Aims: To determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts. Background: Shift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care. Methods: An observational study using wrist actigraphs was conducted from 2019 to 2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift. Results: Nurses demonstrated shorter sleep hours, lower sleep efficiency and longer sleep latency before night shifts compared with other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70. Conclusions: Sleep parameters and fatigue level contributed to the differences in decline in alertness across shifts.

Aging has been implicated in the alteration of taste acuity. Diet can affect taste sensitivity. We aimed to investigate the types of tastes altered in elderly Korean people and factors associated with taste alteration in relation to dietary intake and other factors. Elderly participants (≥65 years) and young adults were assessed to determine their recognition thresholds (RT) for sweet, salty, bitter, sour, and umami tastes. Elderly participants were further surveyed for dietary intake and non-nutritional factors. Five taste RTs were correlated with age, but only four taste RTs, except sweetness, differed between the elderly participants and young adults. Inadequate intake of iron, thiamin, folic acid, zinc, and phosphorus among the elderly participants was related to elevated taste RT levels, except for bitter taste. In both correlation and regression analyses, only salty and sour RTs were associated with energy, iron, thiamin, fiber, vitamin C, and riboflavin levels in the elderly participants. The elderly participants’ taste RTs exhibited strong associations with quality of life (QOL) but showed partial relationships with physical activity, number of medicine intakes, social gatherings, and education. Taste sensitivity may decrease with age, which is further influenced by insufficient dietary intake, especially iron and thiamin, and QOL.

Most nurses work in shifts to deliver 24-h patient care globally (Pélissier et al., 2020). In South Korea, 82.1% of nurses in hospitals work in an eight-hour rapid rotating-shift system (i.e., different shifts every two to three days), including night shifts, and 2.8% work 12-h rotating shifts (Hospital Nurses Association, 2020). Shift work, especially night shifts, can induce fatigue in nurses owing to insufficient sleep and inadequate recovery time between shifts, thus affecting their abilities to provide high-quality care for patients owing to declined alertness (Ganesan et al., 2019;Min et al., 2021;Trinkoff et al., 2011). The decline in alertness from sleep deprivation is equivalent to the effects of blood alcohol concentrations (BAC) of 0.05%-0.1% (James et al., 2020). This is described as sleepiness (Geiger-Brown et al., 2012) and/or vigilance (Geiger-Brown et al., 2012) in previous literature. Scott et al. (2006) indicated that 65% of critical care nurses struggled to stay awake during their shifts, and 20% had fallen asleep at least once. Notably, more than half the nurses

Purpose Cancer treatment may relate to appetite reduction and malnutrition. We investigated taste alterations and dish-type preferences during chemo-and/or radiation therapy in breast cancer patients. Methods Breast cancer patients (BC, n = 59) scheduled to receive cancer therapy and healthy subjects (control group or CTRL, n = 49) were voluntarily recruited. Taste detection thresholds (DTs) and recognition thresholds (RT) were compared between pre-treatment BC patients and CTRL for sweet (sucrose), salty (NaCl), bitter (caffeine), and sour (citric acid) solutions. Changes in taste thresholds and dish preferences during treatment were monitored in the BC group. Blood chemistry and anthropometric data were collected. Results At baseline, BC patients demonstrated lower sweet and salty DTs and RTs and a higher sour RT compared to CTRL. Bitter DT and RT were similar in both groups. Mild/soft dishes were preferred over fried/oily dishes by BC patients. Throughout treatment in BC patients, sweet thresholds significantly declined, while salty, bitter, and sour DTs and RTs were not affected, and there was no increase in preference for a dish. However, preference towards mild/soft dishes remained. While sweet-sour fruits and sweetened nuts were not favored during therapy. Conclusions Sensitivities to sweet, salty, and sour but not bitter tastes differed between BC patients and CTRL. During treatment, sweet taste sensitivity increased while other tastes were unaffected. BC patients preferred mild/soft dishes over fried and sweetened dishes compared to CTRL. Our findings may contribute to developing dishes for breast cancer patients to increase food intake and thereby lower the risk of malnutrition.

Aims and objectives This study aimed to determine the effect of overtime on alertness at work among rotating‐shift nurses in South Korea and to investigate whether these effects of overtime vary across the different types of shifts. Background Nurse overtime is prevalent in healthcare settings to manage nursing shortages and staffing needs; however, it negatively affects patient and nurse outcomes. Furthermore, little attention has been paid to the effects of previous overtime shifts and overtime for consecutive shifts on alertness during work. Design A prospective observational study was employed. The study followed STROBE checklist for observational studies. Methods Data were collected between June 2019 and February 2020 from 82 nurses who worked in acute care hospitals. An ecological momentary assessment was used to capture real‐time data of overtime and alertness. Alertness scores were estimated using the sleep/wake data measured by an actigraph. Mixed‐effect models were employed to investigate the association between overtime and alertness. Results A majority of the shift nurses worked overtime. Episodes of a decline in alertness scores to the level of increased accident or serious error risk (alertness score ≤80) were most frequently seen during night shifts (98.9%), followed by day (59.8%) and evening shifts (10.1%). Previous‐day overtime hours and consecutive overtime days were associated with decreased alertness scores during work. A significantly positive correlation was observed between alertness scores ≤80 and previous‐day overtime hours and consecutive overtime days in all shifts. Conclusions The study findings indicate that a majority of nurses who work overtime experience decreased alertness while on duty. Relevance to clinical practice Policy development at the government, organisational and unit level is needed to guarantee adequate rest for shift nurses by adjusting work schedules and assignments and limiting overtime.