The associations between different types of infections and circadian preference and shift work.

Disturbed sleep and circadian disruption are reported to increase the risk of infections. People with an evening circadian preference and night workers typically report insufficient sleep, and the aims of the present study were to investigate possible associations between various types of infections and circadian preference and shift work status. Data were collected from an online cross-sectional survey of 1023 participants recruited from the Norwegian practice-based research network in general practice - PraksisNett. The participants completed questions about circadian preference (morning type, intermediate type, evening type), work schedule (day work, shift work without nights, shift work with night shifts), and whether they had experienced infections during the last three months (common cold, throat infection, ear infection, sinusitis, pneumonia/bronchitis, COVID-19, influenza-like illness, skin infection, gastrointestinal infection, urinary infection, venereal disease, eye infection). Data were analyzed with chi-square tests and logistic regression analyses with adjustment for relevant confounders (gender, age, marital status, country of birth, children living at home, and educational level). Results showed that evening types more often reported venereal disease compared to morning types (OR = 4.01, confidence interval (CI) = 1.08-14.84). None of the other infections were significantly associated with circadian preference. Shift work including nights was associated with higher odds of influenza-like illness (OR = 1.97, CI = 1.10-3.55), but none of the other infections. In conclusion, neither circadian preference nor shift work seemed to be strongly associated with risk of infections, except for venereal disease (more common in evening types) and influenza-like illness (more common in night workers). Longitudinal studies are needed for causal inferences.

Point-of-care testing with CRP in primary care: a registry-based observational study from Norway.

BACKGROUND: Norwegian primary health care is maintained on the regular general practitioners (RGPs), GP's contracted to the municipalities in a list patient system, working at daytime and at out-of-hours services (OOH services). Respiratory disease is most prevalent during OOH services, and in more than 50 % of the consultations, a CRP test is performed. Children in particular have a high consultation rate, and the CRP test is frequently conducted, but the contributing factors behind its frequent use are not known. This study compares the RGPs rate of CRP use at daytime and OOH in consultations with children and how this rate is influenced by characteristics of the RGPs. METHODS: A cross-sectional register study was conducted based on all (N = 2,552,600) electronic compensation claims from consultations with children ≤ 5 year during the period 2009-2011 from primary health care. Consultation rates and CRP use were estimated and analysed using descriptive methods. Being among the 20% of RGPs with the highest rate of CRP use at daytime or OOH was an outcome measure in regression analyses using RGP-, and RGP list characteristics as explanatory variables. RESULTS: One third of all RGPs work regularly in OOH services, and they use CRP 1.42 times more frequently in consultations with children in OOH services than in daytime services even when the distribution of diagnosis according to ICPC-2 chapters is similar. Not being approved specialist, have a large number at their patient-lists but relatively few children on their list and a large number of consultations with children were significantly associated with frequent use of CRP in daytime services. The predictors for frequent CRP use in OOH services were being a young doctor, having many consultations with children during OOH and a frequent use of CRP in daytime services. CONCLUSIONS: The increase in the frequency of CRP test use from daytime to OOH occurs in general for RGPs and for all most used diagnoses. The RGPs who use the CRP test most frequently in their daytime practice have the highest rate of CRP in OOH services.