Background:Research on the possible association between shiftwork and breast cancer is complicated because there are many different shiftwork factors, which might be involved including: light at night, phase shift, sleep disruption and changes in lifestyle factors while on shiftwork (diet, physical activity, alcohol intake and low sun exposure).Methods:We conducted a population-based case–control study in Western Australia from 2009 to 2011 with 1205 incident breast cancer cases and 1789 frequency age-matched controls. A self-administered questionnaire was used to collect demographic, reproductive, and lifestyle factors and lifetime occupational history and a telephone interview was used to obtain further details about the shiftwork factors listed above.Results:A small increase in risk was suggested for those ever doing the graveyard shift (work between midnight and 0500 hours) and breast cancer (odds ratio (OR)=1.16, 95% confidence interval (CI)=0.97–1.39). For phase shift, we found a 22% increase in breast cancer risk (OR=1.22, 95% CI=1.01–1.47) with a statistically significant dose–response relationship (P=0.04). For the other shiftwork factors, risks were marginally elevated and not statistically significant.Conclusion:We found some evidence that some of the factors involved in shiftwork may be associated with breast cancer but the ORs were low and there were inconsistencies in duration and dose–response relationships.

Health care workers are exposed to numerous workplace hazards. The implementation of safety measures in high-income countries has largely mitigated these risks. However, in many low- and middle- income countries (LMICs), resources to institute safety measures are lacking, increasing the risk of occupational exposures to these hazards. The aim of this scoping review is to map and synthesize the available research on occupational hazards among health care workers in LMICs, identify research gaps and inform policy. Searches for relevant articles were conducted in five electronic databases using a broad range of search terms. The inclusion criteria were: quantitative observational or experimental studies which examined exposure to one or more occupational hazards among health care workers in a LMCI; and the article was published in English in a peer-reviewed journal. A total of 99 studies met the inclusion criteria, and data were extracted from these studies. Large proportions of health care workers in LMICs were exposed to biological hazards (bloodborne pathogens, tuberculosis), psychosocial hazards (workplace violence, burnout, job dissatisfaction), ergonomic hazards (musculoskeletal complaints), and chemical hazards (exposure to latex and antineoplastic drugs). The implementation of risk reduction strategies was suboptimal. The majority of the literature was on biological hazards (48%), and research on other hazards was limited in comparison. Occupational safety needs to become a priority public health issue to protect health care workers in LMICs. More research is needed to understand the magnitude of the problem in these countries.

Aim Aim of this study is to systematically review and synthesize available evidence to identify the association between nurse staffing methodologies and nurse and patient outcomes. Design Systematic review and narrative synthesis. Data sources A search of MEDLINE (EBSCO), CINAHL (EBSCO) and Web of Science was conducted for studies published in English between January 2000 and January 2020. Review methods The reporting of this review and narrative synthesis was guided by the preferred reporting items for systematic and meta‐analysis guidelines (PRISMA) statement and data synthesis guided by the Synthesis Without Meta‐analysis (SWiM) guideline. The quality of each article was assessed using the Mixed Methods Appraisal Tool. Results Twenty‐two studies met the inclusion criteria. Twenty‐one used the mandated minimum nurse‐to‐patient ratio methodology and one study assessed the number of nurse hours per patient day staffing methodology. Both methodologies were mandated. All studies that reported on nurse outcomes demonstrated an improvement associated with the implementation of mandated minimum nurse‐to‐patient ratio, but findings related to patient outcomes were inconclusive. Conclusions Evidence on the impact of specific nurse staffing methodologies and patient and nurse outcomes remains highly limited. Future studies that examine the impact of specific staffing methodologies on outcomes are required to inform this fundamental area of management and practice.

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Background: Qat (also known as Khat, Kat and Miraa) is a green-leaved plant (Catha edu-