structure, and stress fracture healing in premenopausal women with lower-extremity stress fractures. The study found that TPTD treatment led to greater increases in bone formation markers and a larger "anabolic window" compared to placebo. TPTD treatment also showed improvements in bone structure at weight-bearing sites on imaging. A higher percentage of stress fractures showed improvement or healing with TPTD versus placebo on MRI, though the results were not statistically significant. The study provides preliminary evidence that TPTD may help hasten stress fracture healing in premenopausal women.
A study to assess the effectiveness of paced breathing versus back massage fo...pharmaindexing
The document summarizes a study that assessed the effectiveness of paced breathing versus back massage for managing labor pain in antenatal mothers. 200 mothers in labor were divided into 2 groups - Group I received paced breathing training and Group II received back massages. Pain levels were measured before and after the interventions using a visual analog scale. Both interventions significantly reduced reported pain levels from before to after. However, the reductions in pain levels were not significantly different between the two groups. Therefore, the study concluded that both paced breathing and back massage are effective non-pharmacological methods for relieving labor pain.
Effect of Structured Progressive Exercise Protocol on Management of Chronic C...ijtsrd
INTRODUCTION Neck pain is a common degenerative condition which is associated with poor posture and advanced age related to wear and tear. It is the one of the causes of dysfunction, like low back pain. Neck pain is one of the most common conditions for referral management by a physical therapist. The most commonly intervention for the management of neck pain are exercise and rest followed by analgesics. Despite the prevalence of neck pain, there is a lack of evidence for commonly used rehabilitation interventions. OBJECTIVE To find out the effect of structured progressive exercise protocol for patients suffering from chronic cervical spine pain. METHODOLOGY A quantitative experimental research approach with pre test post test control group design was conducted in CIRS, Bhubaneswar, Odisha. The sample comprised of 60 patients suffering from chronic cervical spine pain. The samples were purposively selected and conveniently assigned to 30 in each experimental and control group. The background data were taken through structured interview schedule. Followed by assessment of cervical pain through structured pain assessment proforma, visual analog scale and the neck disability index. The data were analysed by descriptive and inferential statistics in terms of frequency, percentage, mean, median, and “t” test. RESULTS The significant findings of the study were that, the mean post test Pain as well as NDI scores were significantly lower than the mean pre test scores of the experimental group and control group. Mean post test mean 3.3 , SD 1.93 of level of cervical pain were significantly reduced than the pretest mean 4.8 , SD 1.27 as evident from the‘t’ test was 3.70. df, 28 at 0.05 level of significance. Similarly, the post test mean 5.48 and SD 0.62 of neck disability index in cervical pain were significantly reduced than the pretest mean 7.11 and SD 0.28 as evident from the‘t’ test was 3.01at df, 28 differed significantly at 0.05 level of significance. CONCLUSION Findings of the study revealed that structured exercise protocol would be very helpful in alleviating chronic cervical spine pain and found to be more effective in experimental group than the control group. Punyashloka Nayak | Debajani Nayak "Effect of Structured Progressive Exercise Protocol on Management of Chronic Cervical Spine Pain" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6 , October 2020, URL: https://www.ijtsrd.com/papers/ijtsrd33332.pdf Paper Url: https://www.ijtsrd.com/medicine/nursing/33332/effect-of-structured-progressive-exercise-protocol-on-management-of-chronic-cervical-spine-pain/punyashloka-nayak
This study examined whether early improvement in neck function predicted overall response to a cervical strengthening program for chronic neck pain. 214 patients completed a 3-week strengthening program and were assessed for changes in neck disability index (NDI) scores. Patients with a positive change in NDI scores after 3 weeks had a 25 times greater odds of overall improvement. Early improvement likely reflects motor skill acquisition rather than muscle hypertrophy. While early responders saw small additional gains, continued strengthening may provide further benefits like reduced muscle co-activation.
Efficacy of classification-based_cft_in_nsclbpMeziat
Artigo (6) importante para a preparação para o curso de dor lombar crônica. "Eficácia da Terapia Cognitiva Funcional em pacientes com dor lombar crônica inespecífica: ensaio clínico randomizado controlado."
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
Recent advances in Manipulative MedicineSoniya Lohana
What new techniques are been used in manipulative medicine and physical therapy that help the patients to recover better and address their condition by various approaches where surgery is not required.
This study evaluated the effectiveness of a Global Postural Reeducation (GPR) program compared to a Stabilization Exercise (SE) program for patients with persistent low back pain. 100 patients were assigned to either the GPR group or SE group. Outcome measures including disability questionnaires and pain/mobility scales were measured at baseline and 3 and 6 month follow-ups. Results showed significantly greater improvements in all outcome measures in the GPR group compared to the SE group at both short-term and mid-term follow-ups. The GPR intervention was found to be more effective for reducing pain and disability in patients with persistent low back pain.
Short-term effects of teriparatide versus placebo on bone biomarkers, structu...Ellen Almirol
This pilot study evaluated the effects of 8 weeks of teriparatide (TPTD) versus placebo treatment on bone biomarkers, structure, and stress fracture healing in premenopausal women with lower-extremity stress fractures. The study found that TPTD treatment led to greater increases in bone formation markers and a larger "anabolic window" compared to placebo. TPTD treatment also showed improvements in bone structure at weight-bearing sites on imaging. A higher percentage of stress fractures showed improvement or healing with TPTD versus placebo on MRI, though the results were not statistically significant. The study provides preliminary evidence that TPTD may help hasten stress fracture healing in premenopausal women.
This document summarizes and compares different models of back schools for treating chronic low back pain. It discusses the original Swedish back school model and how various programs have modified the content, format, and length. Several recent randomized controlled trials that compared different back school models to other treatments are highlighted. The studies found that back schools based on biopsychosocial principles led to better long-term outcomes than traditional models. Spinal manipulation was also found to result in lower disability scores compared to back school or individual physiotherapy. Overall, back schools may be considered as part of multidisciplinary treatment, though more research is still needed.
This meta-analysis reviewed 16 randomized controlled trials comparing the effectiveness of motor control exercises (MCE) to other treatments for chronic or recurrent low back pain. The analysis found that MCE was superior to general exercise in reducing both disability in the short, intermediate, and long term, and pain in the short and intermediate term. MCE was also superior to minimal interventions like advice or placebo for both pain and disability outcomes at all time periods. Compared to spinal manual therapy, MCE demonstrated superior results for reducing disability but not pain. The studies varied in quality but provided evidence that MCE can better improve pain and disability for low back pain over the short to long term compared to other common treatments.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
This study aimed to assess the feasibility of conducting a randomized controlled trial comparing an osteopathic approach to usual general practice care for patients with chronic low back pain. The study recruited 9 participants with chronic low back pain from one general practice and randomized them to either receive up to 8 osteopathic treatments or usual care. Follow up rates were poor, but participant feedback on the osteopathic treatment was positive. The study demonstrated that recruiting adequate participants from multiple general practices for a randomized controlled trial of osteopathy for chronic low back pain is feasible.
How Isha Yoga can alleviate PMS symptomsGomathy Swamy
1) The study assessed the effects of Isha Yoga practice on various menstrual disorders in 128 women aged 14-55 practicing Isha Yoga for a minimum of 6 months.
2) Results showed significant decreases in symptoms like dysmenorrhea, premenstrual syndrome, heaviness of menstrual flow, irregularity of menstrual cycles, and impairment of work, with fewer women requiring medical intervention.
3) Isha Yoga, which involves a simple 21-minute practice done in a sitting posture, appeared to effectively improve symptoms of menstrual disorders and could be considered an adjunct therapy for such conditions.
‘Clinical Neurodynamics: clinical application from an anatomical perspective’ NVMT-symposium
This document provides an overview of neurodynamics, including:
1. The history and key figures in the development of neurodynamics from the 1920s to present.
2. Anatomy of the peripheral nervous system, including gross anatomy of major nerves in the upper and lower limbs, microanatomy of nerves, and biomechanics of nerve movement.
3. Applications to clinical examination including common nerve pathoanatomies and how joint movement affects nerves.
4. Research on neurodynamic techniques and their effects on nerve displacement and strain.
Effectiveness of manual physical therapy in cervical radiculopatyDelky Meza
This systematic review examined the effectiveness of manual physical therapy for treating cervical radiculopathy. Four randomized controlled trials met the inclusion criteria. The trials involved the use of manual therapy techniques like mobilization combined with therapeutic exercises. The results showed that manual therapy along with exercises was effective in improving function, range of motion, and decreasing pain and disability levels for patients with cervical radiculopathy. High quality randomized controlled trials are still needed to establish clear treatment protocols.
Intensive therapy involves 45-60 hours of therapy over 3-4 weeks, with sessions lasting 3-4 hours per day. It uses strength training and repetitive movements to improve functional mobility. Therapy is broken into preparation and secondary phases, and patients are given home exercise programs. Studies show intensive therapy can improve gross motor skills in patients with neurological and orthopedic conditions, though more research is still needed.
low back pain with radiating lower limbDrHeeraMani
A randomized controlled trial compared the effectiveness of neural mobilization, lumbar stabilization exercises, and radial extracorporeal shock wave therapy in treating chronic low back pain with radiculopathy. 30 participants were randomly assigned to a treatment group receiving neural mobilization plus exercises and shockwave therapy or a control group receiving exercises and shockwave therapy alone. Both groups showed reduced pain scores after 3 weeks, but only the treatment group demonstrated statistically significant improvements in lumbar range of motion and disability levels. After 6 weeks, statistically significant differences favored the treatment group for all outcome measures.
This systematic review analyzed 12 controlled trials that compared the effects of different insoles on postural balance. The insoles studied included vibrating insoles, textured insoles, insoles with different densities, and insoles with wedges or sensors. Most studies found that the insoles improved postural balance and reduced sway, especially in the anteroposterior direction. Textured insoles and vibrating insoles showed benefits by increasing sensory input from the feet. While insole rigidity did not influence balance, soft gel insoles and insoles with spikes were found to improve postural control. The review concluded that insoles can provide benefits that favor better postural balance and control.
Effects of Strength Training in Multiple sclerosis patientsDaniel Yazbek
1) A systematic review of 4 randomized controlled trials investigating the effects of progressive resistance training (PRT) in patients with multiple sclerosis found that PRT can improve muscle strength and size.
2) Meta-analysis of the 3 studies measuring leg strength showed a significant mean increase in strength for patients undergoing PRT compared to controls.
3) While the studies had some limitations, overall they provide evidence that PRT can provide health benefits for MS patients and help increase muscle strength and size. Larger and higher quality studies are still needed.
Intensive therapy involves 45-60 hours of therapy over 3-4 weeks, with sessions lasting 3-4 hours per day. It uses strength training and repetitive movements to improve functional mobility. Therapy is broken into preparation and secondary phases, and patients are given home exercise programs. While evidence is limited, studies show intensive therapy can significantly improve gross motor skills in patients with conditions like cerebral palsy. Further research is still needed to determine long-term effects.
This study compared the effectiveness of hydroplasty versus intra-articular steroid injection for the treatment of idiopathic frozen shoulder. The study included 50 patients divided into two groups. The hydroplasty group showed significantly greater improvement in pain, shoulder function and range of motion compared to the steroid injection group at the 1 month and 3 month follow ups. Hydroplasty was found to be a more effective treatment for idiopathic frozen shoulder than intra-articular steroid injection alone.
This document summarizes and discusses several articles on physical medicine and rehabilitation (PMR) topics that were published in recent issues of various journals. The articles cover a range of topics including the treatment of 12th rib syndrome, the use of the tourniquet ischemia test to diagnose complex regional pain syndrome, physiotherapy interventions for treating spasticity, a telehealth intervention to increase fitness for those with spinal cord injuries, spinal cord involvement in COVID-19, the use of local anesthetic injections in athletes, and a comparison of video-based and text-based physical activity interventions. The document also provides an introduction and welcome from the editor as well as information about new contributors.
A prospective comparative study of three treatmentHemant Pippal
This study compared the effectiveness of three treatment modalities for idiopathic adhesive capsulitis of the shoulder: 1) conservative treatment including physical therapy, 2) intra-articular steroid injections plus physical therapy, and 3) arthroscopic capsular release plus physical therapy. The study found that arthroscopic capsular release resulted in significantly better improvement in external shoulder rotation compared to conservative treatment alone. However, overall functional outcomes as measured by a shoulder rating questionnaire were similar across groups. The study concluded that conservative treatment remains an effective first-line option for adhesive capsulitis, though arthroscopic release may provide faster recovery of external rotation.
The article discusses the impacts of the COVID-19 pandemic on physiatry and rehabilitation medicine. It highlights how physiatrists played a vital role in the front lines during the pandemic by converting rehabilitation units and innovating care delivery. However, the pandemic has also caused significant disruptions and stress for medical practices through reduced patient volumes, higher costs, and threats of reimbursement cuts from insurers and governments. Moving forward, physicians are questioning the level of support they will receive from their employers and the government given the sacrifices many have made during the pandemic.
This study examined the reliability of classifications derived from Cyriax's resisted testing in subjects with painful shoulders and knees. Two physical therapists evaluated subjects' shoulder and knee motions under maximal isometric resistance twice. They rated contractions as strong or weak and noted any pain. Intrarater reliability for the knee was generally acceptable but not for the shoulder. Interrater reliability was generally not acceptable for either. More training and standardized resistance may improve reliability.
This study examined the intertester reliability of using James Cyriax's system for assessing patients with shoulder pain. Two experienced physical therapists independently evaluated 21 cases of painful shoulders using Cyriax's evaluation method. They classified the cases into specific shoulder lesions or indicated that the case did not fit the Cyriax model. The therapists agreed on the classification for 19 of the 21 cases, showing 90.5% agreement. Statistical analysis found "almost perfect" agreement between the therapists. Both therapists also agreed on the same 4 cases that did not fit the Cyriax model. The results demonstrate that Cyriax's evaluation can be a highly reliable method for assessing patients with shoulder pain.
This document discusses dyssynergia and sphincter dyssynergia. It defines dyssynergia as the dissociation of muscles that normally work in harmony and sphincter dyssynergia as the involuntary contraction or lack of relaxation of the striated or smooth sphincter. It describes the causes, types, complications and treatments of striated sphincter dyssynergia. The document was authored by the department of urology at GRH and KMC hospitals in Chennai, India.
This document discusses common causes of sleep problems and potential solutions. It notes that long work hours, multitasking, stress, unhealthy habits like late night snacks and screen time before bed can disrupt sleep. It recommends developing personal discipline, setting a routine, prioritizing relaxation in the evenings, avoiding stimulants before bed, spending time outdoors and exercising to promote natural sleep.
Sleep is essential for optimal functioning as it allows the brain to catalog experiences, prime memory, and regulate hormones. Getting less than 7-8 hours of sleep per night can negatively impact concentration, creativity, mood and productivity. Different stages of the sleep cycle, including deep sleep and REM sleep, are important for physical renewal, learning, memory processing and higher level thought. Lack of sufficient sleep, especially REM sleep, makes tasks like concentrating, multitasking and understanding subtleties more difficult. Managers can get more from their sleep by avoiding caffeine late in the day, creating a restful sleep environment, and taking short 10-20 minute power naps if needed.
This document summarizes and compares different models of back schools for treating chronic low back pain. It discusses the original Swedish back school model and how various programs have modified the content, format, and length. Several recent randomized controlled trials that compared different back school models to other treatments are highlighted. The studies found that back schools based on biopsychosocial principles led to better long-term outcomes than traditional models. Spinal manipulation was also found to result in lower disability scores compared to back school or individual physiotherapy. Overall, back schools may be considered as part of multidisciplinary treatment, though more research is still needed.
This meta-analysis reviewed 16 randomized controlled trials comparing the effectiveness of motor control exercises (MCE) to other treatments for chronic or recurrent low back pain. The analysis found that MCE was superior to general exercise in reducing both disability in the short, intermediate, and long term, and pain in the short and intermediate term. MCE was also superior to minimal interventions like advice or placebo for both pain and disability outcomes at all time periods. Compared to spinal manual therapy, MCE demonstrated superior results for reducing disability but not pain. The studies varied in quality but provided evidence that MCE can better improve pain and disability for low back pain over the short to long term compared to other common treatments.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
This study aimed to assess the feasibility of conducting a randomized controlled trial comparing an osteopathic approach to usual general practice care for patients with chronic low back pain. The study recruited 9 participants with chronic low back pain from one general practice and randomized them to either receive up to 8 osteopathic treatments or usual care. Follow up rates were poor, but participant feedback on the osteopathic treatment was positive. The study demonstrated that recruiting adequate participants from multiple general practices for a randomized controlled trial of osteopathy for chronic low back pain is feasible.
How Isha Yoga can alleviate PMS symptomsGomathy Swamy
1) The study assessed the effects of Isha Yoga practice on various menstrual disorders in 128 women aged 14-55 practicing Isha Yoga for a minimum of 6 months.
2) Results showed significant decreases in symptoms like dysmenorrhea, premenstrual syndrome, heaviness of menstrual flow, irregularity of menstrual cycles, and impairment of work, with fewer women requiring medical intervention.
3) Isha Yoga, which involves a simple 21-minute practice done in a sitting posture, appeared to effectively improve symptoms of menstrual disorders and could be considered an adjunct therapy for such conditions.
‘Clinical Neurodynamics: clinical application from an anatomical perspective’ NVMT-symposium
This document provides an overview of neurodynamics, including:
1. The history and key figures in the development of neurodynamics from the 1920s to present.
2. Anatomy of the peripheral nervous system, including gross anatomy of major nerves in the upper and lower limbs, microanatomy of nerves, and biomechanics of nerve movement.
3. Applications to clinical examination including common nerve pathoanatomies and how joint movement affects nerves.
4. Research on neurodynamic techniques and their effects on nerve displacement and strain.
Effectiveness of manual physical therapy in cervical radiculopatyDelky Meza
This systematic review examined the effectiveness of manual physical therapy for treating cervical radiculopathy. Four randomized controlled trials met the inclusion criteria. The trials involved the use of manual therapy techniques like mobilization combined with therapeutic exercises. The results showed that manual therapy along with exercises was effective in improving function, range of motion, and decreasing pain and disability levels for patients with cervical radiculopathy. High quality randomized controlled trials are still needed to establish clear treatment protocols.
Intensive therapy involves 45-60 hours of therapy over 3-4 weeks, with sessions lasting 3-4 hours per day. It uses strength training and repetitive movements to improve functional mobility. Therapy is broken into preparation and secondary phases, and patients are given home exercise programs. Studies show intensive therapy can improve gross motor skills in patients with neurological and orthopedic conditions, though more research is still needed.
low back pain with radiating lower limbDrHeeraMani
A randomized controlled trial compared the effectiveness of neural mobilization, lumbar stabilization exercises, and radial extracorporeal shock wave therapy in treating chronic low back pain with radiculopathy. 30 participants were randomly assigned to a treatment group receiving neural mobilization plus exercises and shockwave therapy or a control group receiving exercises and shockwave therapy alone. Both groups showed reduced pain scores after 3 weeks, but only the treatment group demonstrated statistically significant improvements in lumbar range of motion and disability levels. After 6 weeks, statistically significant differences favored the treatment group for all outcome measures.
This systematic review analyzed 12 controlled trials that compared the effects of different insoles on postural balance. The insoles studied included vibrating insoles, textured insoles, insoles with different densities, and insoles with wedges or sensors. Most studies found that the insoles improved postural balance and reduced sway, especially in the anteroposterior direction. Textured insoles and vibrating insoles showed benefits by increasing sensory input from the feet. While insole rigidity did not influence balance, soft gel insoles and insoles with spikes were found to improve postural control. The review concluded that insoles can provide benefits that favor better postural balance and control.
Effects of Strength Training in Multiple sclerosis patientsDaniel Yazbek
1) A systematic review of 4 randomized controlled trials investigating the effects of progressive resistance training (PRT) in patients with multiple sclerosis found that PRT can improve muscle strength and size.
2) Meta-analysis of the 3 studies measuring leg strength showed a significant mean increase in strength for patients undergoing PRT compared to controls.
3) While the studies had some limitations, overall they provide evidence that PRT can provide health benefits for MS patients and help increase muscle strength and size. Larger and higher quality studies are still needed.
Intensive therapy involves 45-60 hours of therapy over 3-4 weeks, with sessions lasting 3-4 hours per day. It uses strength training and repetitive movements to improve functional mobility. Therapy is broken into preparation and secondary phases, and patients are given home exercise programs. While evidence is limited, studies show intensive therapy can significantly improve gross motor skills in patients with conditions like cerebral palsy. Further research is still needed to determine long-term effects.
This study compared the effectiveness of hydroplasty versus intra-articular steroid injection for the treatment of idiopathic frozen shoulder. The study included 50 patients divided into two groups. The hydroplasty group showed significantly greater improvement in pain, shoulder function and range of motion compared to the steroid injection group at the 1 month and 3 month follow ups. Hydroplasty was found to be a more effective treatment for idiopathic frozen shoulder than intra-articular steroid injection alone.
This document summarizes and discusses several articles on physical medicine and rehabilitation (PMR) topics that were published in recent issues of various journals. The articles cover a range of topics including the treatment of 12th rib syndrome, the use of the tourniquet ischemia test to diagnose complex regional pain syndrome, physiotherapy interventions for treating spasticity, a telehealth intervention to increase fitness for those with spinal cord injuries, spinal cord involvement in COVID-19, the use of local anesthetic injections in athletes, and a comparison of video-based and text-based physical activity interventions. The document also provides an introduction and welcome from the editor as well as information about new contributors.
A prospective comparative study of three treatmentHemant Pippal
This study compared the effectiveness of three treatment modalities for idiopathic adhesive capsulitis of the shoulder: 1) conservative treatment including physical therapy, 2) intra-articular steroid injections plus physical therapy, and 3) arthroscopic capsular release plus physical therapy. The study found that arthroscopic capsular release resulted in significantly better improvement in external shoulder rotation compared to conservative treatment alone. However, overall functional outcomes as measured by a shoulder rating questionnaire were similar across groups. The study concluded that conservative treatment remains an effective first-line option for adhesive capsulitis, though arthroscopic release may provide faster recovery of external rotation.
The article discusses the impacts of the COVID-19 pandemic on physiatry and rehabilitation medicine. It highlights how physiatrists played a vital role in the front lines during the pandemic by converting rehabilitation units and innovating care delivery. However, the pandemic has also caused significant disruptions and stress for medical practices through reduced patient volumes, higher costs, and threats of reimbursement cuts from insurers and governments. Moving forward, physicians are questioning the level of support they will receive from their employers and the government given the sacrifices many have made during the pandemic.
This study examined the reliability of classifications derived from Cyriax's resisted testing in subjects with painful shoulders and knees. Two physical therapists evaluated subjects' shoulder and knee motions under maximal isometric resistance twice. They rated contractions as strong or weak and noted any pain. Intrarater reliability for the knee was generally acceptable but not for the shoulder. Interrater reliability was generally not acceptable for either. More training and standardized resistance may improve reliability.
This study examined the intertester reliability of using James Cyriax's system for assessing patients with shoulder pain. Two experienced physical therapists independently evaluated 21 cases of painful shoulders using Cyriax's evaluation method. They classified the cases into specific shoulder lesions or indicated that the case did not fit the Cyriax model. The therapists agreed on the classification for 19 of the 21 cases, showing 90.5% agreement. Statistical analysis found "almost perfect" agreement between the therapists. Both therapists also agreed on the same 4 cases that did not fit the Cyriax model. The results demonstrate that Cyriax's evaluation can be a highly reliable method for assessing patients with shoulder pain.
This document discusses dyssynergia and sphincter dyssynergia. It defines dyssynergia as the dissociation of muscles that normally work in harmony and sphincter dyssynergia as the involuntary contraction or lack of relaxation of the striated or smooth sphincter. It describes the causes, types, complications and treatments of striated sphincter dyssynergia. The document was authored by the department of urology at GRH and KMC hospitals in Chennai, India.
This document discusses common causes of sleep problems and potential solutions. It notes that long work hours, multitasking, stress, unhealthy habits like late night snacks and screen time before bed can disrupt sleep. It recommends developing personal discipline, setting a routine, prioritizing relaxation in the evenings, avoiding stimulants before bed, spending time outdoors and exercising to promote natural sleep.
Sleep is essential for optimal functioning as it allows the brain to catalog experiences, prime memory, and regulate hormones. Getting less than 7-8 hours of sleep per night can negatively impact concentration, creativity, mood and productivity. Different stages of the sleep cycle, including deep sleep and REM sleep, are important for physical renewal, learning, memory processing and higher level thought. Lack of sufficient sleep, especially REM sleep, makes tasks like concentrating, multitasking and understanding subtleties more difficult. Managers can get more from their sleep by avoiding caffeine late in the day, creating a restful sleep environment, and taking short 10-20 minute power naps if needed.
Circadian rhythms refer to biological cycles that occur over approximately 24 hours. The suprachiasmatic nucleus (SCN) in the hypothalamus acts as the master pacemaker regulating circadian rhythms. Lesions to the SCN abolish circadian rhythms, while transplanted SCN tissue can impart rhythms to recipient animals. The SCN receives light input from retinal ganglion cells that contain melanopsin photoreceptors sensitive to blue light wavelengths.
Surgical options for Obstructive sleep apnoea syndromeGirish S
OBSTRUCTIVE SLEEP APNEA SYNDROME- REVIEW AND VARIOUS SURGICAL OPTIONS IN DETAIL.. based on Cummings & Scott new edition.. MS OTORHINOLARYNGOLOGY...
complete and detailed review of each operations like uvulopalatoplasty,epiglottoplasty, pillar implantation, tongue base reduction, laser and coblation techniques.. .
This document provides an overview of various sleep disorders including:
1. Dyssomnias are primary sleep disorders involving changes in sleep amount, quality or timing including insomnia, hypersomnia, and narcolepsy.
2. Parasomnias are disorders where sleep physiology or behaviors are affected, such as nightmares.
3. Circadian rhythm sleep disorders result from a mismatch between sleep-wake patterns and environmental demands like jet lag or shift work.
4. Breathing-related sleep disorders interrupt sleep through breathing problems like sleep apnea.
The document discusses various topics related to sleep including:
1. Sleep accounts for about 1/3 of our lifetime and 1/3 of the population has a sleep disorder.
2. Sleep is regulated by our circadian rhythm located in the hypothalamus and lasts approximately 24 hours.
3. A normal sleep cycle occurs every 90 minutes and includes NREM sleep, which accounts for 70-80% of sleep, and REM sleep, which accounts for 20-25% of sleep.
4. More than 80 known sleep disorders are classified as dyssomnias involving difficulties initiating or maintaining sleep or daytime sleepiness, or parasomnias involving abnormal events during sleep.
This document provides a summary of a presentation on sleep disorders organized into three main sections: physiology of normal sleep, disordered sleep, and sleep studies. It describes the stages and cycles of normal sleep including NREM and REM sleep. It discusses several common sleep disorders like insomnia, narcolepsy, restless leg syndrome, sleep apnea, and parasomnias. It also covers sleep disturbances related to medical, neurological and psychiatric conditions. Finally, it provides an overview of polysomnography and its clinical applications in diagnosing and managing various sleep disorders.
This document summarizes the key points from a sleep presentation. It discusses what constitutes normal sleep, common sleep disorders like insomnia, sleep apnea, and consequences of abnormal sleep. It also covers how lifestyle factors like routines, medications, and naps can help improve sleep quality. Specific sections summarize findings on women's sleep, how their biology and life stages impact sleep, and the effects of poor sleep on health.
JONAVolume 47, Number 1, pp 41-49Copyright B 2017 Wolters .docxvrickens
JONA
Volume 47, Number 1, pp 41-49
Copyright B 2017 Wolters Kluwer Health, Inc. All rights reserved.
T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N
The Effect of Reported Sleep,
Perceived Fatigue, and Sleepiness on
Cognitive Performance in a Sample of
Emergency Nurses
Lisa A. Wolf, PhD, RN, CEN, FAEN
Cydne Perhats, MPH
Altair Delao, MPH
Zoran Martinovich, PhD
OBJECTIVE: The aim of this study is to explore
the relationship between reported sleep, perceived
fatigue and sleepiness, and cognitive performance.
BACKGROUND: Although evidence suggests that
fatigue and sleepiness affect the provision of care in
inpatient units, there is a lack of research on the sleep
patterns of emergency nurses and the effects of dis-
turbed sleep and fatigue on their cognitive abilities
and susceptibility to medical errors.
METHODS: A quantitative correlational design was
used in this study; in each of 7 different statistical models,
zero-order relationships between predictors and the
dependent variable were examined with appropriate
inferential tests.
RESULTS: Participants reported high levels of
sleepiness and chronic fatigue that impeded full
functioning both at work and at home.
CONCLUSIONS: Although high levels of self-reported
fatigue did not show any effects on cognitive function,
other factors in the environment may contribute to
delayed, missed, or inappropriate care. Further research
is indicated.
Studies of worker fatigue in the military and com-
mercial trucking industries1,2 suggest that long hours,
especially extending into overnight, can be hazardous
in terms of the potential for errors due to sleepiness
and reduced vigilance. Medical providers, both nurses
and physicians, are at risk because of the need for
around-the-clock coverage and the number and type
of decisions they must make in a given time span; in
1989, the Bell Commission Report cited sleep depri-
vation in medical house officers as a major contrib-
utor to the 1984 death of Libby Zion, an 18-year-old
who died at New York Hospital, leading to a restruc-
turing of the hours involved in medical residencies.3
The long (up to 36 hour) shifts of the medical resi-
dents in charge of her care and the consequences of
their fatigue on the decisions that were made were
cited as factors in her death. As a result of their inves-
tigation of the case, the Bell commission recommen-
ded limiting the work hours of medical residents to
less than 80 hours a week and no more than 24 hours
in a row, and subsequent research has led to similar
recommendations for the nursing workforce.4,5
Emergency care settings are chaotic environ-
ments, where there is high patient turnover, constantly
changing priorities and frequent changes in patient
condition. High demand work settings are associated
with increased fatigue, which can impair nurses_ at-
tentiveness and ability not only to recognize potential
errors they might commit but also to recognize and
mitigate the errors of others, inc ...
This study examined the effect of Swedish massage on sleep quality and quantity in hospitalized children aged 4-12 years. 70 children were randomly assigned to a control or massage group. The massage group received 30 minutes of Swedish massage nightly for 3 nights. Sleep quality was measured using the CSHQ questionnaire completed by parents, and sleep quantity was measured via daily logs. Massage significantly improved scores on all CSHQ subscales and total sleep quality, but did not significantly impact sleep quantity. The study concluded that massage is an effective non-pharmacological intervention to improve children's sleep quality during hospitalization.
Implementation of a Non-Pharmacological Sleep Hygiene Routine Program to Impr...SadafFatima45
This document describes the implementation of a non-pharmacological sleep hygiene program on a transitional care unit. Researchers used experience-based co-design with patients and staff to develop a standardized sleep routine. They conducted two PDSA cycles to test and refine the intervention. Early results found that the routine improved sleep quality by 100% according to patient-reported scores. Next steps include optimizing the routine and spreading it to other units.
The Effect of Sleeping Pattern on the Academic Performance of Undergraduate M...iosrphr_editor
This study examined the relationship between sleeping patterns and academic performance among 190 undergraduate medical students in Ajman, United Arab Emirates. The study found that 48% of students slept 6-8 hours on average per night, while 22% slept less than 6 hours and 30% slept more than 8 hours. Students who slept more than 6 hours on weekends had significantly higher GPAs than those sleeping less than 6 hours. The majority (63%) of students felt 6-8 hours of sleep was needed for better academic performance. The study concluded that students need 6-8 hours of sleep daily for good health and academic success.
This study examined the relationship between sleeping patterns and academic performance among 190
undergraduate medical students in the United Arab Emirates. The results showed that 48% of students slept 6-8
hours on average during weekdays and weekends, while 22% slept less than 6 hours and 30% slept more than 8
hours. There was no significant difference in academic performance as measured by GPA between students who
slept different amounts. However, 63% of students felt that 6-8 hours of sleep was needed for better academic
performance. The study concluded that students need to understand the importance of sleeping 6-8 hours daily
for health and well-being.
Evaluation of Research Essay Discussion.pdfsdfghj21
This document provides guidelines for an assignment to evaluate empirical research related to a PICOT question. Students are instructed to write a 1,250-1,500 word paper evaluating literature on their PICOT question by addressing study conclusions, merits, and limitations. Feedback from instructors is also discussed, noting a revised PICOT question focusing more specifically on patient outcomes and data collection time period.
The document describes a study that compared characteristics of patients with obstructive sleep apnea (OSA) who were classified as sleepy versus non-sleepy. Sleepy patients had shorter total sleep time, less nocturnal sleep, more time awake during sleep, and reported poorer sleep quality and greater functional impairment. The results suggest behavioral factors leading to shorter and poorer sleep may contribute to greater subjective sleepiness and symptoms among OSA patients.
This study explored sleep and daytime function in cardiac surgery patients before and after surgery. It found that patients perceived their nighttime sleep as ineffective throughout their recovery, requiring increased daytime naps. Nighttime routine care like checks were found to disrupt sleep. The study concluded larger and more diverse studies are needed to understand how to improve sleep and subsequent patient outcomes, and that nurses should lead efforts to transform nighttime care processes to better promote patient sleep, health, and well-being.
Have you ever tried to sleep in a brightly lit room with tubes and wires attached to you and people periodically talking to you ! moving you ! and touching you !
Joe a well respected RN with many years of experience, worked in.docxvrickens
"Joe" a well respected RN with many years of experience, worked in the intensive care unit. One afternoon a patient was brought to the unit immediately post heart surgery. Joe assumed his care, and began his assessment. Shortly after the patient's arrival, the surgeon came in to see that patient.
The surgeon decided that he needed to replace a blocked central line, although the patient did have two patent peripheral IVs. Joe assisted the surgeon with the line placement, then called for radiology to come up and confirm line placement, as per protocol. Just as Joe heard the radiology tech coming, the patient developed asystole. Joe and the surgeon instituted ACLS protocol. When the surgeon called for a medication to be pushed, Joe went to push it via the patent peripheral IV, as placement of the central line had not been confirmed. The surgeon yelled 'No! In the central line! Push it in the central line!' Joe responded, 'The central line placement has not been confirmed, so it has to go through the peripheral." At this point, the surgeon yelled, "I want it through the central line, and you have to do what I say, because I'm the physician!" Joe yelled back that he was not going to risk his license just because a physician refused to follow protocol. He told the surgeon that he would push it through the peripheral line. The surgeon was livid, but made no attempt to push the med himself, so Joe pushed it through the peripheral line. The patient was then revived.
Joe and the surgeon continued to argue after the patient was resuscitated, to the point where other staff feared a fist fight would ensue. The house manager, an RN, was called in. Joe explained the situation to her. The surgeon said "I told him he was a nurse and he had to do what I told him to do. He's not going to lose his license or get fired as long as he does what I tell him to do. But he won't listen."
The house manager responded. "Well, the hospital policy does say that central lines cannot be used until placement has been confirmed by radiology." The surgeon went berserk, yelling at everyone. The house manager then said "well, if you want, we can change that policy so if a physician says it's ok, the line can be used without confirmation."
What do you think of the house manager's response to the situation?
What, if anything, do you think Joe should have done differently?
How would you have responded?
What do you suggest should be done about this proposed change in the policy?
Contents lists available at ScienceDirect
International Journal of Nursing Studies
journal homepage: www.elsevier.com/locate/ijns
Effect of non-nutritive sucking and sucrose alone and in combination for
repeated procedural pain in preterm infants: A randomized controlled trial
Haixia Gaoa,⁎, Mei Lib, Honglian Gaoc, Guihua Xua, Fang Lib, Jing Zhoub, Yunsu Zoub,
Honghua Jiangb
a School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
b Children’s Hospital of Nanjing Medical U ...
This study explored factors underlying individual differences in daytime sleepiness in patients newly diagnosed with obstructive sleep apnea (OSA). Participants underwent one week of actigraphy, laboratory tests of sleepiness, and a home sleep study. The results showed 32% of participants were classified as sleepy based on standardized tests, while 27% were non-sleepy. The sleepy group had higher BMI, less alcohol/education, more limb movements and medication use, and spent more time awake during sleep tests. However, variability in apnea severity did not differ between groups. The causes of sleepiness variability in OSA patients are multifactorial, including biological factors like genetics.
The SAFE Study Electronic monitoring of patients with depression when dischar...Petar Zaykov
This study investigated electronic monitoring of mood, sleep, and activity in patients with depression after being discharged from inpatient care. 29 patients used a mobile app called Daybuilder to track these factors daily for 4 weeks, including some time in inpatient care, after discharge, and while receiving outpatient treatment. Preliminary results found high usability of the app with good adherence. Sleep onset times did not change significantly but offset times were delayed after discharge, associated with less mood improvement. Daily variations in mood and sleep were large. The study suggests electronic monitoring with weekly feedback focusing on sleep may help patients avoid delays that could worsen depression outcomes.
Work related musculoskeletal disorders in physical therapistsTuğçehan Kara
This study examined work-related musculoskeletal disorders (WMSDs) in physical therapists through a prospective cohort study with 1-year follow up. The study found that 57.5% of physical therapists reported a WMSD in the follow up year, with a 1-year prevalence rate of 28% and incidence rate of 20.7%. Risk factors for low back WMSDs included patient transfers, repositioning, bent/twisted postures, and job strain. Risk factors for wrist/hand WMSDs included soft tissue work, joint mobilization, and manual therapy techniques. The study recommends safer patient handling policies and further research to examine the link between physical therapy exposures and WMSDs.
HOW CAN SLEEP DEPRIVATION IMPACTS VIGILANCE RESPONSE TIMES: AN ANALYSIS OF SL...KaylahPolzin
- The document is a research paper that analyzes the impact of sleepiness on response times during a vigilance task called the Psychomotor Vigilance Test (PVT).
- The study found a strong, positive correlation between self-reported sleepiness levels and increased lapses (slower response times over 500ms) on the PVT, suggesting increased sleepiness is linked to poorer cognitive performance. However, there was no correlation found between hours slept and PVT lapses.
- The findings indicate that feeling sleepy, rather than simply hours slept, is a better predictor of vigilance and sustained attention performance according to the PVT results. This suggests sleepiness significantly impacts cognitive functions like vigilance.
1) The study aimed to test whether a heart rate variability biofeedback device called StressEraser could reduce the "first night effect" of poor sleep in a lab by moderating adaptation.
2) 10 healthy participants without sleep disorders were randomly assigned to use StressEraser or a no-treatment control during their first night polysomnogram.
3) Participants who used StressEraser had significantly lower scores on a sleep disturbance scale compared to the control group, indicating it improved sleep quality and reduced the first night effect. However, sleep latency was unchanged.
This study examined the relationship between daily physical activity and sleep quality and quantity in college students using Fitbit devices. 11 college students wore Fitbits for 2 weeks to track their active minutes and sleep data. Preliminary descriptive results found a strong positive relationship between average active minutes per day and average hours slept per night, supporting the hypothesis that more activity leads to more sleep. A weaker positive relationship was also found between average active minutes and average number of awakenings per night. With a larger sample, the researchers aim to conduct statistical analyses and further examine potential bidirectional relationships between physical activity and sleep.
Prevalence of musculo skeletal disorders among nurses in osun state, nigeriaAlexander Decker
This study aimed to determine the prevalence of musculoskeletal disorders among nurses in two teaching hospitals in Osun State, Nigeria. A questionnaire was administered to 138 nurses. The results showed:
1) The most common musculoskeletal disorder was lower back pain, affecting 70.3% of nurses.
2) Musculoskeletal disorders were highly prevalent in nurses aged 26-31 years (100%) and those working in theaters (100%) and medical wards (100%).
3) More nurses experienced musculoskeletal disorders after working hours (45.7%) and those working more than 40 hours per week (90.4%).
This study assessed satisfaction in 89 women who underwent concurrent pelvic organ prolapse (POP) repair and midurethral sling placement to treat stress urinary incontinence (SUI). At the 1-year follow-up, 72% of patients had complete cure of both POP and SUI, while 17% and 10% had persistent SUI or POP respectively. Overall, 88% reported being satisfied. Patients who achieved complete cure of both conditions had a 95% satisfaction rate, while 40% were dissatisfied if SUI was not cured and 22% if POP was not cured. The only outcome measure correlated with satisfaction was improvement in vaginal bulge symptoms. The study highlights the complex relationship between surgical outcomes and patient
Similar to Perceived effects of rotating shift work on nurses’ sleep quality and duration (20)
Socio-demographic characteristics associated with HIV and syphilis seroreacti...Humphrey Misiri
This document summarizes a study of socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre, Malawi between 2000-2004. The study found that 30% of women were HIV positive and 5% were syphilis seroreactive. In multivariate analysis, HIV infection was positively associated with higher socioeconomic status, being formerly married, and older age. Syphilis seroreactivity was positively associated with rural residence, multigravidity, and previous STI diagnosis and negatively associated with higher education levels. The results demonstrate the need for improved strategies to prevent HIV and syphilis in women in Malawi.
This study analyzed records of leprosy cases from Nkhotakota District Hospital in Malawi between 1992-2001:
- A total of 526 leprosy cases were identified, with prevalence rates peaking at 3.39 per 10,000 people in 1995 before declining.
- Paucibacillary leprosy was more common than multibacillary leprosy, accounting for 84.8% of cases.
- More males had multibacillary leprosy compared to females, while more females had paucibacillary leprosy than males.
- The results indicate that paucibacillary leprosy remains a public health issue in the region as a reflection
Cancer incidence in Malawi: Time trends in Blantyre 1996-2005 and predictions...Humphrey Misiri
This document analyzes cancer incidence data from the Malawi National Cancer Registry from 1996 to 2005 to describe cancer patterns and predict incidence up to 2015. The most common cancers were Kaposi sarcoma, cervical cancer, esophageal cancer, non-Hodgkin lymphoma, eye cancer, and breast cancer. Linear trend models predicted the number of cancer cases in Malawi would increase nearly threefold by 2015, from 961 cases to an estimated upper limit of 2512 cases, due to population growth, aging, and the HIV pandemic.
- The study analyzed age at cancer diagnosis data from Malawi's National Cancer Registry from 1996-2005.
- The median ages at diagnosis were lower for AIDS-defining cancers (most 42 years) than non-AIDS defining cancers (at least 46 years).
- Childhood and adult cancer ages followed lognormal distributions. The overall age distribution was best fit by a finite mixture of two lognormal distributions, with means of 5.1 and 45.1 years, suggesting a bimodal distribution with peaks in childhood and mid-adulthood.
Estimation of HIV incidence in Malawi from cross-sectional population-based s...Humphrey Misiri
This document summarizes a study that estimated HIV incidence rates in Malawi using cross-sectional HIV prevalence data from the 2004 Malawi Demographic and Health Survey. The researchers developed a recurrence relation to model population prevalence over age groups as a function of age-specific force of infection (FOI) and mortality rates. They estimated parameters by maximum likelihood and assessed model fit. Estimated HIV incidence per 100,000 person-years was highest for females ages 15-24 (2030) and males ages 25-34 (2700), and lowest for males ages 15-24 (610). The method provides a simple way to simultaneously estimate incidence and prevalence from single-time-point cross-sectional data.
Are Public Antenatal Clinics in Blantyre, Malawi, Ready to Offer Services for...Humphrey Misiri
The document summarizes a study that assessed midwives' perceptions of services for preventing mother-to-child transmission of HIV in public antenatal clinics in Blantyre, Malawi. Key findings included:
1) Midwives reported routinely providing HIV prevention messages but few clinics offered condoms or STI screening.
2) While most midwives advised exclusive breastfeeding, some were unsure how to advise HIV-positive women.
3) Facilities often lacked appropriate space, counselors, and supplies to properly provide maternity services and HIV testing.
4) Additional training and support are needed for midwives to adequately care for antenatal women regarding HIV prevention.
Estimation of HIV incidence in Malawi from cross-sectional population-based s...Humphrey Misiri
This document summarizes a study that estimated HIV incidence rates in Malawi using cross-sectional population data from 2004. The researchers formulated a recurrence relation to model population prevalence over time based on a piecewise-constant force of HIV infection that adjusts for natural and HIV-induced mortality. They estimated parameters by maximum likelihood and assessed model fit. Estimated HIV incidence per 100,000 person-years was 610 for men aged 15-24, 2700 for men 25-34, and 1320 for men 35-49. For women it was 2030 for 15-24, 1710 for 25-34, and 1730 for 35-49. The method provides a simple way to estimate incidence from cross-sectional prevalence data
An assessment of food supplementationto chronically sick patients receiving ...Humphrey Misiri
1. The study assessed the impact of food supplementation provided by the World Food Programme to patients enrolled in a home-based care program for chronically ill patients in Malawi, most of whom had HIV/AIDS.
2. The study compared the survival and nutritional status of patients who did not receive food supplementation before July 2003 to those who received supplementation after. It found that food supplementation did not improve patient survival or nutritional status, though it had a small non-significant effect on nutritional status.
3. Providing additional oil to some families may have improved survival slightly but did not affect nutritional status. The study concludes that food supplementation was not very effective for these patients, possibly because the intervention came too late or
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Perceived effects of rotating shift work on nurses’ sleep quality and duration
1. Malawi Medical Journal; 21(1):19 - 21 March 2009
Perceived effects of rotating shift work on nurses’
sleep quality and duration
Yuri P Zverev1, Humphrey E.Misiri2
1. Department of Physiology, College of Medicine, University of
Malawi
2. Department of Community Health, College of Medicine, University
of Malawi
Corresponding author: Prof. Y.P. Zverev, Physiology Department College
of Medicine, University of Malawi, P.O.Bag 360, Chichiri, Blantyre 3,
Malawi E-mail: yzverev@yahoo.com Phone : +2658-861-600
Abstract
The aim of this longitudinal study was to assess the effect
of rotating shift work on perceived sleep quality and sleep
duration of nurses at Queen Elizabeth Central Hospital,
Blantyre, Malawi. Twenty four female nurses were recruited
at random from among personnel engaged in rotating shift
work. The nurses worked a three-phase schedule: five day
shifts (7.00 – 17.00) followed by three night shifts (17.00
– 7.00) and five days off. Controls were 22 female nurses
who did not perform night duties. Sleep quality and duration was assessed using standardized and validated questionnaires on sleep duration and subjective sleep quality (SSQ).
One-way analysis of variance revealed a significant effect of
shift phase on total sleep duration (F = 36.8, d.f. = 8, P <
0.000) and perceived sleep quality (F = 8.81, d.f. = 3, P <
0.000). Night shift work was associated with reduction of
sleep quality and duration. The after effects of night shifts
persisted during days of the recovery period indicating accumulation of fatigue.
Introduction
It has been well documented that shift work results in
psychosomatic disorders, decreased alertness, increased
tiredness, changes in mood and motivation, malaise and
irritability, decreased safety and productivity of work,
gastrointestinal and musculoskeletal disorders1-3. However,
sleep disturbances are among the most frequent complaints
reported by shift workers4,5. Impaired sleep pattern and
alertness of shift workers have been attributed to the conflict
between circadian rhythms and working irregular hours6.
During prolonged periods of shift work circadian rhythms
gradually adapt to the new schedule but adaptation is not
complete especially when shift work is irregular6.
The effects of shift work on sleep behaviour have been
studied for workers of various professions in natural
environment as well as in laboratory conditions5-8. There are
very few studies which involved medical personnel9-11 and
most of them were conducted in western countries. Reallife settings in Africa are different from those in developed
countries with augmented disadvantages of shift work and
minimal advantages such as increased pay or increased time
for education. Therefore it is reasonable to suggest that
shift work might have considerable adverse effects on sleep
behaviour of Malawian nurses.
The aim of the present study was to assess the effect of
rotating shift work on perceived sleep quality and sleep
duration of nurses at Queen Elizabeth Central Hospital,
Blantyre, Malawi.
Materials and methods
The survey was conducted at Queen Elizabeth Central
Hospital, Blantyre, Malawi. Twenty-nine female nurses were
recruited using systematic random sampling from among
the personnel involved in rotation shift work. Workload of
the nurses varied from shift to shift and from ward to ward.
However, nurses working in very busy units such as labour
ward and intensive care unit were not included into study
population in order to increase homogeneity of the sample.
24 of them completed all questionnaires and were included in
study population. The nurses worked a three-phase schedule:
five day shifts (7.00 – 17.00) followed by three night shifts
(17.00 – 7.00) and five days off. The nurses were followed
for one entire shift cycle, which lasted 13 days. All nurses in
the study group have been doing shift work for at least one
month. Controls were recruited from among female nurses
working day time only and who were not performing night
time duties for at least 4 months prior to the study in order to
reduce long-term effects of night work12. Control group was
matched with study group by age and length of service.
The participants filled in standardized questionnaires
concerning their sleep duration and sleep quality5, which
were locally validated. The nurses reported duration of night
sleep and daytime naps. The subjective sleep quality (SSQ)
questionnaire included 14 items, which covered various
sleep complaints such as trouble with falling asleep (2 items),
insufficient sleep (3 items), general sleep quality (3 items),
tossing and turning (1 item), trouble with sleeping on (3
items), waking up unrested (2 items). The items were grouped
in ascending order of severity of sleeping complaints. The
higher score on the scale corresponded with lower subjective
quality of sleep. High reliability of the SSQ questionnaire
has been demonstrated by several international studies
(Cronbach coefficient alpha was 0.89)5,13. We tested the
instrument for content or face validity to determine if it
still measures what it was intended to test. To carry out this
procedure the instrument was initially reviewed by 10 nurses.
They were asked to comment and to clarify confusing items,
to update terms, and to comment on the apparent validity of
each item. No items were changed, which indicated the high
validity of the instrument in local setting14.
There are two response variables for this study and these are
total sleep duration (minutes) and sleep quality. Sleep quality
is measured by the sleep quality score (SSQ). These outcome
variables are quantitative. There are two independent
variables and these are shift phase and study group. Shift
phase has three levels namely day shift, night shift and days
off .There are two study groups. Both shift phase and study
group are nominal variables. Other variables are age and
length of service. These two were used to match study and
control subjects. The effect of shift phase on total sleep
duration was examined using one-way analysis of variance.
The total sleep duration for the three shift phases were also
compared. These multiple comparisons were performed
using the Bonferroni correction15. All tests were conducted
at the 5% level of significance.
2. Perceived effects of rotating shift work on nurses 20
Table 1. Means (±SD) of reported sleep duration (minutes) and mean (±SD) scores on the subjective sleep quality scale of
group of nurses during day shift (days 1 to 5), subsequent night shifts (days 6 to 8) and days off (days 9 to 13).
Shift Phase
Day Shift
Day of Shift
Phase (i)
1
2
Sleep duration
(mins)
384±66
Sleep quality
(SSQ)
3.2±1.6
3
Night Shift
4
5
Days Off
6
7
8
9
10
11
402±54 396±73 390±68 407±64
228±58
232±49 241±55 597±88 582±106 586±111 562±84 538±79
3.0±1.5 3.1±1.4 3.2±1.7 3.1±1.6
6.2±1.8
6.5±1.7 6.7±1.8 4.1±1.7 4.3±1.5
4.1±1.5
12
13
3.9±1.6 3.2±1.3
Table 2. Means and SD of reported sleep duration (minutes) and scores on the subjective sleep
quality scale of control group of nurses during week days (1-5) and weekends (6 and 7).
Days of week
1
2
3
4
5
6
7
Sleep duration
410±69
398±76
367±58
413±67
407±79
469±79
451±84
Sleep quality
2.7±1.1
3.1±1.2
2.6±1.1
3.0±1.1
3.2±1.3
2.4±1.2
2.5±1.0
Results
Twenty six nurses were approached, 22 returned completed
questionnaires.The mean age of nurses in the study group
was 40.0±7.4 years and in the control group it was 41.4
± 7.9 years. The mean length of medical service was 14.3
± 5.7 years and 15.1 ±6.1 years in the study and control
groups, respectively. All subjects gave informed consent to
participate in the survey and permission was also obtained
from hospital management.
Table 1 shows the mean values and SD of self-reported total
sleep duration (night sleep plus day time naps) of a group
of rotating shift nurses during three phases (day shift, night
shift and days off) of a shift cycle. One-way analysis of
variance revealed a significant effect of shift phase on total
sleep duration (F = 36.8, d.f. = 8, P < 0.000). Comparison
of means total duration of sleep of the 3 phases of shift
cycle showed that total duration of sleep was significantly
lower during days of night shifts (t = 2.84, P < 0.01) and
significantly higher during days off (t = 2.58, P < 0.02).
However no significant difference was observed between
various days of the same shift phase. The average duration
of naps during night shifts and days off was not significantly
different (84 ± 66 minutes and 96 ± 77 minutes, respectively).
The mean duration of night time sleep during night shifts
(151 ± 52 minutes) was significantly shorter (t = 16.09, P <
000) than during days off (477 ± 87 minutes). None of the
participants napped during day- shift phase.
The mean values of perceived sleep quality scores for the
study group are shown in Table 1. Shift work had a significant
effect on SSQ score (F = 8.81, d.f. = 3, P < 0.0001). The
difference in subjective sleep quality between various days
within one phase of shift cycle was not significant.
Table 2 shows the mean sleep duration and SSQ scores
of the control group of nurses. There was no significant
difference in total sleep duration and SSQ scores between
work days and days off in this group. Comparison of the
study and control groups indicated that nurses on rotating
shift system slept significantly less than nurses in the control
group during night-shift phase (t = 10.91, P < 0.000) but
significantly longer during days off (t = 6.92, P < 0.000). The
mean duration of total sleep time during day- shift phase of
rotating shift system was similar to that of the control group.
SSQ score in the study group was higher than in the control
group during night shifts and days off (t = 2.34, P < 0.05,
and t = 2.86, P < 0.01, respectively) and it was similar to the
control group during day-shift phase.
Discussion
The most striking finding of the present study is the
considerably shortened duration of total sleep time and low
sleep quality of nurses on rotating shift system during nightshift phase. On average, nurses on night shift slept 3 hours
less than nurses of similar age who did not work during
nights. This reduction in total sleep time was due to decreased
duration of day-time sleep which was considerably shorter
than in studies conducted in western countries9,16,17. As a
result, day-time naps did not compensate for reduced night
sleep and by the end of the 3-days night shift period nurses
have accumulated about 10 hours of sleep deprivation. Most
of our participants indicated that they do not have a place
for day-time rest in their houses. Environmental noise and
social demands might be also responsible for short duration
of day time sleep of nurses in this study. In addition, the
interval between 2 night shifts in rotating system was too
short, only 10 hours. Therefore it was difficult for the nurses
on night shifts in this study to find a consistent 7-hour
period to sleep. It has been demonstrated that more than 16
hours between work shifts is required to allow more than 7
hours of total sleep time18. Therefore, it is not surprising that
duration of sleep was prolonged during 5 days off when on
average nurses slept 9 to 10 hours per day and accumulated
about 15 hours of excessive sleep time, which was higher
than cumulative sleep deprivation. Prolonged duration of
sleep during days off indicated presence of significant aftereffects of night work during the entire recovery period.
In addition to reduced sleep duration, the study group
of nurses had low sleep quality during night shifts and
subsequent days off compared to the control group. It
has been demonstrated that under normal conditions of
undisturbed night sleep, the SSQ score varies between 1 and
2 units5,9. In the present study the mean values of SSQ score
were above 6 units during night shifts and between 3 and 4
units during day work and days off. Therefore, sleep quality
of nurses improved during undisturbed nights – probably
due to reduction in cumulative sleep deficit – but it remained
lower than that of nurses who were not engaged in shift work.
The presence of prolonged period of after-effects which
MMJ 21(1) 2009 www.mmj.medcol.mw
3. 21 Perceived effects of rotating shift work on nurses
continued through the days off to the day shift period of the
next shift cycle suggests that nurses might start their next
shift period in a sub-optimal condition which could reduce
adjustment to shift work and professional performance.8
Several factors can contribute to poor sleep quality of nurses
on rotating shifts. First, rapid and continuous rotation of
shifts leads to a lasting alteration of circadian rhythm and to
a transitory increase of psychological disturbances after the
night shift19. Both factors affect sleep quality and should be
targeted in coping strategies with shift work. Second, sleep
quality directly relates to sleep duration. For example, getting
less than 6 hours of sleep significantly correlates with sleep
disturbances and low sleep quality20. In the present study,
sleep duration of nurses during night shifts was 4 hours and
less per day. Therefore, it is not surprising that they reported
low sleep quality. Longer duration of sleep during day shift
and days off was also associated with better sleep quality of
nurses.”
The findings of our study indicated that additional
administrational and organizational interventions and coping
strategies should be introduced at the hospital. In the present
study the duration of shift cycle was 13 days, which indicated
biweekly rotating system. This system was often altered due
to insufficient staffing situation and might be considered as
irregular. From the point of view of freedom from sleep
deprivation, the shift system currently used at the hospital
is far from being optimal. The duration of a night shift at
the hospital was 14 hours. It has been demonstrated that
long night shift decreases alertness of nurses during the
terminal hours of work and suggests risk of compromised
patient care7 Long night shift can be considered acceptable
provided the work load of nurses is reduced and there are
sufficient rest pauses available to compensate for tiredness
and sleepiness,21,22 It has been suggested9 that permanent
or very slowly rotating shift systems might be superior to
rapidly rotating and irregular shift systems used at the
hospital. Therefore, the hospital should consider replacing
current shift system with slowly rotating shift system.
Preservation of normal diurnal orientation is very important
for good sleep quality and adequate sleep duration of nurses.
From this prospective, the sleep-wake strategy with long
naps during night work and short day-time sleep is more
beneficial for sleep quality and readjustment to diurnal life
than the strategy with long day-time sleep and preventive late
afternoon naps to anticipate sleepiness during night work23.
Therefore, shift-work nurses should be properly counselled
on their sleep-wake strategy. It has been demonstrated that
individual psychological counselling or group educational
interventions can significantly reduce negative impact of
shift work on nurses24.
All data reported in this study are subjective and have
limitations similar to other investigations where assessment
of psychophysiological parameters was done using selfreports. There are many physiological and psychological
events that occur during the sleep period and during the
state of wakefulness that impact the individual’s perceived
sleep quality. These subjective aspects of sleep are difficult to
examine with objective physiological measures. However, it
is this subjective component of sleep that is most important
to an individual.
MMJ 21(1) 2009 www.mmj.medcol.mw
In conclusion, night shifts were associated with decreased
self-reported sleep duration and perceived sleep quality of
nurses. The after-effects of night shifts persisted during
days of the recovery period indicating accumulation of
fatigue. We suggest that replacing current shift system with
slowly rotating shift system and optimization of sleep-wake
strategy could improve sleep quality of nurses.
Acknowledgements
The authors wish to acknowledge with gratitude the
cooperation of hospital management and the nurses who
participated in the survey. Technical assistance of Mr. D.
Mbewe and Ms K. Mpesi and second year medical students
is highly appreciated.
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