Newly qualified nurses and midwives have higher rates of long-term sickness absence

Hospital-based nurses and midwives have higher rates of long-term sickness absence and are more frequently diagnosed with back disorders than similarly aged graduates with the same level of education working in other sectors 

University of Southern Denmark Faculty of Health Sciences

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The early years of working life differ for newly qualified nurses and midwives working in hospitals and comparable graduates working in other sectors. Louise Schubert Paaske, PhD student in health economics at the Danish Centre for Health Economics (DaCHE) at the University of Southern Denmark, and her colleagues have used Danish national registers to follow the graduates' health trajectories over their first six years in employment.

The study shows that hospital-based nurses and midwives have higher rates of long-term sick leave and are more frequently diagnosed with back disorders during the first four years. Around 13 per cent leave hospital work within six years, and the analyses show increasing health problems in the period leading up to their departure and improvements in some health outcomes afterwards.

Differences emerge early

The study follows newly qualified graduates from their first job and for six years thereafter. This distinguishes it from much of the existing research in the field, which has examined employees later in their working lives.

This is an important distinction because employees experiencing strain or health problems may already have moved to another sector or left the labour market altogether by that point.

– We can see the differences as early as the first years in employment, long before we can talk about the effects of wear and tear over a long working life. Precisely because these newly qualified employees are at the beginning of their working lives, even a modest increase in long-term sickness absence and early departure from hospital work could have consequences over an entire career, says Louise Schubert Paaske.

The researchers compared newly qualified nurses and midwives who began their careers in hospitals with newly qualified graduates with the same level of education who started working in 36 other sectors.

The final analysis included 8,752 people. Among other factors, the groups were matched by age, gender, ethnicity, marital status, number of children, municipality of residence, timing of their first job and use of healthcare services before entering employment.

More sickness absence and more back disorders

During the first four years, hospital-based nurses and midwives had a higher annual likelihood of both long-term sick leave and diagnosed back disorders than the comparison group.

The difference was up to 2.8 percentage points per year for long-term sickness absence and up to 0.6 percentage points for diagnosed back disorders.

After around four years, the differences between the groups became smaller. However, this does not necessarily mean that the health of the hospital-based nurses and midwives improved.

To examine this development more closely, the researchers looked at the nurses and midwives who left hospital work during the follow-up period.

Some nurses and midwives with health problems leave hospital work

Around 13 per cent of the hospital-based nurses and midwives left hospital work during the six-year period.

A supplementary analysis shows that long-term sickness absence and recorded mental health problems increased in the period leading up to their departure from hospital work and declined again afterwards.

– When the differences become smaller after a few years, we cannot simply conclude that the health of those working in hospitals is improving. Part of the explanation may be that employees with health problems gradually leave hospital work, says Louise Schubert Paaske.

This also means that studies looking only at people who remain in hospital work may present an overly positive picture of how their health develops.

However, the analysis cannot show that leaving hospital work in itself leads to better health. It describes developments before and after leaving but cannot establish what causes the changes.

Less treatment does not necessarily indicate better mental well-being

In one respect, the results initially appear to point in the opposite direction. Hospital-based nurses and midwives were less likely than the comparison group to have recorded use of healthcare services and treatment related to mental health conditions. This included talking therapy with a general practitioner, medication, psychological treatment and psychiatric treatment.

According to the researchers, this finding should be interpreted with caution.

The study is based on register data, meaning that the researchers do not measure participants’ mental well-being directly. They can see whether a person has a recorded diagnosis or has received certain types of treatment, but they cannot identify psychological strain that has not resulted in contact with the healthcare system or a recorded diagnosis.

– The lower use of treatment and healthcare services should not be interpreted as evidence that hospital-based nurses and midwives have better mental health. The higher level of sickness absence may, among other things, reflect psychological strain that has not yet resulted in a recorded diagnosis or treatment, says Louise Schubert Paaske.

The result therefore primarily tells us about recorded use of healthcare services and treatment, rather than whether hospital-based nurses and midwives generally have better or poorer mental well-being.

The study follows newly qualified graduates from their first job

The study is based on nationwide Danish register data. The researchers identified people who completed a bachelor’s degree and entered employment no later than 180 days after graduation between 2010 and 2015.

Participants were followed for six years. The researchers compared developments in areas including long-term sick leave, diagnosed back disorders and recorded use of healthcare services and treatment related to mental health problems.

The study was designed to ensure that the groups were as comparable as possible, but the researchers cannot rule out all differences between people who choose different professions and workplaces. Register data also have the limitation that they can only provide information about health conditions that are actually recorded.

Furthermore, the results concern the first six years in employment for the groups included in the study and cannot automatically be generalised to all nurses and midwives working in hospitals.

The first years may be important for retention

The study was conducted in collaboration between the Danish Centre for Health Economics (DaCHE) at the University of Southern Denmark and the National Research Centre for the Working Environment (NFA).

By following employees from the very beginning of their working lives and continuing to follow them if they leave hospital work, the study provides a different perspective on the relationship between work and health compared with studies of employees later in their careers.

According to the researchers, the results suggest that the first years after graduation are an important period to focus on if hospitals are to retain more nurses and midwives.

– The results do not in themselves tell us which specific conditions in hospitals need to change. But they do suggest that it is important to focus on the first years after graduation if more nurses and midwives are to remain in hospital work, says Louise Schubert Paaske.

About the study

Method

The study is based on nationwide Danish register data and follows newly qualified graduates who entered the labour market between 2010 and 2015. Using a target trial emulation framework, hospital-based nurses and midwives were compared with newly qualified graduates with the same level of education who began their careers in 36 other sectors. The final analysis included 8,752 people, who were followed for six years.

The study was conducted by researchers from the Danish Centre for Health Economics (DaCHE) at the University of Southern Denmark and the National Research Centre for the Working Environment (NFA).

Funding

Helsefonden, Lån & Spar Fonden

Read the study

Health trajectories of early career hospital nurses and midwives compared to other graduates in Denmark by Louise Schubert Paaske, Nicolai Simonsen Damslund, Anne Helene Garde, Ann Dyreborg Larsen and Kim Rose Olsen is published in Communications Health

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Journal

Communications Health

DOI

10.1038/s44528-026-00023-4

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Health trajectories of early career hospital nurses and midwives compared to other graduates in Denmark

 

Nearly 1 in 3 new U.S. nurse practitioners educated at for-profit schools, study finds

Researchers from Brown’s School of Public Health say the surge raises questions about the programs’ oversight and training quality

Brown University

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PROVIDENCE, R.I. [Brown University] — For-profit schools appear to be playing an outsized role in training the nation’s expanding nurse practitioner workforce, according to a study that found nearly one-third of newly licensed nurse practitioners in four states were educated at for-profit programs in 2024, up from just 2.4% in 2010.

“That is enormous growth, especially since nurse practitioners are such a big workforce to begin with,” said senior study author Dr. Michael Barnett, a professor of health services, policy and practice at the Brown University School of Public Health.

The study, published in Annals of Internal Medicine, examined 117,156 nurse practitioners licensed in California, Florida, Iowa and Texas from 2010 to 2024. (The researchers note that these are large states that represent different geographic areas of the country.)

While all four states saw an increase in the share of for-profit-trained nurse practitioners, they were most prevalent among new licensees in California at 40.9%, followed by Florida at 35.1%, Texas at 21.1% and Iowa at 14.8%.

The number of advanced nurse practitioners is projected by the U.S. Bureau of Labor Statistics to grow by 35% over the next 10 years — far outpacing physicians, whose numbers are expected to grow by just 3% during the same period.

Also on the rise is the number of for-profit nurse-practitioner training programs themselves, which increased 400% between 2007 and 2016 alone.

“There has been an explosion in the nurse practitioner workforce that is drawing more and more schools into the fray to provide training,” Barnett said. “One of the newer entrants are for-profit schools, which have a checkered past in the U.S.”

The rising number of nurse practitioners graduating from for-profit programs prompts concerns among the study’s authors about the quality of care resulting from for-profit education, especially as prior evidence shows that for-profit nursing education was a significant predictor of lower pass rates of National Council Licensure Examinations.

“For-profit nursing programs have drawn regulatory scrutiny, FTC settlements and many lawsuits in the past,” Barnett said. “We don’t have enough hard data yet to make decisions about the impact of for-profit nursing programs, but there isn’t much transparency to judge at the moment.”

For Barnett, the next important steps include disclosure of licensure exam pass rates and other student statistics from all nurse training programs so the public can better judge the programs’ merits. He added that researchers should look at the outcomes for patients treated by nurse practitioners with different training backgrounds to understand where or if there is a significant difference in quality of care.

This study was funded by grants from Arnold Ventures and the National Institute on Aging (R01AG076580).

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Journal

Annals of Internal Medicine

DOI

10.7326/ANNALS-26-01211

Article Title

Growth in the Share of Advanced Practice Registered Nurses Educated at For-Profit Programs in Four U.S. States

Article Publication Date

6-Oct-2026

 

Stratospheric winds can warn of extreme energy demand in Europe

University of Exeter

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A breakdown of normal polar winds in winter raises the chance of extreme cold – and a resulting spike in energy demand – in Europe, new research shows.

Normally, strong and stable westerly winds circle high above the Arctic in the winter, in what is known as the “stratospheric polar vortex”.

About once every two years, the vortex temporarily breaks down, in what is called a “sudden stratospheric warming” (SSW) – heating the vortex but causing cold air near Earth’s surface to spill south to locations including Europe and North America.

The new study, led by the University of Exeter, found that SSWs raise the chance of extreme electricity demand (defined as at least 20% above average) in northern and central Europe by 1.5-3 times.

Cold weather after SSWs – such as during the 2018 “Beast from the East” – typically arrives a few weeks after the stratospheric polar winds shift, meaning that SSWs can give governments and energy providers a warning to prepare for extreme demand.

“In February 2018, the polar vortex split in two,” said Dr Regan Mudhar, now at the University of Lausanne.

“These events don’t always affect surface temperatures, but this one was followed by severe cold weather in the UK and much of northern Europe.

“We analysed the relationship between SSWs and extreme electricity demand, driven by demand for heating, and found a clear link.

“Extreme cold weather creates multiple risks – including high energy demand – and our findings can be used to help prepare for future events.”

The study found that the change in energy demand differed between nations.

For example, Scandinavian countries – which are largely well adapted to extreme cold – saw a smaller increase in energy usage when temperatures fell.

Meanwhile, France – which has a highly electrified energy system – experienced a much steeper increase in demand.

Dr Hannah Bloomfield, from Newcastle University, added: "The UK is relatively well adapted to cold weather at present due to our reliance on gas central heating.

“However, as we transition to net-zero, a lot of the traditional gas heating must be electrified (i.e. replaced with heat pumps) and then periods of cold weather with low wind will become increasingly challenging to keep the lights on at a low cost to consumers."

Dr Mudhar said: “We are, and will continue to, experience warming driven by greenhouse gas emissions, but SSWs will very likely still happen, bringing cold weather with them.

“This means that, though it is crucial that we continue to cut emissions to mitigate climate change, it's important to consider how prepared we are for extreme events such as these, as we transition toward renewable energy sources."

The study was funded by the Natural Environment Research Council GW4+ Doctoral Training Partnership.

The paper, published in the journal Meteorological Applications, is entitled: “The influence of sudden stratospheric warmings on extreme European electricity demand.”

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Journal

Meteorological Applications

DOI

10.1002/met.70241

Article Title

The influence of sudden stratospheric warmings on extreme European electricity demand.

Article Publication Date

8-Oct-2026

 

Where does Earth's nitrogen go? Two atoms offer a clue

A rare atomic fingerprint reveals how nitrogen cycles through the biosphere

University of California - Santa Barbara

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(Santa Barbara, Calif.) — Nitrogen is one of life’s building blocks, but it’s only helpful in the right amounts. Too much nitrogen in water, for example, can lead to poor water quality and the gradual death of aquatic organisms. Microbes remove nitrogen from water by converting it to a gas that escapes into the atmosphere. But scientists have difficulty determining how much nitrogen is removed this way.

Biogeochemists at UC Santa Barbara, UCLA and collaborating institutions have shown that a rare form of nitrogen gas can act as a natural fingerprint for microbial nitrogen conversion. The study, published in Science, reveals microbial nitrogen loss that conventional methods obscure.

The technique requires sophisticated machinery, so it won't find its way into routine field monitoring any time soon. However, it offers a new tool to improve water-quality assessments and estimates of the global nitrogen budget.

“The problem is that our water naturally has a huge amount of nitrogen gas that is dissolved from the air, so the gas that microbes produce can be very difficult to see,” explained first author Jiarui Liu, who conducted the research as a postdoctoral fellow at UCSB’s Marine Science Institute and at UCLA. “The answer is written in the way nitrogen atoms are paired inside the nitrogen molecule.”

The nitrogen cycle

Nitrogen is essential for proteins and DNA, yet most organisms can’t use nitrogen gas directly from the atmosphere. As nitrogen cycles through air, water and life, some microbes convert the gas into usable compounds while others return those compounds to gas. The balance between these processes helps determine how much nitrogen is available to support life. However, quantifying these processes has proven challenging.

Nitrogen gas, or N2, consists of two nitrogen atoms joined together. These come in two weights, called isotopes: the common nitrogen-14 and the heavier nitrogen-15, which has one extra neutron. Most N2 molecules contain two nitrogen-14 atoms; some contain one of each isotope; and very rarely, both atoms are nitrogen-15.

In atmospheric nitrogen gas, the two heavy nitrogen-15 atoms pair up more often than expected by chance. Meanwhile, the nitrogen gas produced by microbes has atoms paired nearly at random. When nitrogen from microbes mixes with nitrogen from the air, it reduces that excess of heavy pairs. As a result, the relative abundance of the rare molecule can reveal how much nitrogen gas was produced by microbial activity.

Using a bigger machine

The team measured nitrogen gas extracted from water and sediment samples using UCLA’s Panorama mass spectrometer. The instrument uses electric and magnetic fields to separate molecules according to their mass and charge. Usually, the rare nitrogen pairs are difficult to distinguish because other molecules have almost exactly the same mass. But Panorama’s unusually large size enables it to separate molecules with these tiny differences in mass.

“At UCLA we discovered the anomalous pairing of heavy nitrogen atoms in Earth’s atmosphere and are now making use of this signature of nitrogen in air as a powerful and unique geochemical tool,” said geochemist Edward Young, one of the paper’s co-authors and Liu’s postdoctoral advisor at UCLA.

The study brought together researchers working in groundwater, lakes and marine environments. Their combined field and laboratory expertise made it possible to apply the approach to Texas groundwater, lakes in Antarctica and Minnesota, coastal basins off Southern California, the Bay of Bengal and deep-sea sediments offshore from Alaska.

Results with global reach

In modern times, fertilizer runoff, wastewater discharge and other human activities have played an increasingly large role in the nitrogen cycle. Excess nitrogen from these sources can degrade water quality and fuel harmful algal blooms. As blooms die off, their decay consumes oxygen and can create low-oxygen “dead zones” that threaten fish and other aquatic life.

Studying the nitrogen cycle helps scientists identify how people can intervene to reduce or remediate environmental harm. By measuring how much nitrogen microbes remove naturally, the approach can help assess fertilizer and wastewater inputs and inform efforts to protect water quality.

“We want to understand whether microbes in groundwater can mitigate nitrate pollution, and how much nitrogen is removed along the way before it can fuel algal growth in lakes, rivers and coastal waters,” Liu said. “This gives us a clearer picture of whether nitrogen stays in an ecosystem or is removed from the nutrient pool as N2 gas.”

The approach could also address a gap in groundwater monitoring. “Many routine groundwater-quality monitoring programs do not measure the N2 gas produced within an aquifer, which can create substantial biases in our accounting of where nitrogen comes from and where it goes,” said co-author Alan Seltzer, assistant professor of hydrogeology at University College Dublin. “This study, and this exciting new technique, opens the door to a much more complete picture of the sources and fate of nitrogen in groundwater systems.”

The broader goal is to understand the pace of Earth’s nitrogen cycle. Scientists calculate nitrogen budgets to compare the rates at which usable nitrogen is supplied and removed. This balance influences the growth of plants and microbes that sustain food webs around the world.

“We study how nitrogen cycles on the planet, and we know that these processes of nitrogen removal occur,” said co-author David Valentine, the Norris Presidential Chair of Biogeochemistry and Liu’s postdoctoral advisor at UCSB. “But it’s very difficult to figure out how quickly that’s happening in a given environment, which makes it hard to work out the global nitrogen budget. Our new approach gives us a direct measure of that loss.”

Combined with information about water transport and how nitrogen gas accumulates, the measurements allow researchers to estimate nitrogen-loss rates at the ecosystem level. Extending those measurements across environments can link local estimates of nitrogen loss to regional and global budgets. Together, they offer an independent way to test whether nitrogen inputs and losses balance across the planet, and how that balance changes over time.

This story was written by Harrison Tasoff and Holly Ober at UCLA.

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Journal

Science

DOI

10.1126/science.aei0940

Article Title

Natural 15N15N abundances constrain fixed nitrogen loss

Article Publication Date

8-Oct-2026

 

A train, a solar storm and an 185-year-old mystery

Did Space Weather Delay the 10:05 p.m. Train Departure From Exeter on 18 October 1841?

Baylor researcher helps uncover the likely truth behind one of the earliest recorded examples of space weather disrupting technology

Baylor University

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WACO, Texas (Oct. 7, 2026) – Nearly two centuries ago, a train scheduled to leave Exeter, England, at 10:05 p.m. sat motionless for 16 minutes.

The problem was not the train, the tracks or the weather on Earth. Instead, a powerful disturbance originating from the sun appeared to interfere with the railway’s telegraph system, preventing operators from confirming that the line ahead was clear.

The unusual delay has been described as the earliest known example of “space weather” disrupting human technology. But a new international study co-authored by space weather historian William B. (Trey) Cade III, Ph.D., of Baylor University’s Institute for Aviation Sciences reveals that an important detail in the historical account was wrong.

It could not have happened in 1841. The railway did not exist yet.

Published in the journal Space Weather, the study brings together researchers from Baylor, Lancaster University in the U.K., the British Geological Survey, Natural Resources Canada, RMIT University in Melbourne, Australia, and RAL Space in the U.K. Their investigation combined scientific observations with railway schedules, archival documents and 19th-century newspaper reports to solve the mystery.

“It’s a clear demonstration that, as soon as humans developed the first electricity-based technology, it became susceptible to disruption by large space weather events,” Cade said. “That vulnerability has continued and increased to this day with so much of our technology, including power grids, satellites, communications systems, GPS navigation and space travel.”

A historical account that did not add up

The story can be traced to an article published by Nature in 1871. It described a “very intense magnetic disturbance” on Oct. 18, 1841, that interfered with telegraph equipment along the South Devon Railway.

Telegraph operators used electrical signals to communicate whether sections of track were clear. According to the account, the instruments malfunctioned so badly that the superintendent in Exeter initially thought someone was playing tricks with them. Unable to determine whether the track near Starcross was safe, railway officials delayed the train.

If the date was correct, the episode would be the earliest documented case of space weather affecting modern technology. Cade, whose research focuses on the history of space weather science, rediscovered the forgotten account, bringing renewed attention to its possible historical importance.

“I have researched numerous articles and newspapers from the 1600s to the 1800s to better understand how scientific understanding progressed,” Cade said. “When I came across the original Nature article, I published a paper about it in 2013, citing it as the earliest example I could find of space weather impacting technology.”

Cade was contacted by a research team after it uncovered a significant discrepancy. The railway line from Exeter through Starcross did not open until 1846, nearly five years after the reported incident. The team also found no evidence of unusual geomagnetic activity over England on Oct. 18, 1841. They invited Cade to join the investigation and help determine what actually occurred by identifying possible space weather events that could have inspired the original account and providing historical context for the research.

Finding the correct date

The train’s scheduled departure provided an important clue. Researchers examined historical railway timetables to determine if and when a 10:05 p.m. train left Exeter for communities along the route. That schedule was in place from 1848 and 1849. Their attention soon turned to Oct. 18, 1848, the same month and day reported by Nature, but exactly seven years later.

This time the evidence lined up.

Researchers discovered magnetic records from the Greenwich Observatory that showed powerful disturbances beginning during the evening of Oct. 18, 1848. Newspaper reports described brilliant auroras visible across England, while astronomical observations documented a large group of sunspots facing Earth.

Together, the records point to a period of intense solar activity capable of producing electrical currents that could interfere with telegraph equipment. The researchers concluded that the original Nature article most likely contained a typographical error, with “1848” mistakenly printed as “1841.”

An early warning from the sun

Space weather refers to changing conditions caused by activity on the sun. Solar eruptions can send charged particles and magnetic fields toward Earth, producing beautiful auroras but also disrupting technological systems.

In the 1840s, the electric telegraph was an emerging technology used by railways for communication and signaling. As telegraph networks expanded, the rise in solar activity exposed a vulnerability few people knew existed.

The corrected date means the Exeter delay was not the first recorded technological disruption caused by space weather. That distinction belongs to an event on March 19, 1847, when geomagnetic activity interfered with the Midland Railway’s telegraph system during a vivid auroral display. Still, the Exeter incident remains one of the earliest known examples of space weather affecting infrastructure, more than a decade before the famous Carrington Event of 1859 caused widespread telegraph disruptions.

The research also offers a lesson that extends beyond space science. Historical accounts, even those published in respected scientific journals, can contain errors that persist for generations. By comparing magnetic measurements with transportation records, solar observations and local news reports, the team was able to reconstruct what likely happened on that October night. The result is both a scientific correction and a compelling glimpse into the moment when humanity’s growing dependence on technology first collided with the power of the sun.

About the Authors

• William B. Cade III, Ph.D., Baylor Institute for Aviation Sciences, Baylor University School of Engineering and Computer Science, Waco, TX, USA

 

• James Wild, Ph.D., corresponding author, School of Physics and Astronomy, Lancaster University, Lancaster, UK

 

• Ciaran D. Beggan, Ph.D., British Geological Survey, Edinburgh, UK

 

• David H. Boteler,Ph.D., School of Physics and Astronomy, Lancaster University, Lancaster, UK, and Natural Resources Canada, Ottawa, ON, Canada

 

• Brett A. Carter, Ph.D., School of Science, RMIT University, Melbourne, VIC, Australia

 

• Michael Hapgood, Ph.D., RAL Space, STFC Rutherford Appleton Laboratory, Didcot, UK

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Journal

Space Weather

DOI

10.1029/2026SW005239

Method of Research

Literature review

Subject of Research

Not applicable

Article Title

Did Space Weather Delay the 10:05 p.m. Train Departure From Exeter on 18 October 1841?