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Post-electrocution persistent manic-depressive syndrome: a unique diagnostic syndrome and a red flag against electroconvulsive therapy?

Nahdiya S, Syukri C

Med J Malaysia, 2018 12;73(6):441-442.
PMID: 30647228

Bipolar mood disorder is an established psychiatric disorder affecting 1% of the population and it is a highly disabling disease. As of today, its aetiology is still a confounding question. This case is interesting as the patient presented with a full-blown mania after suffering from electrical injury. The persistent syndrome in this case could point to a unique diagnostic entity and offer possible explanation of the pathophysiology of manic depressive as well as a consideration for caution when prescribing electroconvulsive therapy (ECT).

Matched MeSH terms: Middle Aged
IgG4 related orbit disease - An unusual cause of an orbital mass

Chidambaram VA, Anita CSY, Robert C, Garry C

Med J Malaysia, 2018 12;73(6):415-417.
PMID: 30647218

IgG4-related disease is a newly described systemic autoimmune and allergic disease, characterized histologically by a fibroinflammatory response with IgG4 plasma cells. It was initially described as affecting the pancreas, but commonly involves the head and neck region as well. While a biopsy is essential for definitive diagnosis, cross sectional imaging may be the initial modality which may suggest this entity. We describe a case of pathologically proven IgG4 related disease which highlights some key radiologic features seen in this entity. Our case highlights some key radiological features of IgG4- related disease in the head and neck, with involvement of the lacrimal glands, pituitary gland and cranial nerves on CT.

Matched MeSH terms: Middle Aged
Surgical challenges of duplicated gallbladder during cholecystectomy

Muhd Yusairi K, Vasu Pillai L, Voon ML, Manisekar KS

Med J Malaysia, 2018 12;73(6):418-419.
PMID: 30647219

No abstract provided.

Matched MeSH terms: Middle Aged
Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma

Hanif Khan A, Faisal M, Mohd Ali R, Abdul Rahaman JA

BMJ Case Rep, 2019 Jan 17;12(1).
PMID: 30659001 DOI: 10.1136/bcr-2018-226202

Mucoepidermoid carcinoma (MEC) is a rare tumour of the trachea accounting for up to 0.2% of reported primary lung malignancy. We report a case of a 54-year-old man, ex-smoker, whose presentation mimicked adult onset asthma with cough and wheezing, which did not respond to conventional treatment. He had occasional haemoptysis and weight loss in which CT scan performed for malignancy screening showed a protruding mass in the distal trachea causing endobronchial obstruction. Bronchoscopic intervention was performed to relieve the obstruction that resulted in resolution of asthmatic symptoms. Histological diagnosis confirmed MEC. This case emphasised the importance of a high index of suspicion in an unusual presentation of a common disease and the pivotal role of bronchoscopic intervention in malignant central airway obstruction.

Matched MeSH terms: Middle Aged
Impact of gender on sexual problems and perceptions among urban Malay elderly in Malaysia

Minhat HS, Mat Din H, Vasudevan R, Raja Adnan RNE, Ibrahim R

Arch Gerontol Geriatr, 2019 01 08;81:240-244.
PMID: 30669017 DOI: 10.1016/j.archger.2019.01.001

BACKGROUND: Physical and pathological changes associated with advancing age affect sexual behaviours of the elderly. The aim of this study was to explore the impact of gender on sexual problems and perceptions among the urban Malay elderly.
METHODS: A cross-sectional study was conducted among 160 Malaysian elderly participants aged 60 years and older who live in Kuala Lumpur. Twelve neighbourhood associations were randomly selected using multi-stage cluster sampling. Data was collected using standardized and validated questionnaire by face-to-face interview technique with which was conducted by trained interviewers.
RESULTS: Mean age of the participants was 65.33 (5.87) year old with majority were still married. Female (55.7%) reported more sexual problems as evidenced by the higher proportion of those with lacked interest in having sex (72.5%), find sex is unpleasant (34.8%) and unable to come to orgasm (55.1%). Gender was found to have significant impact on every model obtained in the analysis for both sexual problems and perceptions. Female elderly were 10.6 times more likely to have sexual problem compared to male elderly (OR = 10.64, P

Matched MeSH terms: Middle Aged
Development and evaluation of a hearing aid manual in the Malay language

Mohd Yusoff WNH, Quar TK, Chong FY, Mazlan R

Int J Audiol, 2019 05;58(5):278-286.
PMID: 30672346 DOI: 10.1080/14992027.2018.1562244

OBJECTIVE: This study aimed to (a) translate a hearing aid (HA) manual into Malay language and revise the translated manual based on best practice guidelines; (b) compare the effectiveness of the translated and the revised Malay HA manuals in helping individuals to perform HA management tasks.
DESIGN: Cross-sectional, randomised, single-blinded study.
STUDY SAMPLE: An Oticon-Dynamo HA manual was translated and revised based on best practice guidelines. Ninety participants aged 55 years and above participated in this study. They were randomly assigned into the control group (received translated manual) and the experimental group (received the revised translated manual). The Hearing Aid Management (HAM) test, which was developed in a previous study, was conducted to evaluate participant's ability to perform HA management tasks using the translated and the revised version of Malay HA manual.
RESULTS: The revised Malay HA manual had a lower reading grade level relative to the initial translated Malay HA manual. The ability to perform HA management tasks was better in the experimental group (mean = 12.2, SD = 1.15) versus the control group (mean = 8.7, SD = 2.11).
CONCLUSION: Further revision of existing HA manuals based on best practice guidelines is recommended to help individuals better manage their HAs.

Matched MeSH terms: Middle Aged
Fulltext Culture, Self, and Medical Decision Making in Australia and China: A Structural Model Analysis

Dolan H, Alden DL, Friend JM, Lee PY, Lee YK, Ng CJ, et al.

MDM Policy Pract, 2019 09 20;4(2):2381468319871018.
PMID: 31565670 DOI: 10.1177/2381468319871018

Objective. To explore and compare the influences of individual-level cultural values and personal attitudinal values on the desire for medical information and self-involvement in decision making in Australia and China. Methods. A total of 288 and 291 middle-aged adults from Australia and China, respectively, completed an online survey examining cultural and personal values, and their desired level of self-influence on medical decision making. Structural equation modeling was used to test 15 hypotheses relating to the effects of cultural and personal antecedents on the individual desire for influence over medical decision making. Results. Similar factors in both Australia and China (total variance explained: Australia 29%; China 35%) predicted desire for medical information, with interdependence (unstandardized path coefficient βAustralia = 0.102, P = 0.014; βChina = 0.215, P = 0.001), independence (βAustralia = 0.244, P < 0.001; βChina = 0.123, P = 0.037), and health locus of control (βAustralia = -0.140, P = 0.018; βChina = -0.138, P = 0.007) being significant and positive predictors. A desire for involvement in decisions was only predicted by power distance, which had an opposite effect of being negative for Australia and positive for China (total variance explained: Australia 11%; China 5%; βAustralia = 0.294, P < 0.001; China: βChina = -0.190, P = 0.043). National culture moderated the effect of independence on desire for medical information, which was stronger in Australia than China (Z score = 1.687, P < 0.05). Conclusions. Study results demonstrate that in both countries, desire for medical information can be influenced by individual-level cultural and personal values, suggesting potential benefits of tailoring health communication to personal mindsets to foster informed decision making. The desired level of self-involvement in decision making was relatively independent of other cultural and personal values in both countries, suggesting caution against cultural stereotypes. Study findings also suggest that involvement preferences in decision making should be considered separately from information needs at the clinical encounter.

Matched MeSH terms: Middle Aged
Effects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta-analysis

Asbaghi O, Sadeghian M, Sadeghi O, Rigi S, Tan SC, Shokri A, et al.

Phytother Res, 2021 Jan;35(1):20-32.
PMID: 32525606 DOI: 10.1002/ptr.6748

The effect of saffron supplementation on subclinical inflammation remains inconclusive. We performed a systematic review and meta-analysis to summarize available findings on the effect of saffron supplementation on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor-α [TNF-α], and interleukin-6 [IL-6]) in adults. We searched PubMed/Medline, Scopus, Web of Science, and Google Scholar databases up to November 2019 using relevant keywords to identify eligible trials. All randomized controlled trials (RCTs) that examined the effect of oral saffron supplementation on plasma concentrations of CRP, TNF-α, and IL-6 were included. For each outcome, mean differences and SDs were pooled using a random-effects model. Overall, eight RCTs were included in this meta-analysis. The pooled results showed that saffron supplementation did not result in significant changes in serum CRP (weighted mean difference [WMD]: -0.43 mg/L; 95% confidence interval [CI]: -1.04 to 0.17; p = .16), serum TNF-α (WMD: -1.29 pg/mL; 95% CI: -4.13 to 1.55; p = .37), and IL-6 concentrations (WMD: 0.11 pg/mL; 95% CI: -0.79 to 1.00; p = .81). Subgroup analysis indicated a significant reduction in serum CRP levels in studies with baseline CRP of ≥3 mg/L, saffron dosage of ≤30 mg/day, and intervention duration of <12 weeks, as well as trials that used crocin. Similarly, saffron was found to decrease TNF-α in studies that recruited non-diabetic subjects, subjects with baseline levels of ≥15 pg/mL, and participants with <50 years old, as well as trials that administered saffron at the dosage of ≤30 mg/day. We also found a significant non-linear effect of saffron dosage on serum CRP concentrations (pnon-linearity = .03). The overall results indicated that saffron supplementation did not affect inflammatory cytokines. Further high-quality studies are needed to firmly establish the clinical efficacy of supplemental saffron on inflammatory biomarkers.

Matched MeSH terms: Middle Aged
Fulltext Anthropometric characteristics of Malay nose- a pilot study

Tengku Fazrina Tengku Mohd Arif, Farah Farhana Muhamad Hanafi, Nur Wardah Hanis Abdul Razak, Narissaporn Chaiprakit, Hazmyr Abdul Wahab

ESTEEM Academic Journal, 2020;16(2):11-20.
MyJurnal

Anthropometric analysis provides the most reliable comparison of the body forms by using specific landmarks determined in respect of anatomical prominences. The knowledge of unique shape, anatomy and dimensions of the nose is very useful for surgeon undertaking its repair and reconstruction. Prosthetic rehabilitation also requires the ability to imagine the position and dimension of the nose within the facial proximity. Therefore, the access to nasal data for each
population are advantageous. The aims were to measure parameters of external nose of a Malay population and to determine the significant difference in nose value parameters between gender and age group. The direct anthropometric measurements were carried out in 86 Malay subjects within the age range of 18 to 55 years old who attended UiTM dental clinic. Nasal landmarks were
identified, and the nose parameters were measured using digital calliper. The values were expressed as mean, standard deviation and range. Nasal height, width and length of the nasal bridge were higher in male. The intercanthal width and philtrum length were statistically not significant for both genders. There were significant differences in nasal width, philtrum length, intercanthal width and outer intercommisural mouth width between the three age groups. However, the height of the nose, length of the nasal bridge and nasal index between age group were statistically not significant. The male population and the 41-55 years age group have higher nose value parameters. The most common type of nose was platyrrhine: broad. This study also suggested that Malay population have medium broad nose as the nasal index for both genders was ≤ 84.90.

Matched MeSH terms: Middle Aged
Unilateral hemihyperhidrosis in a stroke patient and literature review on its clinicoanatomical correlation

May, Honey Ohn, Khin, Maung Ohn, Khin, Nyein Yin, Teh, Yong Guang, Ng, Pey Luen, Chin, Li Bing

Borneo Journal of Medical Sciences, 2020;14(2):41-47.
MyJurnal

Contralateral hyperhidrosis from the cardiovascular accident has been infrequently described in the stroke literature. The clinical significance and pathogenesis are yet well understood. This is a case of a 60-year-old man who developed excessive sweating of the paralyzed side with a pure division along the midline of the body secondary to a subcortical stroke, which region is supplied by branches of middle cerebral artery territory known as deep perforating lenticulostriate. To the best of our knowledge, a precise clinicoanatomic correlation between hyperhidrosis and subcortical stroke has not been widely reported. In this review, we summarize the existing literature of post-stroke hyperhidrosis to evaluate the correlation between clinical manifestation and its neuroanatomical location. According to the location of the infarction and clinical features, it can be concluded that both tracks en route through the ipsilateral internal capsule, after originating in the opercular cortex before crossing the brain stem and terminal connections with the contralateral thoracic spinal cord. Therefore, the phenomenon of hyperhidrosis in anterior circulation stroke might be postulated as due to the disruption of the sympathoinhibitory pathway that controls sweat glands, similarly like posterior circulation stroke.

Matched MeSH terms: Middle Aged
The pattern of intestinal obstruction in Malaysia

Ti TK, Yong NK

Br J Surg, 1976 Dec;63(12):963-5.
PMID: 1009347

This is a review of 261 patients operated for 271 instances of mechanical intestinal obstruction over a 5-year period in a developing country in the tropics. The pattern of intestinal obstruction in Chinese is similar to that in Caucasians, where adhesions account for the largest number of cases. The occurrence in Malays, Indians, Pakistanis and Ceylonese is similar to that in other developing communities where external hernia is commonest while adhesive or tumour obstruction is rare; however, these racial groups do not exhibit the high incidence of intussusception and volvulus found in Africa and India. The operative mortality was 13-9 per cent, which is comparable to that in Western series. The major adverse factors in intestinal obstruction, i.e. extremes of age, associated disease, gangrenous bowel, large bowel obstruction and malignancy, were confirmed. Fluid and electrolyte imbalance was frequent, as in other tropical series, but with intensive preoperative correction it was not an important adverse factor.

Matched MeSH terms: Middle Aged
Fulltext Empyema thoracis presented as giant back abscess

Abd Karim SH, Wan Zain WZ, Mohd Hashim MN, Zakaria AD, Hayati F, Ng CY

Radiol Case Rep, 2021 May;16(5):1061-1064.
PMID: 33680277 DOI: 10.1016/j.radcr.2021.02.030

Empyema thoracis (ET) is defined as pus in the pleural space, either localized or involving the entire pleural cavity, due to diverse etiologies. In severe form, it may infiltrate the extrapulmonary region. Clinical guideline describes 3 stages of parapneumonic effusion before developing into an ET, namely the exudative stage, the fibrinopurulent stage, and the organizing/late stage. We highlight a 59-year-old gentleman who presented a back swelling masquerading as a deep-seated abscess, in which the diagnosis of ET had not been established early. The principles of treatment are treating the underlying condition such as pneumonia, pleural drainage and debridement, full re-expansion of the collapsed lung by performing chest physiotherapy, and improving nutrition. ET is a condition with a dynamic process due to diverse etiologies, either localized or involving the entire pleural cavity. The gold standard in diagnosing ET is the pleural aspiration of fluid from the pleural space, whereas the management of ET may include non-surgical and/or surgical treatments based on the basic principles of ET treatment.

Matched MeSH terms: Middle Aged
Fulltext Estimating Blood Pressure from the Photoplethysmogram Signal and Demographic Features Using Machine Learning Techniques

Chowdhury MH, Shuzan MNI, Chowdhury MEH, Mahbub ZB, Uddin MM, Khandakar A, et al.

Sensors (Basel), 2020 Jun 01;20(11).
PMID: 32492902 DOI: 10.3390/s20113127

Hypertension is a potentially unsafe health ailment, which can be indicated directly from the blood pressure (BP). Hypertension always leads to other health complications. Continuous monitoring of BP is very important; however, cuff-based BP measurements are discrete and uncomfortable to the user. To address this need, a cuff-less, continuous, and noninvasive BP measurement system is proposed using the photoplethysmograph (PPG) signal and demographic features using machine learning (ML) algorithms. PPG signals were acquired from 219 subjects, which undergo preprocessing and feature extraction steps. Time, frequency, and time-frequency domain features were extracted from the PPG and their derivative signals. Feature selection techniques were used to reduce the computational complexity and to decrease the chance of over-fitting the ML algorithms. The features were then used to train and evaluate ML algorithms. The best regression models were selected for systolic BP (SBP) and diastolic BP (DBP) estimation individually. Gaussian process regression (GPR) along with the ReliefF feature selection algorithm outperforms other algorithms in estimating SBP and DBP with a root mean square error (RMSE) of 6.74 and 3.59, respectively. This ML model can be implemented in hardware systems to continuously monitor BP and avoid any critical health conditions due to sudden changes.

Matched MeSH terms: Middle Aged
Erythema multiforme: epidemiology, clinical characteristics and natural history in fifty-nine patients

Ting HC, Adam BA

Australas J Dermatol, 1984 Aug;25(2):83-8.
PMID: 6529404
Matched MeSH terms: Middle Aged
Quantitative and qualitative retinal microvascular characteristics and blood pressure

Cheung CY, Tay WT, Mitchell P, Wang JJ, Hsu W, Lee ML, et al.

J Hypertens, 2011 Jul;29(7):1380-91.
PMID: 21558958 DOI: 10.1097/HJH.0b013e328347266c

The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs.

Matched MeSH terms: Middle Aged
Fulltext Anxiety in Frontline and Non-Frontline Healthcare Providers in Kelantan, Malaysia

Mohd Noor N, Che Yusof R, Yacob MA

Int J Environ Res Public Health, 2021 Jan 20;18(3).
PMID: 33498397 DOI: 10.3390/ijerph18030861

In response to the coronavirus disease 2019 (COVID-19) pandemic, healthcare providers are exposed to psychological and mental health implications, including vicarious traumatization, anxiety, and depression. Gradual increases in the number of COVID-19 cases meant they were inadequately protected from contamination due to a shortage of protective equipment, excessive workloads, emotional exhaustion and frustration. These circumstances affect their work performance in delivering health services. This study aims to compare the levels of anxiety in frontline and non-frontline healthcare providers during the COVID-19 pandemic. This study applied a comparative cross-sectional design between May and July 2020 at the Hospital Raja Perempuan Zainab II. Convenient sampling was applied in the selection of eligible participants. The case report form contained two self-administered questionnaires, namely, The Hospital Anxiety and Depression Scale and Medical Outcome Study Social Support Survey. Descriptive analysis, analysis of variance, and analysis of covariance were conducted using SPSS version 26. The number of participants recruited was 306, including 160 healthcare providers in the frontline group and 146 in the non-frontline group. The non-frontline healthcare providers reported a significantly higher anxiety mean score of 1.7 than the frontline providers after adjusting for gender, duration of employment, and social support. It indicates that non-frontline healthcare providers require psychological support similar to that of frontline healthcare providers during the COVID-19 pandemic.

Matched MeSH terms: Middle Aged
Fulltext No Interaction Effect between Interleukin-6 Polymorphisms and Acid Ash Diet with Bone Resorption Marker in Postmenopausal Women

Lim SY, Chan YM, Ramachandran V, Shariff ZM, Chin YS, Arumugam M

Int J Environ Res Public Health, 2021 Jan 19;18(2).
PMID: 33478001 DOI: 10.3390/ijerph18020827

BACKGROUND: Evidence is growing that a high-acid diet might accelerate the rate of bone loss, and gene polymorphisms such as Interleukin 6 (IL6) -174G/C and -572G/C are related to bone deterioration. However, no study of the interaction between diet and IL6 polymorphisms has been conducted among Asians. Thus, the objective of this study was to determine whether IL6 gene polymorphisms modified the association between dietary acidity and the rate of bone resorption.
METHODS: This cross-sectional study recruited 203 postmenopausal women (age ranged from 51 to 85 years old) in community settings. The dietary intakes of the participants were assessed using a validated interviewer-administered semi-quantitative food frequency questionnaire (FFQ), while dietary acid load (DAL) was estimated using net endogenous acid production (NEAP). Agena® MassARRAY genotyping analysis and serum collagen type 1 cross-linked C-telopeptide (CTX1) were used to identify the IL6 genotype and as a bone resorption marker, respectively. The interactions between diet and single-nucleotide polymorphisms (SNPs) were assessed using linear regressions.
RESULTS: A total of 203 healthy postmenopausal women aged between 51 and 85 years participated in this study. The mean BMI of the participants was 24.3 kg/m2. In IL6 -174 G/C, all the participants carried the GG genotype, while the C allele was absent. Approximately 40% of the participants had a high dietary acid load. Dietary acid load (B = 0.15, p = 0.031) and the IL6 -572 CC genotype group (B = 0.14, p = 0.044) were positively associated with a higher bone resorption. However, there was no moderating effect of the IL6 genetic polymorphism on the relationship between and acid ash diet and bone resorption markers among the postmenopausal women (p = 0.79).
CONCLUSION: High consumption of an acid ash diet and the IL6 -572 C allele seem to attribute to high bone resorption among postmenopausal women. However, our finding does not support the interaction effect of dietary acidity and IL6 (-174G/C and -572G/C) polymorphisms on the rate of bone resorption. Taken together, these results have given scientific research other candidate genes to focus on which may interact with DAL on bone resorption, to enhance planning for preventing or delaying the onset of osteoporosis among postmenopausal women.

Matched MeSH terms: Middle Aged
Emergency Laparotomy in a COVID-19 patient with acute abdomen

Hassan R, Johari M, Nijhar JS, Sharifah BSA, Low LL, Amri N

Med J Malaysia, 2021 03;76(2):254-257.
PMID: 33742640

We describe here the first laparotomy involving a COVID-19 patient in Malaysia. A 60-year-old man screened positive for SARS-CoV-2 in March 2020 and developed acute abdomen in the ward in Hospital Sultanah Bahiyah, Kedah. He underwent laparotomy and cholecystectomy for gangrenous cholecystitis. All personnel adhered to infectious control precautions, donning full personal protective equipment (PPE) throughout the surgery. Post-operatively, due to raised septic parameters, he was carefully diagnosed with and treated empirically for superimposed bacterial sepsis instead of cytokine release syndrome, with confirmed blood culture of Klebsiella pneumoniae. Patient was discharged well later. None of the staff involved in his care developed COVID-19 infection.

Matched MeSH terms: Middle Aged
Healthcare utilisation among elderly in Malaysia: The mediating role of health literacy

Mohamad Yunus M, Abd Manaf NH, Omar A, Juhdi N

Med J Malaysia, 2021 03;76(2):218-222.
PMID: 33742631

BACKGROUND: The relationship between the sociodemographic characteristics of the older persons and healthcare utilisation is well established. However, the process underlying this relationship is poorly understood particularly in the Malaysian context.
MATERIALS AND METHODS: A cross-sectional study was conducted from February to April in 2016 to examine the mediating effect of health literacy on the relationship between age and healthcare utilisation. A total of 452 older persons were recruited from 14 public hospitals in Malaysia.
RESULTS: The average age of the respondents was 66.69 years old, with an age range between 60 to 105 years. The findings reveal that the relationship between age and healthcare utilisation was mediated by health literacy.
CONCLUSION: The results help to improve the understanding of healthcare utilisation among the older persons in Malaysia, which is beneficial to the healthcare provider and policymakers.

Matched MeSH terms: Middle Aged
Fulltext Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting

Lim YC, Hoe VCW, Darus A, Bhoo-Pathy N

BMJ Open, 2020 09 06;10(9):e034455.
PMID: 32895261 DOI: 10.1136/bmjopen-2019-034455

OBJECTIVES: Night-shift work may adversely affect health. This study aimed to determine the impact of night-shift work on health-related quality of life (HRQoL), and to assess whether sleep quality was a mediating factor.
DESIGN: A cross-sectional study.
SETTING: 11 manufacturing factories in Malaysia.
PARTICIPANTS: 177 night-shift workers aged 40-65 years old were compared with 317 non-night-shift workers.
PRIMARY AND SECONDARY OUTCOMES: Participants completed a self-administered questionnaire on socio-demographics and lifestyle factors, 12-item Short Form Health Survey V.2 (SF-12v2) and the Pittsburgh Sleep Quality Index (PSQI). The Baron and Kenny's method, Sobel test and multiple mediation model with bootstrapping were applied to determine whether PSQI score or its components mediated the association between night-shift work and HRQoL.
RESULTS: Night-shift work was associated with sleep impairment and HRQoL. Night-shift workers had significantly lower mean scores in all the eight SF-12 domains (p<0.001). Compared with non-night-shift workers, night-shift workers were significantly more likely to report poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction (p<0.001). Mediation analyses showed that PSQI global score mediated the association between night-shift work and HRQoL. 'Subjective sleep quality' (indirect effect=-0.24, SE=0.14 and bias corrected (BC) 95% CI -0.58 to -0.01) and 'sleep disturbances' (indirect effect=-0.79, SE=0.22 and BC 95% CI -1.30 to -0.42) were mediators for the association between night-shift work and physical well-being, whereas 'sleep latency' (indirect effect=-0.51, SE=0.21 and BC 95% CI -1.02 to -0.16) and 'daytime dysfunction' (indirect effect=-1.11, SE=0.32 and BC 95% CI -1.86 to -0.58) were mediators with respect to mental well-being.
CONCLUSION: Sleep quality partially explains the association between night-shift work and poorer HRQoL. Organisations should treat the sleep quality of night-shift workers as a top priority area for action to improve their employees' overall wellbeing.

Matched MeSH terms: Middle Aged

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