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Fenwick R, Price R, Kershaw T, Boddy R, Chessum P. Advanced clinical practitioners' inter-shift need for recovery: a cross-sectional survey in emergency medicine. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:738-747. [PMID: 35856584 DOI: 10.12968/bjon.2022.31.14.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Healthcare settings are high-risk environments for fatigue and staff burnout. The Need For Recovery (NFR) scale quantifies inter-shift recovery, which contributes to cumulative fatigue and may precede occupational burnout. Advanced clinical practitioners (ACPs) are an established feature of the emergency medicine workforce in the UK, however, little is known about factors affecting their inter-shift recovery, fatigue or how NFR correlates with formal burnout inventories. METHODS A prospective cross-sectional online survey of UK emergency medicine ACPs from 1 September to 30 September 2020. The primary aim was to determine the NFR of these ACPs. The secondary aims were to determine any statistical associations between NFR and selected variables, and whether NFR could reliably predict burnout using the Copenhagen Burnout Inventory (CBI) as a comparator. RESULTS There were 529 responses to the survey from 50 sites (response rate: 88%). The median NFR was 63.6 (95% CI 54.5-63.6). Lower NFR scores were found in ACPs who see both adults and children (54.5, 95% CI 45.4-63.6), work shifts of 7-10 hours (54.5, 95% CI 36.3-63.6) and who found it easy to park before work (54.5, 95% CI 45.5-54.5). Linear regression modelling indicated significant associations between shift length, ease of parking, ability to get breaks and feeling overwhelmed. Spearman's rho between NFR and CBI for personal and work-related burnout was 0.741 and 0.766 respectively. Correlation between NFR and patient-related burnout was less at 0.471. CONCLUSION This study has shown the second highest NFR score reported in any occupational group. Several factors have been identified that may potentially reduce NFR and could be changed by organisations. NFR could also be used to identify those suffering with occupational burnout.
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Affiliation(s)
- Rob Fenwick
- Lead Advanced Clinical Practitioner, Emergency Department, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust
| | - Rebecca Price
- Advanced Clinical Practitioner, Emergency Department, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust
| | - Tanya Kershaw
- Lead Advanced Clinical Practitioner, Emergency Department, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust
| | - Rachael Boddy
- Consultant in Emergency Medicine, Emergency Department, Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust
| | - Peter Chessum
- Lead Advanced Clinical Practitioner, Emergency Department/SDEC, Walsall Manor Hospital, Walsall Healthcare NHS Trust
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Dopolani FN, Arefi MF, Akhlaghi Pirposhteh E, Ghalichi Zaveh Z, Salehi AS, Khajehnasiri F, Hami M, Poursadeqiyan M, Khammar A. Investigation of occupational fatigue and safety climate among nurses using the structural equation model. Work 2022; 72:1129-1139. [PMID: 35661045 DOI: 10.3233/wor-213648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Nursing is associated with many stressful situations that can lead to fatigue, reduced efficiency, and physical and mental illness. Safety climate is one of the most important indicators of safety management performance assessment that assesses employees' attitudes towards safety issues. OBJECTIVE The purpose of this study was to investigate the relationship between safety climate and occupational fatigue in nurses. METHOD This descriptive-analytical study was performed on nurses working in hospitals affiliated to Zabol University of Medical Sciences in 2019. 143 nurses were selected by the proportional sampling method and entered the study. Demographic questionnaires, Occupational Fatigue Inventory (SOFI), and Nurses' Safety Assessment Questionnaire were used for data collection. Statistical tests, including Independent T-Test, ANOVA, Mann-Whitney U, Kruskal-Wallis, and multivariate analysis of variance (MANOVA) were used to analyze the results using SPSS software version 21, and the multivariate structural equation was used for modeling. RESULTS The mean scores of safety climate and occupational fatigue were 67.15±12.73 and 85.09±41.49, respectively. Job and demographic variables except for the second job (P-value = 0.065) had a significant effect on the variables of safety climate and occupational fatigue. There were also higher scores for occupational fatigue and all of its subscales in the group of women compared to the group of men. CONCLUSION The results showed that occupational and demographic variables have significant effects on safety climate and occupational fatigue. There was a significant relationship between demographic variables of age, work experience, and education level with safety climate. There was also a significant relationship between education level, job satisfaction, satisfaction with colleagues and work experience with occupational fatigue. Therefore, paying attention to fatigue and safety climate of nurses in workplaces is recommended.
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Affiliation(s)
| | - Maryam Feiz Arefi
- Department of Occupational Health Engineering, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Elham Akhlaghi Pirposhteh
- Department of Occupational Health Engineering, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Ghalichi Zaveh
- Department of Occupational Health Engineering, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Ali Sahlabadi Salehi
- Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farahnaz Khajehnasiri
- Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Hami
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Poursadeqiyan
- Department of Occupational Health and Safety Engineering, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran.,Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Alireza Khammar
- Department of Occupational Health Engineering, School of Health, Zabol University of Medical Sciences, Zabol, Iran
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Moon J, Kong Y, Chon KH. Language-Independent Sleepy Speech Detection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:1981-1984. [PMID: 36085715 DOI: 10.1109/embc48229.2022.9870900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Prolonged sleepiness can lead to impairment of cognitive and physical performance and may cause unfortunate accidents. Speech signals are easily accessible using a simple microphone or other means, hence, automated approaches for accurate sleepiness detection from speech signals are desired to prevent degradation in human performance and accidental injury. Sleepiness is known to affect acoustic patterns of speech so that they are different from those of normal speech, and this change is also independent of the language being spoken. To date, there have been no studies examining linguistic-independent sleepy speech detection. We used two different languages, English and German, to detect sleepy speech, where the former was used to train/validate and the latter to test the effectiveness of machine and deep learning models. Specifically, we trained ResNet50, a deep learning model, and five machine learning models with relevant vocal features. Speech data segments from three English-speaking subjects were used for training the model and segments from an English-speaking subject were used for validation. We then tested ResNet50 and the five different machine-learning models using speech data segments from one German-speaking subject. Deep learning far outperformed all of the machine learning approaches. The accuracy, sensitivity, specificity, and geometric mean values were found to be 0.96, 0.92, 0.99, and 0.95, respectively, using ResNet50 on the test data. Our preliminary results suggest that sleepiness can be accurately detected independently from linguistic speech. Clinical Relevance-It is not known if sleepiness can be detected regardless of the language spoken. Our results show the feasibility of accurate sleepiness detection using deep learning even when tested with a different language than trained on.
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Understanding Factors Underlying Fatigue among Collegiate Aviation Pilots in the United States. SAFETY 2022. [DOI: 10.3390/safety8020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An increase in evidence-based studies into the deleterious effects of fatigue on flight operations has been reported by key aviation groups globally. The collegiate aviation flight training environment has not been researched at the same level when compared to military and airline operations. College aged students are unique in the sense that they are tasked with classwork, studying, participation in student organizations, social activities, and often have part time jobs within and outside of the academic environment. These conditions may cause errors, incidents, accidents, poor academic performance, and undesirable health metrics. The purpose of this study was to understand fatigue as a multi-factorial dimension and to assess potential relationships among these factors using hypothesized measurement models. The research team distributed the Collegiate Aviation Fatigue Inventory II (CAFI-II) to eight small, medium, and large collegiate aviation programs in the United States. The CAFI-II primarily focuses on fatigue awareness, causes and symptoms of fatigue, and lifestyle choices. Four hundred and twenty-two (n = 422) valid responses were obtained. Results suggested a direct predictive relationship between fatigue in collegiate flight training and the perceptions of respondents of conditions that are known to cause fatigue. Findings also suggested that respondents who had a favorable perception of fatigue risk and management programs had a better understanding of the causes of fatigue.
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Damato EG, Fillioe SJ, Margevicius SP, Mayes RS, Somogyi JE, Vannix IS, Abdollahifar A, Turner AM, Ilcus LS, Decker MJ. Increased Serum Levels of Proinflammatory Cytokines Are Accompanied by Fatigue in Military T-6A Texan II Instructor Pilots. Front Physiol 2022; 13:876750. [PMID: 35574470 PMCID: PMC9097024 DOI: 10.3389/fphys.2022.876750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 12/01/2022] Open
Abstract
Tactical aviation imposes unprecedented physical challenges including repetitive exposure to hypergravity, hyperoxia, increased work of breathing, and profound cognitive workloads. Each stressor evokes outcomes ranging from musculoskeletal duress and atelectasis to physical and cognitive fatigue, the latter among the foremost threats to aviators. Whereas sleep loss is traditionally considered the primary cause of fatigue in aviators, converging experimental, observational, and medical studies have identified biochemical mechanisms promoting onset of fatigue. Those mechanisms, which fundamentally differ from sleep loss, revolve around increased proinflammatory cytokines, produced and released in response to tissue injury, chronic inflammatory disorders, allergens, or physical duress. This study’s objective was to inform our understanding of potential relationships between serum levels of proinflammatory cytokines and onset of fatigue within a cohort of aviators who experience multiple high-performance sorties on a daily basis. Methods: Active duty and reservist T-6A Texan II instructor pilots were studied on three separate days across their week-long flying schedule. Data collected included a physical assessment, subjective fatigue levels, venous blood samples for measures of chemistry and serum analytes, and urine samples for specific gravity. Results: Twenty-three persons were studied, of which 22 fulfilled minimum study requirements of completing two sorties. The study cohort was comprised of primarily males, age 37.95 ± 4.73 years with a BMI of 26.63 ± 3.15 kg/m2. Of 37 measurable serum analytes, 20 differed significantly (p < 0.05) between baseline values with those measured at the study endpoint. Thirteen of the aviators reported increased fatigue scores across their flying schedule whereas nine did not. Eleven blood serum analytes were associated with increasing levels of fatigue. Discussion: Fatigue in aviators has been attributed almost solely to sleep loss, nocturnal sorties, or disrupted circadian rhythmicity. In contrast, our study findings suggest an alternative mechanism that can promote onset of fatigue: increased blood levels of proinflammatory cytokines. Specific mechanisms triggering synthesis and release of those cytokines and other analytes are yet to be determined. However, their expression patterns suggest responses to both chronic and acute inflammation, hyperoxia, or bronchopulmonary responses to inspiration of dry gas, positive airway pressure, or perhaps atelectasis.
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Affiliation(s)
- Elizabeth G. Damato
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Naval Medical Research Unit Dayton, Dayton, OH, United States
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Seth J. Fillioe
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Seunghee P. Margevicius
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Ryan S. Mayes
- 711th Human Performance Wing, U. S. Air Force School of Aerospace Medicine, Dayton, OH, United States
| | | | - Ian S. Vannix
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Alireza Abdollahifar
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Anthony M. Turner
- 711th Human Performance Wing, U. S. Air Force School of Aerospace Medicine, Dayton, OH, United States
| | | | - Michael J. Decker
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
- Naval Medical Research Unit Dayton, Dayton, OH, United States
- *Correspondence: Michael J. Decker,
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The Effect of Worktime Control on Overtime Employees' Mental Health and Work-Family Conflict: The Mediating Role of Voluntary Overtime. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073767. [PMID: 35409451 PMCID: PMC8997466 DOI: 10.3390/ijerph19073767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/17/2022]
Abstract
Overtime has become a widespread phenomenon in the current information age that creates a high speed working pace and fierce competition in the high technology global economy. Based on the time-regulation mechanism and effort-recovery model, we examined the effect of worktime control (WTC) on mental health and work-family conflict (WFC) among overtime employees, and whether voluntary overtime mediated the relationships. We also examined two separate dimensions of WTC (control over time-off and control over daily hours). The results showed that control over time-off was related to decreased depression, anxiety, stress and WFC, while control over daily hours was related to decreased stress and WFC. Generally, control over time-off was beneficial to females and employees with dependents. Furthermore, mediation results showed that voluntary overtime was a complete mediator of relationships between WTC and depression and anxiety as well as a partial mediator of the relationship between WTC and stress. However, this study did not find a mediating effect of voluntary overtime on the WTC-WFC relationship. Limitations and practical implications are discussed.
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Tusher HM, Nazir S, Mallam S, Rusli R, Botnmark AK. Learning from accidents: Nontechnical skills deficiency in the European process industry. PROCESS SAFETY PROGRESS 2022. [DOI: 10.1002/prs.12344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hasan Mahbub Tusher
- Faculty of Technology, Natural Sciences and Maritime Sciences University of South‐Eastern Norway Horten Norway
| | - Salman Nazir
- Faculty of Technology, Natural Sciences and Maritime Sciences University of South‐Eastern Norway Horten Norway
- Nord University Business School Nord University Bodø Norway
| | - Steven Mallam
- Faculty of Technology, Natural Sciences and Maritime Sciences University of South‐Eastern Norway Horten Norway
| | - Risza Rusli
- Chemical Engineering Department Universiti Teknologi PETRONAS Seri Iskandar Malaysia
| | - Anne Kari Botnmark
- Faculty of Technology, Natural Sciences and Maritime Sciences University of South‐Eastern Norway Horten Norway
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Sprajcer M, Thomas MJW, Sargent C, Crowther ME, Boivin DB, Wong IS, Smiley A, Dawson D. How effective are Fatigue Risk Management Systems (FRMS)? A review. ACCIDENT; ANALYSIS AND PREVENTION 2022; 165:106398. [PMID: 34756484 PMCID: PMC8806333 DOI: 10.1016/j.aap.2021.106398] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Fatigue Risk Management Systems (FRMS) are a data-driven set of management practices for identifying and managing fatigue-related safety risks. This approach also considers sleep and work time, and is based on ongoing risk assessment and monitoring. This narrative review addresses the effectiveness of FRMS, as well as barriers and enablers in the implementation of FRMS. Furthermore, this review draws on the literature to provide evidence-based policy guidance regarding FRMS implementation. METHODS Seven databases were drawn on to identify relevant peer-reviewed literature. Relevant grey literature was also reviewed based on the authors' experience in the area. In total, 2129 records were screened based on the search strategy, with 231 included in the final review. RESULTS Few studies provide an evidence-base for the effectiveness of FRMS as a whole. However, FRMS components (e.g., bio-mathematical models, self-report measures, performance monitoring) have improved key safety and fatigue metrics. This suggests FRMS as a whole are likely to have positive safety outcomes. Key enablers of successful implementation of FRMS include organisational and worker commitment, workplace culture, and training. CONCLUSIONS While FRMS are likely to be effective, in organisations where safety cultures are insufficiently mature and resources are less available, these systems may be challenging to implement successfully. We propose regulatory bodies consider a hybrid model of FRMS, where organisations could choose to align with tight hours of work (compliance) controls. Alternatively, where organisational flexibility is desired, a risk-based approach to fatigue management could be implemented.
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Affiliation(s)
| | | | | | | | - Diane B Boivin
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Imelda S Wong
- Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health, USA
| | | | - Drew Dawson
- Appleton Institute, CQUniversity, Adelaide, Australia
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Maisey G, Cattani M, Devine A, Lo J, Fu SC, Dunican IC. Digging for data: How sleep is losing out to roster design, sleep disorders, and lifestyle factors. APPLIED ERGONOMICS 2022; 99:103617. [PMID: 34700190 DOI: 10.1016/j.apergo.2021.103617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
Shift workers employed at a remote mining operation may experience sleep loss, impaired alertness, and consequently negative health and safety outcomes. This study determined the sleep behaviors and prevalence of risk for sleep disorders among shift workers; and quantified alertness for a roster cycle. Sleep duration was significantly less following; night shift by 77 ± 7 min and day shift by 30 ± 7 min. The wake after sleep onset was less by 23 ± 3 min for night shifts and 22 ± 3 min for day shifts (p < 0.05 for all). The prevalence of risk for sleep apnea was 31%, insomnia was 8%, and shiftwork disorder was 44%. Average alertness for all working hours was 75%. Shiftwork in remote mining operations is a significant factor that leads to sleep loss and reduced alertness, which is exacerbated by the high prevalence of risk for sleep disorders.
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Affiliation(s)
- Gemma Maisey
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia.
| | - Marcus Cattani
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Amanda Devine
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Shih Ching Fu
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Ian C Dunican
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
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Quiquempoix M, Sauvet F, Erblang M, Van Beers P, Guillard M, Drogou C, Trignol A, Vergez A, Léger D, Chennaoui M, Gomez-Merino D, Rabat A. Effects of Caffeine Intake on Cognitive Performance Related to Total Sleep Deprivation and Time on Task: A Randomized Cross-Over Double-Blind Study. Nat Sci Sleep 2022; 14:457-473. [PMID: 35321359 PMCID: PMC8935086 DOI: 10.2147/nss.s342922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION It is widely admitted that both total sleep deprivation (TSD) and extended task engagement (Time-On-Task, TOT) induce a cognitive fatigue state in healthy subjects. Even if EEG theta activity and adenosine both increase with cognitive fatigue, it remains unclear if these modifications are common mechanisms for both sustained attention and executive processes. METHODS We performed a double-blind counter-balanced (placebo (PCBO) and caffeine (CAF) - 2×2.5 mg/kg/24 h)) study on 24 healthy subjects (33.7 ± 5.9 y). Subjects participated in an experimental protocol including an habituation/training day followed by a baseline day (D0 and D1) and a total sleep deprivation (TSD) day beginning on D1 at 23:00 until D2 at 21:00. Subjects performed the psychomotor vigilance test (PVT) assessing sustained attention, followed by the executive Go-NoGo inhibition task and the 2-NBack working memory task at 09:15 on D1 and D2. RESULTS We showed differential contributions of TSD and TOT on deficits in sustained attention and both executive processes. An alleviating effect of caffeine intake is only observed on sustained attention deficits related to TSD and not at all on TOT effect. The caffeine dose slows down the triggering of sustained attention deficits related to TOT effect. DISCUSSION These results suggest that sustained attention deficits induced by TSD rely on the adenosinergic mechanism whereas TOT effect observed for both sustained attention and executive would not.
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Affiliation(s)
- Michael Quiquempoix
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Fabien Sauvet
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Mégane Erblang
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France.,LBEPS, Univ Evry, IRBA, University of Paris-Saclay, Paris, France
| | - Pascal Van Beers
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Mathias Guillard
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Catherine Drogou
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Aurélie Trignol
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Anita Vergez
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Damien Léger
- VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France.,Centre du sommeil et de la vigilance, Hôpital Hôtel Dieu AP-HP, Paris, 75004, France
| | - Mounir Chennaoui
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Danielle Gomez-Merino
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
| | - Arnaud Rabat
- Department of Operational Environments, Fatigue and Vigilance Team, French Armed Forces Biomedical Research Institute (IRBA), Paris, France.,VIFASOM Team (EA 7330), University of Paris - Hôtel Dieu AP-HP Hospital, Paris, France
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Maynard S, Miller KA, Filtness A. Keeping the service running: Examining working relationships and workload of London bus network iBus controllers. APPLIED ERGONOMICS 2022; 98:103577. [PMID: 34488189 DOI: 10.1016/j.apergo.2021.103577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 06/13/2023]
Abstract
Bus controllers are an essential part of the London bus network. Although the bus driver is the individual directly in control of the vehicle, inputs from both the controller and driver influence operations. Currently, little research has focused on the dynamic between these parties, and how it works in the day-to-day operation of a bus. In the current study, data was collected across focus groups with controllers to understand the controller-driver relationship from the controller perspective. The objectives of the research were to: investigate interactions and working relationships between bus controllers and drivers in London and to explore the effect of controller/driver relationships on workload, stress and fatigue. It is clear that the working relationship between controllers and drivers is a challenging one, with both parties often misunderstanding the role of the other. This is made worse by the nature of communication via radio including poor quality audio leading to difficult interactions. All of the participating controllers expressed being overloaded with work, leading to feelings of stress and fatigue, with shift work and irregular hours being discussed as a cause of controller fatigue. Any steps taken to improve the difficult working relationship between drivers and controllers can be seen as beneficial because they could improve efficiency, worker wellbeing, and possibly safety.
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Affiliation(s)
- Sally Maynard
- Transport Safety Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, LE11 3TU, UK.
| | - Karl A Miller
- Transport Safety Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, LE11 3TU, UK; University of Nottingham Since 2019, UK
| | - Ashleigh Filtness
- Transport Safety Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, LE11 3TU, UK
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Dugan AG, Decker RE, Zhang Y, Lombardi CM, Garza JL, Laguerre RA, Suleiman AO, Namazi S, Cavallari JM. Precarious Work Schedules and Sleep: A Study of Unionized Full-Time Workers. OCCUPATIONAL HEALTH SCIENCE 2022; 6:247-277. [PMID: 35372671 PMCID: PMC8962924 DOI: 10.1007/s41542-022-00114-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
Unlike precarious employment which is temporary and insecure, with inadequate pay, benefits, and legal protections, precarious work schedules can affect workers with permanent full-time jobs in sectors where employment has historically been secure, well-compensated, and even unionized. Precarious work schedules - characterized by long shifts, non-daytime hours, intensity and unsocial work hours - are increasingly prevalent. Relations between precarious work schedules and poor health are not well understood, and less is known about how to attenuate this relation. We examined the indirect effects of precarious work schedules on fatigue and depressive symptoms through sleep quantity. Two moderators - schedule flexibility and sleep quality - were examined as buffers of these associations. Workers from the Departments of Correction and Transportation in a northeast state (N = 222) took surveys and reported on demographics, work schedule characteristics, schedule flexibility, sleep quality and quantity, fatigue, and depressive symptoms. Results revealed that precarious work schedules had indirect effects on fatigue and depressive symptoms through sleep quantity. Schedule flexibility moderated the relation between precarious work schedules and sleep quantity, such that workers with greater schedule flexibility had more hours of sleep. Sleep quality moderated the association between sleep quantity and fatigue and depressive symptoms, such that workers reported greater fatigue and depressive symptoms when they had poorer sleep quality. Findings have direct applicability for developing initiatives that enhance Total Worker Health® through individual and organizational changes. Supplementary Information The online version contains supplementary material available at 10.1007/s41542-022-00114-y.
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Affiliation(s)
- Alicia G Dugan
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Ragan E Decker
- Society for Human Resource Management, 1800 Duke Street, Alexandria, VA 22314 USA
| | - Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, 113 Wilder Street, Lowell, MA 01854-5126 USA
| | - Caitlin M Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269 USA
| | - Jennifer L Garza
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Rick A Laguerre
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269 USA
| | - Adekemi O Suleiman
- Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
| | - Sara Namazi
- Department of Health Sciences, Springfield College, 468 Alden St, Springfield, MA 01109 USA
| | - Jennifer M Cavallari
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA.,Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
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Ma YL, Yang Y, Thakur K, Cespedes-Acuña CL, Zhang JG, Wei ZJ. Evaluation of spatial memory and anti-fatigue function of long-term supplementation of <i>β</i>-alanine and confirmation through cAMP-PKA and apoptosis pathways in mice. EFOOD 2021. [DOI: 10.53365/efood.k/144395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
With an aim to explore the effects of <i>β</i>-alanine (<i>β</i>-A) on spatial memory and fatigue resistance, Kunming mice were treated with different concentrations of β-A (418, 836, and 2090 mg·kg<sup> -1</sup>·day<sup> -1</sup>). After gavage feeding with <i>β</i>-A for 10 weeks, results of the maze and MWM tests showed that <i>β</i>-A can enhance spatial learning and memory in mice. After evaluating the fatigue resistance, biochemical parameters (LG, GG, BUN, SOD, and MDA) showed significant differences in the low concentration treatment group compared to control group. Our data demonstrated that the appropriate dose of <i>β</i>-A can alleviate the oxidative stress and muscle fatigue in mice. Subsequently, expression of mRNA of key genes involved in cAMP-PKA pathway (PDE4A, MAPK1, adcy1, cAMP and CREB) was up regulated. Also, expression levels of apoptotic pathway genes were significantly affected as confirmed by qPCR and Western blotting. Our results demonstrated that <i>β</i>-A can enhance spatial learning and memory in mice via regulation of cAMP-PKA and apoptotic pathway.
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Schweizer T, Wyss T, Gilgen-Ammann R. Detecting Soldiers' Fatigue Using Eye-Tracking Glasses: Practical Field Applications and Research Opportunities. Mil Med 2021; 187:e1330-e1337. [PMID: 34915554 PMCID: PMC10100772 DOI: 10.1093/milmed/usab509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/04/2021] [Accepted: 11/29/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Objectively determining soldiers' fatigue levels could help prevent injuries or accidents resulting from inattention or decreased alertness. Eye-tracking technologies, such as optical eye tracking (OET) and electrooculography (EOG), are often used to monitor fatigue. Eyeblinks-especially blink frequency and blink duration-are known as easily observable and valid biomarkers of fatigue. Currently, various eye trackers (i.e., eye-tracking glasses) are available on the market using either OET or EOG technologies. These wearable eye trackers offer several advantages, including unobtrusive functionality, practicality, and low costs. However, several challenges and limitations must be considered when implementing these technologies in the field to monitor fatigue levels. This review investigates the feasibility of eye tracking in the field focusing on the practical applications in military operational environments. MATERIALS AND METHOD This paper summarizes the existing literature about eyeblink dynamics and available wearable eye-tracking technologies, exposing challenges and limitations, as well as discussing practical recommendations on how to improve the feasibility of eye tracking in the field. RESULTS So far, no eye-tracking glasses can be recommended for use in a demanding work environment. First, eyeblink dynamics are influenced by multiple factors; therefore, environments, situations, and individual behavior must be taken into account. Second, the glasses' placement, sunlight, facial or body movements, vibrations, and sweat can drastically decrease measurement accuracy. The placement of the eye cameras for the OET and the placement of the electrodes for the EOG must be chosen consciously, the sampling rate must be minimal 200 Hz, and software and hardware must be robust to resist any factors influencing eye tracking. CONCLUSION Monitoring physiological and psychological readiness of soldiers, as well as other civil professionals that face higher risks when their attention is impaired or reduced, is necessary. However, improvements to eye-tracking devices' hardware, calibration method, sampling rate, and algorithm are needed in order to accurately monitor fatigue levels in the field.
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Affiliation(s)
- Theresa Schweizer
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
| | - Thomas Wyss
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
| | - Rahel Gilgen-Ammann
- Monitoring, Swiss Federal Institute of Sport Magglingen (SFISM), Macolin 2532, Switzerland
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Akter R, Larose TL, Sandvik J, Fonne V, Meland A, Wagstaff AS. Excessive Daytime Sleepiness and Associated Factors in Military Search and Rescue Personnel. Aerosp Med Hum Perform 2021; 92:975-979. [PMID: 34986937 DOI: 10.3357/amhp.5946.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Abnormal excessive daytime sleepiness (EDS) has been reported worldwide, but too little is known about EDS and its determinants in Search and Rescue (SAR) populations. We aimed to determine the prevalence of abnormal EDS and contributing factors among Royal Norwegian Air Force (RNoAF) SAR helicopter personnel.METHODS: In this cross-sectional study, a total of N = 175 RNoAF SAR personnel completed an electronic survey including socio-demographic and lifestyle questions. The Epworth Sleepiness Scale (ESS) was used as both a continuous and categorical outcome variable to measure EDS.RESULTS: Abnormal EDS defined by ESS was found in 41% of the participants in this study. We observed no associations between socio-demographic and lifestyle factors and abnormal EDS in this study. DISCUSSION: There is a high prevalence of abnormal EDS in the current RNoAF SAR population. Despite this elevated level of fatigue, we did not find that the socio-demographic and lifestyle factors assessed in this study were associated with abnormal EDS in RNoAF SAR helicopter personnel. Also unusually, the study cohort did not demonstrate higher scores in factors found to change ESS scores in similar study populations (e.g., caffeine use, tobacco use, exercise level). Further research is required to investigate other factors (organizational, operational) that may be associated with abnormal EDS in this and other SAR populations.Akter R, Larose TL, Sandvik J, Fonne V, Meland A, Wagstaff AS. Excessive daytime sleepiness and associated factors in military search and rescue personnel. Aerosp Med Hum Perform. 2021; 92(12):975-979.
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HP. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. J Clin Sleep Med 2021; 17:2283-2306. [PMID: 34666885 PMCID: PMC8636361 DOI: 10.5664/jcsm.9512] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022]
Abstract
CITATION Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M. Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B. Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E. Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P. Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J. Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P.A. Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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Hilty DM, Armstrong CM, Smout SA, Crawford A, Maheu MM, Drude KP, Chan S, Yellowlees PM, Krupinski EA. PROVIDER TECHNOLOGY, FATIGUE AND WELL-BEING: A SCOPING REVIEW (Preprint). J Med Internet Res 2021; 24:e34451. [PMID: 35612880 PMCID: PMC9178447 DOI: 10.2196/34451] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/20/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Video and other technologies are reshaping the delivery of health care, yet barriers related to workflow and possible provider fatigue suggest that a thorough evaluation is needed for quality and process improvement. Objective This scoping review explored the relationship among technology, fatigue, and health care to improve the conditions for providers. Methods A 6-stage scoping review of literature (from 10 databases) published from 2000 to 2020 that focused on technology, health care, and fatigue was conducted. Technologies included synchronous video, telephone, informatics systems, asynchronous wearable sensors, and mobile health devices for health care in 4 concept areas related to provider experience: behavioral, cognitive, emotional, and physical impact; workplace at the individual, clinic, hospital, and system or organizational levels; well-being, burnout, and stress; and perceptions regarding technology. Qualitative content, discourse, and framework analyses were used to thematically analyze data for developing a spectrum of health to risk of fatigue to manifestations of burnout. Results Of the 4221 potential literature references, 202 (4.79%) were duplicates, and our review of the titles and abstracts of 4019 (95.21%) found that 3837 (90.9%) were irrelevant. A full-text review of 182 studies revealed that 12 (6.6%) studies met all the criteria related to technology, health care, and fatigue, and these studied the behavioral, emotional, cognitive, and physical impact of workflow at the individual, hospital, and system or organizational levels. Video and electronic health record use has been associated with physical eye fatigue; neck pain; stress; tiredness; and behavioral impacts related to additional effort owing to barriers, trouble with engagement, emotional wear and tear and exhaustion, cognitive inattention, effort, expecting problems, multitasking and workload, and emotional experiences (eg, anger, irritability, stress, and concern about well-being). An additional 14 studies that evaluated behavioral, emotional, and cognitive impacts without focusing on fatigue found high user ratings on data quality, accuracy, and processing but low satisfaction with clerical tasks, the effort required in work, and interruptions costing time, resulting in more errors, stress, and frustration. Our qualitative analysis suggests a spectrum from health to risk and provides an outline of organizational approaches to human factors and technology in health care. Business, occupational health, human factors, and well-being literature have not studied technology fatigue and burnout; however, their findings help contextualize technology-based fatigue to suggest guidelines. Few studies were found to contextually evaluate differences according to health professions and practice contexts. Conclusions Health care systems need to evaluate the impact of technology in accordance with the Quadruple Aim to support providers’ well-being and prevent workload burden, fatigue, and burnout. Implementation and effectiveness approaches and a multilevel approach with objective measures for clinical, human factors, training, professional development, and administrative workflow are suggested. This requires institutional strategies and competencies to integrate health care quality, technology and well-being outcomes.
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Affiliation(s)
- Donald M Hilty
- Department of Psychiatry & Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
- Northern California Veterans Affairs Health Care System, Mather, CA, United States
| | - Christina M Armstrong
- Office of Connected Care, Department of Veterans Affairs, Washington, DC, United States
| | - Shelby A Smout
- Virginia Commonwealth University, Richmond, VA, United States
| | - Allison Crawford
- Extension for Community Healthcare Outcomes, Ontario Mental Health at Centre for Addiction and Mental Health, University of Toronto Virtual Mental Health, and Canada Suicide Prevention Service, Toronto, ON, Canada
| | - Marlene M Maheu
- Telebehavioral Health Institute, LLC and Coalition for Technology in Behavioral Science, San Diego, CA, United States
| | - Kenneth P Drude
- Coalition for Technology in Behavioral Science & Ohio Board of Psychology, Dayton, OH, United States
| | - Steven Chan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine & Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Peter M Yellowlees
- Department of Psychiatry & Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, United States
| | - Elizabeth A Krupinski
- Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States
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Matsuo T, Ishii A, Minami T, Nanjo H, Yoshikawa T. Neural mechanism by which physical fatigue sensation suppresses physical performance: a magnetoencephalography study. Exp Brain Res 2021; 240:237-247. [PMID: 34689244 DOI: 10.1007/s00221-021-06250-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
The right dorsolateral prefrontal cortex (DLPFC) has been proposed to be the brain region regulating performance through fatigue sensation in fatigue, but direct evidence has been lacking for right DLPFC activation when physical performance is suppressed in the presence of fatigue sensation. We examined whether the right DLPFC is activated when physical performance is suppressed by remembering a physical fatigue sensation. Eighteen healthy male volunteers participated. They performed a rest session followed by a handgrip session to induce physical fatigue sensation. Then, they were instructed to remember the state of the right hand with (i.e., the target condition) and without (i.e., the control condition) fatigue sensation as experienced in the handgrip and rest sessions, respectively while performing motor imagery of maximum handgrip of the right hand. Neural activity during both conditions was recorded using magnetoencephalography. The level of fatigue sensation was higher in the target condition than in the control condition. Decreases of handgrip strength and beta band power in the right Brodmann's area 46 were observed in the target condition, suggesting that the right DLPFC is involved in the regulation of physical performance through fatigue sensation. These findings may help elucidate the neural mechanisms regulating performance under fatigue conditions.
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Affiliation(s)
- Takashi Matsuo
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka, 545-8585, Japan.
| | - Akira Ishii
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Takayuki Minami
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Hitoshi Nanjo
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
| | - Takahiro Yoshikawa
- Department of Sports Medicine, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka, 545-8585, Japan
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Cochran KR, Letvak SA, McCoy TP, Bacon C, Karper WB. Can Nurses Self-Assess Fatigue?: Implications for Nurse Leaders. J Nurs Adm 2021; 51:507-512. [PMID: 34519698 DOI: 10.1097/nna.0000000000001055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aims of this study were to describe nurses' self-perceptions of fatigue and to examine nurses' acceptance of specific fatigue countermeasures. BACKGROUND The work of nurses places them at a high risk of fatigue. Evidence suggests 75% to 80% of nurses in the United States experience high levels of fatigue. METHODS This descriptive, cross-sectional correlational study surveyed 279 nurses. RESULTS Results suggest that almost half of nurses (46%) are not able to accurately self-assess fatigue. Nurses expressed acceptance of several workplace fatigue reduction strategies. CONCLUSIONS It may be unrealistic to expect nurses to self-assess fatigue levels and make decisions about their ability to safely provide patient care. Reliable methods for assessing fatigue in the workplace are needed. Several strategies exist that may be used to alleviate fatigue, and many were acceptable to nurses. Nurse leaders are well positioned to implement changes that impact the occurrence of nurse fatigue and thereby the quality of patient care.
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Affiliation(s)
- Karen R Cochran
- Author Affiliations : Grant Specialist (Dr Cochran), School of Nursing, Western Carolina University, Asheville, North Carolina; and Professor (Dr Letvak), Clinical Professor (Dr McCoy), and Assistant Professor (Dr Bacon), School of Nursing, and Associate Professor (Dr Karper), Department of Kinesiology, University of North Carolina at Greensboro
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Overtime working patterns and adverse events in work-related suicide cases: hierarchical cluster analysis of national compensation data in Japan (fiscal year 2015-2016). Int Arch Occup Environ Health 2021; 95:887-895. [PMID: 34564732 PMCID: PMC9038865 DOI: 10.1007/s00420-021-01760-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/10/2021] [Indexed: 11/17/2022]
Abstract
Background Although various work-related adverse events affect workers’ mental health, the association between long working hours and mental disorders remains unclear. We investigated the characteristics of overtime work and work-related adverse events among all cases of compensated work-related suicide in Japan to empirically reveal the context of the serious consequences. Methods We analysed all 167 cases of mental disorders resulting in suicide that were compensated in fiscal year 2015–2016. Hierarchical clustering was applied to the overtime working history. Work-related adverse events were also evaluated as the qualitative aspects of their jobs. Results More than half of the cases committed suicide within a month of developing a mental disorder. The Administrative and professional or engineering workers had a higher suicide rate. The clustering analysis revealed chronic long working hours (19%), gradual increase (27%), or rapid increase (25%) in working hours before the onset of a mental disorder. A group of cases with less overwork experienced more interpersonal conflicts. Conclusion This is the first study to employ a clustering technique to objectively reveal the actual working patterns behind suicide. The patterns of working overtime before the onset of mental disorders varied considerably among the cases. Taking the transition of working overtime into account may provide clearer insight into the relationship between long working hours and workers’ mental health. These results highlight the need for countermeasures especially for causes of chronic overworking, drastic increases in working hours, and interpersonal conflicts to prevent work-related suicide. Supplementary Information The online version contains supplementary material available at 10.1007/s00420-021-01760-5.
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Wilson M, Elkins-Brown N, James L, James SM, Stevens K, Butterfield P. Psychometric Evaluation of the Creighton Competency Evaluation Instrument in a Population of Working Nurses. J Nurs Meas 2021; 30:148-167. [PMID: 34518427 DOI: 10.1891/jnm-d-20-00083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE This study explored the psychometric properties of the Creighton Competency Evaluation Instrument (C-CEI), previously validated for use with nursing students, to assess simulation performance among registered nurses working 12-hour shifts. Valid and reliable measurements are needed to test clinical and simulation competencies and characterize the effects of fatigue on nursing performance. METHODS Trained raters scored nurses' patient care performance in simulation scenarios using the C-CEI. We analyzed the instrument's principal components, internal reliability, and construct validity. RESULTS Internal reliability of the C-CEI aggregate score and the Clinical Decision-making component were high (>.70). The latter robustly correlated with predicted cognitive effectiveness, a measure of fatigue. CONCLUSIONS The C-CEI is a reliable measure for use among registered nurses and its further development will be important for testing performance of working nurses and fatigue-mitigation innovations.
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Affiliation(s)
| | | | - Lois James
- Washington State University, Spokane, Washington
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Santos J, Ramos C, Silva A, Amorim S, Winwood P, Carvalhais C. Psychometric properties of the Portuguese version of the occupational fatigue exhaustion/recovery (OFER) scale among industrial shift workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:554-560. [PMID: 34402749 DOI: 10.1080/19338244.2021.1967842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Reliable and valid instruments are essential for understanding fatigue in occupational settings. This study analyzed the psychometric properties of the Portuguese version of the Occupational Fatigue Exhaustion/Recovery (OFER). A cross-sectional study was conducted with 260 workers (M = 46.52 ± 13.16 years) from a textile industry, exposed to shift work. Convergent and discriminant validity, internal consistency reliability and exploratory and confirmatory factor analysis were performed. Results showed an adequate fit to data (χ2 (84) = 209,102, CFI = 0.936, GFI = 0.902, RMSEA = 0.076 CI90% (0.063-0.089)), yielding a 13-item, three factor structure. Two items were removed due to low factor loading. The OFER presented an adequate internal consistency, with the subscales presenting good reliability values (Chronic Fatigue (α = 0.81), Acute Fatigue (α = 0.84) and Recovery between Shifts (α = 0.77)). Findings suggest that the Portuguese version of OFER can be a useful tool to assess occupational fatigue of shift workers and prevent work related injuries.
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Affiliation(s)
- Joana Santos
- Scientific Area of Environmental Health and Environment and Health Research Center (CISA/ESS|P.Porto), School of Health, Polytechnic Institute of Porto, Porto, Portugal
- Associated Laboratory for Energy, Transports and Aeronautics (LAETA), Institute of Mechanical Engineering and Industrial Management (INEGI) - Biomechanics and Health Unit, Faculty of Engineering, University of Porto, Porto, Portugal
- Center for Rehabilitation Research (CIR/ESS|P.Porto), School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Catarina Ramos
- LabPSI-EM, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Caparica, Portugal
| | - André Silva
- Faculty of Engineering, University of Porto, Portugal, Portugal
| | - Sara Amorim
- Scientific Area of Environmental Health and Environment and Health Research Center (CISA/ESS|P.Porto), School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | - Peter Winwood
- School of Psychology, Social Work and Social Policy, University of South Australia, Adelaide, SA, Australia
| | - Carlos Carvalhais
- Scientific Area of Environmental Health and Environment and Health Research Center (CISA/ESS|P.Porto), School of Health, Polytechnic Institute of Porto, Porto, Portugal
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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Gurubhagavatula I, Barger LK, Barnes CM, Basner M, Boivin DB, Dawson D, Drake CL, Flynn-Evans EE, Mysliwiec V, Patterson PD, Reid KJ, Samuels C, Shattuck NL, Kazmi U, Carandang G, Heald JL, Van Dongen HPA. Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society. Sleep 2021; 44:6312566. [PMID: 34373924 DOI: 10.1093/sleep/zsab161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/17/2021] [Indexed: 11/12/2022] Open
Abstract
Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.
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Affiliation(s)
- Indira Gurubhagavatula
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Christopher M Barnes
- Department of Management and Organization, Foster School of Business, University of Washington, Seattle, WA, USA
| | - Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane B Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Drew Dawson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | | | - Erin E Flynn-Evans
- Fatigue Countermeasures Laboratory, NASA Ames Research Center, Moffett Field, CA, USA
| | - Vincent Mysliwiec
- STRONG STAR ORU, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX, USA
| | - P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathryn J Reid
- Center for Circadian and Sleep Medicine, Department of Neurology, Division of Sleep Medicine, Northwestern University, Chicago, IL, USA
| | - Charles Samuels
- Centre for Sleep and Human Performance, Calgary, Alberta, Canada
| | - Nita Lewis Shattuck
- Operations Research Department, Naval Postgraduate School, Monterey, CA, USA
| | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, IL, USA
| | | | | | - Hans P A Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, WA, USA.,Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
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Smithies TD, Toth AJ, Dunican IC, Caldwell JA, Kowal M, Campbell MJ. The effect of sleep restriction on cognitive performance in elite cognitive performers: a systematic review. Sleep 2021; 44:zsab008. [PMID: 33438751 PMCID: PMC8271199 DOI: 10.1093/sleep/zsab008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Indexed: 01/08/2023] Open
Abstract
STUDY OBJECTIVES To synthesize original articles exploring the effects of sleep restriction on cognitive performance specifically for Elite Cognitive Performers, i.e. those who engage in cognitively demanding tasks with critical or safety-critical outcomes in their occupation or area of expertise. METHODS Backward snowballing techniques, gray literature searches, and traditional database searches (Embase, MEDLINE, Web of Science, Google Scholar, PSYCinfo, and SportDiscus) were used to obtain relevant articles. A quality assessment was performed, and the risk of training effects was considered. Results were narratively synthesized. Fourteen articles fit the criteria. Cognitive outcomes were divided into three categories defined by whether cognitive demands were "low-salience," "high-salience stable," or "high-salience flexible." RESULTS Low-salience tests (i.e. psychomotor vigilance tasks & serial reaction tests), mainly requiring vigilance and rudimentary attentional capacities, were sensitive to sleep restriction, however, this did not necessarily translate to significant performance deficits on low-salience occupation-specific task performance. High-salience cognitive outcomes were typically unaffected unless when cognitive flexibility was required. CONCLUSIONS Sleep restriction is of particular concern to occupations whereby individuals perform (1) simple, low-salience tasks or (2) high-salience tasks with demands on the flexible allocation of attention and working memory, with critical or safety-critical outcomes.
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Affiliation(s)
- Tim D Smithies
- Department of Physical Education & Sport Science, University of Limerick, Castletroy, Limerick, Ireland
- Lero, the SFI Centre for Software Research, University of Limerick, Castletroy, Limerick, Ireland
| | - Adam J Toth
- Department of Physical Education & Sport Science, University of Limerick, Castletroy, Limerick, Ireland
- Lero, the SFI Centre for Software Research, University of Limerick, Castletroy, Limerick, Ireland
| | - Ian C Dunican
- Melius Consulting, Mount Hawthorn, Western Australia, Australia
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | | | - Magdalena Kowal
- Department of Physical Education & Sport Science, University of Limerick, Castletroy, Limerick, Ireland
- Lero, the SFI Centre for Software Research, University of Limerick, Castletroy, Limerick, Ireland
| | - Mark J Campbell
- Department of Physical Education & Sport Science, University of Limerick, Castletroy, Limerick, Ireland
- Lero, the SFI Centre for Software Research, University of Limerick, Castletroy, Limerick, Ireland
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Abstract
Canine sports medicine and rehabilitation recently have evolved to embody the optimization of performance, injury prevention, and mitigation of musculoskeletal degeneration. This article discusses the diverse factors and considerations of working dog wellness and injury prevention and the importance of recognizing normal and abnormal posture and anatomic structure for performance evaluation and early indication of musculoskeletal injury. The importance of a canine physical fitness program is highlighted and the need for a 4-phase recovery plan to determine if a working dog can safely return to work after injury discussed.
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76
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Xiao M, Lin L, Chen H, Ge X, Huang Y, Zheng Z, Li S, Pan Y, Liu B, Zeng F. Anti-fatigue property of the oyster polypeptide fraction and its effect on gut microbiota in mice. Food Funct 2021; 11:8659-8669. [PMID: 32936195 DOI: 10.1039/d0fo01713b] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We aimed to evaluate the anti-fatigue effects of the oyster polypeptide (OP) fraction and its regulatory effect on the gut microbiota in mice. Our exhaustive swimming experiment showed that the swimming time of the low-, middle- and high-dose groups of the OP fraction was increased by 1.82, 2.18 and 2.44 times compared with the control group, respectively. Besides, the liver glycogen levels of the three groups were increased by 19.3%, 42.02% and 65.07%, while the lactate levels were decreased by 18.85%, 21.18% and 28.74%, respectively. Moreover, administration of the OP fraction upregulated the expressions of PEPCK and AMPK, but downregulated the TNF-α expression. Correlation analysis between the gut microbiota and fatigue-related biochemical indicators showed that Faecalibacterium, Desulfovibri and Intestinibacter were negatively correlated with the swimming time, blood lactate, blood urea nitrogen, liver glycogen and muscle glycogen, while Yaniella and Romboutsia were positively correlated. Therefore, the OP fraction had anti-fatigue effects, and could regulate the abundance of gut microbiota and maintain its balance.
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Affiliation(s)
- Meifang Xiao
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China. and Key Laboratory of Inshore Resources Biotechnology (Quanzhou Normal University) Fujian Province University, Quanzhou, Fujian 362000, China and College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou, Fujian 362000, China
| | - Luan Lin
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China. and Key Laboratory of Inshore Resources Biotechnology (Quanzhou Normal University) Fujian Province University, Quanzhou, Fujian 362000, China and College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou, Fujian 362000, China
| | - Hongpei Chen
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Xiaodong Ge
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Ying Huang
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Zongping Zheng
- Key Laboratory of Inshore Resources Biotechnology (Quanzhou Normal University) Fujian Province University, Quanzhou, Fujian 362000, China and College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou, Fujian 362000, China
| | - Shiming Li
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Yuyang Pan
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Bin Liu
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China.
| | - Feng Zeng
- Engineering Research Centre of Fujian-Taiwan Special Marine Food Processing and Nutrition, Ministry of Education, Fuzhou, Fujian 350002, China. and College of Food Science, Fujian Agriculture and Forestry University, Fuzhou, Fujian 350002, China. and Key Laboratory of Inshore Resources Biotechnology (Quanzhou Normal University) Fujian Province University, Quanzhou, Fujian 362000, China and College of Oceanology and Food Science, Quanzhou Normal University, Quanzhou, Fujian 362000, China
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Lieberman HR, Agarwal S, Caldwell JA, Fulgoni VL. Demographics, sleep, and daily patterns of caffeine intake of shift workers in a nationally representative sample of the US adult population. Sleep 2021; 43:5599823. [PMID: 31628471 DOI: 10.1093/sleep/zsz240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/26/2019] [Indexed: 01/30/2023] Open
Abstract
STUDY OBJECTIVE Caffeine is the most widely consumed stimulant in the world, and sociodemographic factors including occupation are associated with intake. Shift work, required in various occupations, is associated with poor sleep, inadequate diet, and adverse health effects. Using a large nationally representative database, demographics, sleep, and caffeine intake of US adults working various shifts were assessed. METHODS The 24-hour dietary recall data from NHANES 2005-2010 (N = 8,500) were used to estimate caffeine intake from foods and beverages. Work shifts were self-reported as follows: regular day shift; evening shift; night shift; rotating shift; or other shift. Regression analyses assessed associations of shift work with caffeine intake after adjustment for sociodemographic factors. RESULTS Approximately 74% of employed adults were day-shift workers and 26% were nonday-shift workers. Night-shift workers slept for 6.25 ± 0.09 hours per day, somewhat less than day-shift workers who only slept 6.83 ± 0.02 hours (p < .0001). Mean 24-hour weekday caffeine intake of evening-, night-, and rotating-shift workers (217 ± 23, 184 ± 19, and 206 ± 15 mg, respectively) was similar (p > .3) to day-shift workers (203 ± 5 mg). Regardless of work schedule, individuals consumed the most caffeine during morning hours. Evening- and night-shift workers reported consuming 36%-46% less caffeine during their work hours and 72%-169% more during nonwork hours than day-shift workers (p < .01). CONCLUSIONS Total daily caffeine intake of shift workers is similar to nonshift workers; most caffeine is consumed in the morning regardless of shift. Because shift workers consume less caffeine during regular work hours and more during nonwork hours than day workers, they may be using caffeine to, in part, optimize off-duty alertness.
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Affiliation(s)
- Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Sanjiv Agarwal
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
| | - John A Caldwell
- Oak Ridge Institute for Science and Education, Belcamp, MD, USA
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Zaehle T. Frontal Transcranial Direct Current Stimulation as a Potential Treatment of Parkinson's Disease-Related Fatigue. Brain Sci 2021; 11:brainsci11040467. [PMID: 33917684 PMCID: PMC8068015 DOI: 10.3390/brainsci11040467] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/22/2021] [Accepted: 03/30/2021] [Indexed: 12/28/2022] Open
Abstract
In contrast to motor symptoms, non-motor symptoms in Parkinson’s disease (PD) are often poorly recognized and inadequately treated. Fatigue is one of the most common non-motor symptoms in PD and affects a broad range of everyday activities, causes disability, and substantially reduces the quality of life. It occurs at every stage of PD, and once present, it often persists and worsens over time. PD patients attending the 2013 World Parkinson Congress voted fatigue as the leading symptom in need of further research. However, despite its clinical significance, little progress has been made in understanding the causes of Parkinson’s disease-related fatigue (PDRF) and developing effective treatment options, which argues strongly for a greater effort. Transcranial direct current stimulation (tDCS) is a technique to non-invasively modulate cortical excitability by delivering low electrical currents to the cerebral cortex. In the past, it has been consistently evidenced that tDCS has the ability to induce neuromodulatory changes in the motor, sensory, and cognitive domains. Importantly, recent data present tDCS over the frontal cortex as an effective therapeutic option to treat fatigue in patients suffering from multiple sclerosis (MS). The current opinion paper reviews recent data on PDRF and the application of tDCS for the treatment of fatigue in neuropsychiatric disorders to further develop an idea of using frontal anodal tDCS as a potential therapeutic strategy to alleviate one of the most common and severe non-motor symptoms of PD.
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Affiliation(s)
- Tino Zaehle
- Department of Neurology, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany;
- Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany
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Iridiastadi H. Fatigue in the Indonesian rail industry: A study examining passenger train drivers. APPLIED ERGONOMICS 2021; 92:103332. [PMID: 33249276 DOI: 10.1016/j.apergo.2020.103332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 11/08/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The railway industry in Indonesia has grown substantially in the past five years, with greater network and tracks length that will double in 2030. There has been a growing concern, however, that fatigue among front-line personnel have not been addressed satisfactorily. This study aimed at evaluating the degree of fatigue among passenger train drivers and suggested practical recommendations to the Indonesian Railway Company. METHOD A total of 32 train drivers (driving for about 4 h during the morning or afternoon shifts) agreed to participate in the study. Subjective and objective measures of fatigue (and sleepiness) were obtained prior to, during, and immediately following the end of a duty. Fatigue and driving performance were also determined based on (off-line) analysis of continuous video recordings of the drivers performing the duty. RESULTS Fatigue generally increased as a function of time and, for some, 2 h of driving was sufficient in inducing substantial level of fatigue increase. Unlike the morning shift, the afternoon shift was characterized with increased undue fatigue and unacceptable level of performance decrements. CONCLUSION In general, fatigue was not found among train drivers working the morning shift. For these drivers, however, there were a couple of individuals with excessive levels of fatigue. The effects of fatigue were more apparent for the afternoon shift. This is possibly due to the degraded sleep quality as a result of split rest periods obtained prior to the duty. It is suggested in this study that the company pay a much closer attention to the work-sleep schedules, and to improve sleep quality by redesigning better sleeping arrangements.
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Affiliation(s)
- Hardianto Iridiastadi
- Faculty of Industrial Technology, Institut Teknologi Bandung, JL. Ganesha No. 10, Bandung, 40132, Indonesia.
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80
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Objective electrophysiological fatigability markers and their modulation through tDCS. Clin Neurophysiol 2021; 132:1721-1732. [PMID: 33867262 DOI: 10.1016/j.clinph.2021.02.391] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/28/2021] [Accepted: 02/05/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Cognitive fatigability is a frequent symptom after sustained performance. Fatigability is evident in healthy subjects but is also often comorbid in several neuropsychiatric diseases. However, to date, clinical diagnostic almost solely relies on the self-reported subjective experience of fatigue. The goals of this present study were i) to complement the purely subjective fatigue diagnostic with objective electrophysiological fatigability parameters and ii) to prove the potential therapeutic application of transcranial direct current stimulation (tDCS) as a fatigability intervention. METHODS We performed a pseudo-randomized, sham-controlled, parallel-group trial. Forty healthy participants received either anodal or sham tDCS over the left dorsolateral prefrontal cortex (DLPFC) while they performed an exhaustive cognitive task to induce cognitive fatigability. To assess fatigability changes, we analyzed variations of prepulse inhibition (PPI) and P50 suppression as well as frontomedial theta and occipital alpha power with time-on-task. RESULTS The task reliably induced subjective exhaustion in all participants. Furthermore, we confirmed fatigability-related increases in frontomedial theta and occipital alpha power throughout the task. Additionally, fatigability significantly reduced PPI as well as P50 sensory gating. Anodal tDCS over the left DLPFC successfully counteracted fatigability and reduced the fatigability-related increase in alpha power as well as the decline in both gating parameters. CONCLUSION Occipital alpha and sensorimotor/sensory gating are suitable parameters to assess the severity of fatigability objectively. Anodal tDCS can counteract fatigability and has therapeutic potential for the treatment of fatigability in neuropsychiatric diseases. SIGNIFICANCE Fatigability can be objectively assessed by electrophysiological measures and attenuated by tDCS.
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81
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Rutledge DN, Douville S, Winokur E, Drake D, Niedziela D. Impact of engagement factors on nurses' intention to leave hospital employment. J Nurs Manag 2021; 29:1554-1564. [PMID: 33606341 DOI: 10.1111/jonm.13287] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/19/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
AIM To determine the impact of workforce engagement factors on nurses' intention to leave their hospital. BACKGROUND Nurse retention is important for safe patient care. It is unknown whether meaning and joy in work, occupational fatigue, job satisfaction and unprofessional behaviour experiences predict hospital nurse turnover intentions. METHOD This cross-sectional study involved responses from 747 nurses from two south-western hospitals. Measures included surveys to capture meaning and joy in work, job satisfaction, occupational fatigue and unprofessional behaviour exposure/impact. RESULTS Following correlational analyses, manifest variables significantly correlated with related latent factors. In structural equation modelling, greater chronic occupational fatigue was the strongest and meaning and joy at work (negative direction) the next strongest predictor of turnover intention. Although significant, job satisfaction and acute fatigue were weak predictors. Inter-shift recovery did not predict intent to leave. CONCLUSION This is the first study to identify Chronic Fatigue and meaning and joy in work as significant predictors of hospital nurse turnover intentions. IMPLICATIONS FOR NURSING MANAGEMENT Employing practices that decrease chronic fatigue and increase meaning/joy in work are recommended to improve nurse retention.
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Affiliation(s)
| | | | | | - Diane Drake
- Mission Hospital, Mission Viejo & Laguna Beach, Laguna Beach, CA, USA
| | - Deanne Niedziela
- Mission Hospital, Mission Viejo & Laguna Beach, Laguna Beach, CA, USA
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Abstract
OBJECTIVE To examine self-perceived fatigue among nurses and to quantify levels of fatigue and the ability to recover from fatigue between worked shifts across various work characteristics. BACKGROUND Fatigue is associated with working long hours, disruption of sleep, and inadequate time to recover between shifts. Fatigue degrades the nurses' performance leading to poorer patient outcomes and increased occupational injuries. METHODS This quantitative study surveyed 573 nurses across 5 hospitals in the southeastern United States. RESULTS Significant levels of acute fatigue were associated with working labor and delivery and medical-surgical units and working a 12-hour shift. Nurses working night shift and on the behavioral health unit showed a significantly lower ability to recover between worked shifts. CONCLUSIONS Fatigue threatens safety and the quality of patient care. Leaders should ensure that nurses take duty-free breaks and schedule adequate time off to recover between worked shifts.
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Affiliation(s)
- Karen R Cochran
- Author Affiliation: Grant Evaluation Specialist, Western Carolina University, Asheville, North Carolina
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Febriyanto K, Rachman A, Rahman FF. The contribution of human error related to occupational accident among traditional divers. GACETA SANITARIA 2021; 35 Suppl 1:S27-S29. [PMID: 33832619 DOI: 10.1016/j.gaceta.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/04/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The research aims to identify human error committed by traditional divers while fishing, and to determine the relationship between human error as a cause of occupational accidents at sea. METHOD A cross-sectional study with total of 186 traditional divers participated. The data was collected by questionnaires, and analyzing with chi-square test (p-value=0.05). RESULTS More than 83% of respondents had experienced occupational accident and behave human error while diving (81%). Type of human error such as rush of work, never attend safety training and does not have diving certificate, dives more than 30min, continues to work even tired, dives more than once a day, and continues to dive despite bad weather. The types of occupational accidents were slips, scratches, shipwrecks, hit by rocks, and suffered open wounds. The statistical test p value=0.000 (<0.05) and OR=44.883. CONCLUSIONS There is a relationship between human errors and occupational accident.
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Affiliation(s)
- Kresna Febriyanto
- Department of Public Health, Universitas Muhammadiyah Kalimantan Timur, Samarinda, Indonesia.
| | - Ainur Rachman
- Department of Public Health, Universitas Muhammadiyah Kalimantan Timur, Samarinda, Indonesia
| | - Ferry Fadzlul Rahman
- Department of Public Health, Universitas Muhammadiyah Kalimantan Timur, Samarinda, Indonesia
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Tirloni AS, Reis DC, Moro ARP. Rest Break Frequency and Duration: Self-Reported Preference of Brazilian Poultry Slaughterhouse Workers. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2021. [DOI: 10.1590/1806-9061-2021-1504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | - DC Reis
- Federal University of Santa Catarina, Brazil
| | - ARP Moro
- Federal University of Santa Catarina, Brazil
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Hu CJ, Lee FP, Hong RM. Fatigue Management Health Education Intervention Effects on Flight Attendants. Aerosp Med Hum Perform 2020; 91:911-917. [PMID: 33243333 DOI: 10.3357/amhp.5643.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: This study explored the impact of a fatigue management health education intervention (FMI) on flight attendants fatigue management knowledge, attitudes, behavioral intention, self-efficacy, and fatigue intensity.METHODS: A quasi-experimental pretest-posttest design was used. The sample included 70 flight attendants of an international airline company in Taiwan. The experimental group (N 34) received an FMI, while the control group (N 36) had no intervention. Fatigue management knowledge, attitude, behavior intention, self-efficacy, and fatigue intensity were assessed at baseline and 1 wk later. Single-factor analysis of covariance and Jensen Neman methods were used to assess the differences in outcomes between the two groups.RESULTS: Attitude and self-efficacy in the experimental group were significantly improved after the FMI [standardized mean difference (SMD), 0.96; 1.98]. The intervention also reduced their fatigue intensity (SMD 6.05) and both knowledge and behavioral intention scores were increased in more than 80% of subjects in the experimental group.DISCUSSION: FMI can effectively improve fatigue management knowledge, attitudes, behavioral intention, and self-efficacy and reduce fatigue intensity in flight attendants.Hu CJ, Lee FP, Hong RM. Fatigue management health education intervention effects on flight attendants. Aerosp Med Hum Perform. 2020; 91(12):911917.
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Chen Y, Broman AT, Priest G, Landrigan CP, Rahman SA, Lockley SW. The Effect of Blue-Enriched Lighting on Medical Error Rate in a University Hospital ICU. Jt Comm J Qual Patient Saf 2020; 47:165-175. [PMID: 33341396 DOI: 10.1016/j.jcjq.2020.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Fatigue-related errors that occur during patient care impose a tremendous socioeconomic impact on the health care system. Blue-enriched light has been shown to promote alertness and attention. The present study tested whether blue-enriched light can help to reduce medical errors in a university hospital adult ICU. METHODS In this interventional study, a blue-enriched white light emitting diode was used to enhance traditional fluorescent light at the nurse workstation and common areas in the ICU. Medical errors were identified retrospectively using an established two-step surveillance process. Suspected incidents of potential errors detected on nurse chart review were subsequently reviewed by two physicians blinded to lighting conditions, who made final classifications. Error rates were compared between the preintervention fluorescent and postintervention blue-enriched lighting conditions using Poisson regression. RESULTS The study included a total of 1,073 ICU admissions, 522 under traditional and 551 under interventional lighting (age range 17-97 years, mean age ± standard deviation 58.5 ± 15.8). No difference was found in overall medical error rate (harmful and non-harmful) pre- vs. postintervention, 45.5 vs. 42.7 per 1,000 patient-days (rate ratio: 0.94, 95% confidence interval = 0.71-1.23, p = 0.64). CONCLUSION Interventional lighting did not have an effect on overall medical error rate. The study was likely underpowered to detect the 25% error reduction predicted. Future studies are required that are powered to assess more modest effects for lighting to reduce the risk of fatigue-related medical errors and errors of differing severity.
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Lin TT, Park C, Kapella MC, Martyn-Nemeth P, Tussing-Humphreys L, Rospenda KM, Zenk SN. Shift work relationships with same- and subsequent-day empty calorie food and beverage consumption. Scand J Work Environ Health 2020; 46:579-588. [PMID: 32449516 PMCID: PMC7737792 DOI: 10.5271/sjweh.3903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objectives Shift work may contribute to unhealthy eating behaviors. However, the evidence is built mainly on comparisons of eating behaviors between shift and non-shift workers. Growing research has suggested daily experiences and exposures may contribute to daily fluctuations in people's food consumption. The purpose of this study was to examine within-person associations between shift work and same- and subsequent-day empty calorie food/beverage consumption. Methods This was a 14-day intensive longitudinal study using ecological momentary assessment. A convenience sample of 80 hospital registered nurses working a rotating shift in Taiwan completed a 21-item food checklist assessing their empty food/beverage consumption (ie, fast/fried food, sweet and salty snacks, sugar-sweetened beverages) four times at random daily. Daily shift work (ie, day, evening, or night shift) was derived from the registry-based work schedule. Three-level mixed-effects regression models were employed for hypothesis testing. Results A total of 77 participants with 2444 momentary assessments were included in the final analysis. The results suggested that participants on night compared to day shifts had higher likelihoods of fast/fried food intake [adjusted odds ratio (OR adj) 1.7, 95% CI 1.2-2.6] and sugar-sweetened beverage consumption (OR adj1.5, 95% CI 1.0-2.1). However, there were no significant associations between shift work and subsequent-day empty calorie food/beverage consumption. Conclusions Night shift work is associated with same-day increased empty calorie food/beverage consumption among workers. Strategies that help to prevent unhealthy eating behaviors on night shifts may help to reduce rotating shift workers' empty calorie food/beverage consumption and ultimately improve their health.
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Affiliation(s)
- Ting-Ti Lin
- School of Nursing, National Defense Medical Center, No. 161, Sec. 6, Minquan E Rd., Neihu District, Taipei City, 11490, Taiwan.
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Caldwell JL, Schroeder VM, Kunkle CL, Stephenson HG. Differential effects of modafinil on performance of low-performing and high-performing individuals during total sleep deprivation. Pharmacol Biochem Behav 2020; 196:172968. [DOI: 10.1016/j.pbb.2020.172968] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/08/2020] [Accepted: 06/13/2020] [Indexed: 12/31/2022]
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89
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Liu L, Wu D, Wang L, Qu Y, Wu H. Effort-Reward Imbalance, Resilience and Perceived Organizational Support: A Moderated Mediation Model of Fatigue in Chinese Nurses. Healthc Policy 2020; 13:893-901. [PMID: 32801964 PMCID: PMC7394598 DOI: 10.2147/rmhp.s259339] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/04/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Fatigue undermines nurses' well-being and work performance worldwide. Work stress is a critical factor that causes nurses' fatigue, but the solutions are not well known. This study aimed to identify the moderated mediation model of fatigue involving effort-reward imbalance (ERI), resilience and perceived organizational support (POS) in Chinese nurses. METHODS In a cross-sectional investigation conducted in Liaoning Province of China, 996 nurses completed the self-administered measurements of fatigue, ERI, resilience and POS. Moderated mediation was tested using the PROCESS procedure. The "pick-a-point" method was adopted to assess conditional effect on fatigue. RESULTS The indirect effect of ERI on fatigue through resilience was significant (a×b = 0.119, BCa 95% CI: 0.094 to 0.146), indicating a partial mediation of resilience. POS moderated the association of resilience with fatigue (β = -0.056, p = 0.006). The higher the level of POS was, the stronger the resilience-fatigue association became. Thus, the mediating role of resilience in the ERI-fatigue association was gradually increased with the increase of POS level (low POS: 0.073; moderate POS: 0.095; high POS: 0.116). CONCLUSION Resilience could partially mediate the ERI-fatigue association. POS could act as a moderator that enhanced the association of resilience with fatigue. A moderated mediation model of fatigue was demonstrated in Chinese nurses. Managers should establish a balanced social reciprocity, and improve nurses' resilience and POS in order to decrease nurses' fatigue.
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Affiliation(s)
- Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Di Wu
- School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Lulu Wang
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yunting Qu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Hui Wu
- Department of Social Medicine, School of Public Health, China Medical University, Shenyang, Liaoning, People's Republic of China
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90
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Forouzan F, Teimouri H, Safari A. Leisure time management in the workplace: Providing a model. HUMAN SYSTEMS MANAGEMENT 2020. [DOI: 10.3233/hsm-200883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Farkhondeh Forouzan
- Department of Management, Faculty of Administrative Science and Economics, University of Isfahan, Isfahan, Iran
| | - Hadi Teimouri
- Department of Management, Faculty of Administrative Science and Economics, University of Isfahan, Isfahan, Iran
| | - Ali Safari
- Department of Management, Faculty of Administrative Science and Economics, University of Isfahan, Isfahan, Iran
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Abstract
PURPOSE OF REVIEW Communication and teamwork are essential to enhance the quality of care, especially in operating rooms and ICUs. In these settings, the effective interprofessional collaboration between surgeons and intensivists impacts patients' outcome. This review discusses current opinions and evidence for improving communication strategies and the relationship between surgeons and intensivists/anesthesiologist. RECENT FINDINGS Effective teamwork has been demonstrated to improve patient outcome and foster healthier relationships between professionals.With the expansion of new medical superspecialist disciplines and the latest medical developments, patient care has been put through a progressive fragmentation, rather than a holistic approach. Operating theaters and ICU are the common fields where surgeons and anesthesiologists/intensivists work. However, communication challenges may frequently arise. Therefore, effective communication, relational coordination, and team situation awareness are considered to affect quality of teamwork in three different phases of the patient-centered care process: preoperatively, intraoperatively, and postoperatively. SUMMARY Although limited, current evidence suggests to improve communication and teamwork in patient perioperative care. Further research is needed to strengthen the surgeon-intensivist relationship and to deliver high-quality patient care.
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93
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Leger D, Guilleminault C. Environmental open-source data sets and sleep-wake rhythms of populations: an overview. Sleep Med 2020; 69:88-97. [PMID: 32058233 DOI: 10.1016/j.sleep.2019.12.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/18/2019] [Accepted: 12/27/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVE/BACKGROUND In recent decades, the epidemiology of sleep disorders has mainly consisted of interviewing subjects through validated questionnaires; more recently, this has been done by assessing total sleep time (TST) per 24 h via sleep logs or connected devices. Thus, a vast amount of data has helped demonstrate the decline of TST in most countries. Nonetheless, we believe from a societal and environmental point of view that sleep researchers have largely overlooked a wide-open field of data that may help us to better understand and describe global sleep wake rhythms (SWR), eg, data regarding the sleep environment. METHODS Based on recent literature, we identified several environmental and societal fields that may have an effect on SWR. With the help of an expert panel, we selected the five most pertinent fields with multiple open-source data sets that may have an impact on human SWR. Then, we performed web-based research and proposed open-field data sets for each field, all of which are open to researchers and possibly scientifically associated with SWR. RESULTS The open fields relevant to the environment that we selected were noise, light pollution, and radio frequencies. The two societal fields were transportation and internet use. The evolution of most of these fields in recent decades may explain (even partially) the decline in TST. Importantly, the open data sets in each field are widely available to sleep researchers. CONCLUSIONS SWR must be assessed not only by patient accounts, but also in terms of the evolution of environmental cues.
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Affiliation(s)
- Damien Leger
- Université de Paris, Equipe D'accueil Vigilance Fatigue Sommeil (VIFASOM) EA, 7330, Paris, France; Assistance Publique-Hôpitaux de Paris (APHP) Hôtel Dieu, Centre Du Sommeil et de La Vigilance, Paris, France.
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94
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Can Workplace Rest Breaks Prevent Work-Related Injuries Related to Long Working Hours? J Occup Environ Med 2019; 62:179-184. [PMID: 31743306 DOI: 10.1097/jom.0000000000001772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined the relationship between long working hours, rest breaks, and work-related injuries. METHODS A total of 25,439 employees were examined from the 4th Korean Working Conditions Survey. Rest breaks were divided into two groups and working hours were divided into four groups. Multiple logistic regression was conducted to estimate the relationship between long working hours, rest breaks, and work-related injuries. RESULTS Work-related injuries were significantly associated with long working hours. Stratified by rest breaks, the risk of work-related injuries increased with increasing working hours in a dose-response pattern among those with insufficient rest breaks, while the risk was not significant among those with sufficient rest breaks. CONCLUSION It is important to provide sufficient rest breaks to prevent work-related injuries among workers with long working hours.
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95
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Soukup T, Lamb BW, Weigl M, Green JSA, Sevdalis N. An Integrated Literature Review of Time-on-Task Effects With a Pragmatic Framework for Understanding and Improving Decision-Making in Multidisciplinary Oncology Team Meetings. Front Psychol 2019; 10:1245. [PMID: 31354555 PMCID: PMC6634259 DOI: 10.3389/fpsyg.2019.01245] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 05/13/2019] [Indexed: 01/04/2023] Open
Abstract
Multidisciplinary oncology team meetings (MDMs) or tumor boards, like other MDMs in healthcare, facilitate the incorporation of diverse clinical expertise into treatment planning for patients. Decision-making (DM) in relation to treatment planning in MDMs is carried out repeatedly until all patients put forward for discussion have been reviewed. Despite continuing financial pressure and staff shortages, the workload of cancer MDMs, and therefore meeting duration continue to increase (up to 5 h) with patients often receiving less than 2 min of team input. This begs the question as to whether the current set-up is conducive to achieve optimal DM, which these multi-specialty teams were set out to achieve in the first place. Much of what it is known, however, about the effects of prolonged cognitive activity comes from various subfields of science, leaving a gap in applied knowledge relating to complex healthcare environments. The objective of this review was thus to synthesize theory, evidence and clinical practice in order to bring the current understanding of prolonged, repeated DM into the context of cancer MDMs. We explore how and why time spent on a task affects performance in such settings, and what strategies can be employed by cancer teams to counteract negative effects and improve quality and safety. In the process, we propose a pragmatic framework of repeated DM that encompasses the strength, the process and the cost-benefit models of self-control as applied to real-world contexts of cancer MDMs. We also highlight promising research avenues for closing the research-to-practice gap. Theoretical and empirical evidence reviewed in this paper suggests that over prolonged time spent on a task, repeated DM is cognitively taxing, leading to performance detriments. This deterioration is associated with various cognitive-behavioral pitfalls, including decreased attentional capacity and reduced ability to effectively evaluate choices, as well as less analytical DM and increased reliance on heuristics. As a short to medium term improvement for ensuring safety, consistently high quality of care for all patients, and the clinician wellbeing, future research and interventions in cancer MDMs should address time-on-task effects with a combination of evidence-based cognitive strategies. We propose in this review multiple measures that range from food intake, short breaks, rewards, and mental exercises. As a long term imperative, however, capacity within cancer services needs to be reviewed as well as how best to plan workforce development and service delivery models to achieve population coverage whilst maintaining safety and quality of care. Hence the performance detriments that arise in healthcare workers as a result of the intensity (time spent on a task) and complexity of the workload require not only more research, but also wider regulatory focus and recognition.
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Affiliation(s)
- Tayana Soukup
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Benjamin W. Lamb
- Department of Urology, Cambridge University Healthcare NHS Foundation Trust, Cambridge, United Kingdom
| | - Matthias Weigl
- Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - James S. A. Green
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Whipps Cross University Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Nick Sevdalis
- Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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96
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Misery L, Cochener B, Brenaut E, Séité S, Taieb C. Association of sensitive skin with sensitive corneas and sensitive eyelids. J Eur Acad Dermatol Venereol 2019; 33:1358-1362. [PMID: 30903713 DOI: 10.1111/jdv.15595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/12/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sensitive scalp or irritable bowel syndrome has been previously shown to be associated with sensitive skin. We wondered whether sensitive eyelids and sensitive eyes could also be associated with sensitive skin. METHODS A cross-sectional epidemiological study was carried out on a representative sample of French people, according to the quota method, using a questionnaire. RESULTS A total of 2048 subjects were included in the present study. Notably, 52.2% declared sensitive eyes, which was more frequent in women than in men. The subjects who reported sensitive eyes were more numerous according to the severity of skin sensitivity, the severity of sleep disorders and the presence of bright eyes. More than half of the subjects with sensitive eyes thought that they were sensitive to sun exposure, dust, computer or touch pads or dry air. The presence of sensitive eyelids was reported by 18.65% (more frequent in women) and was associated with sensitive skin and sensitive eyes, sun exposure and exposure to dust. CONCLUSION This study is the first to investigate sensitive eyelids or sensitive eyes. Sensitive eyelids can be considered a localization of sensitive skin. The concept of sensitive eyes is not commonly used by ophthalmologists and remains to be more precisely defined.
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Affiliation(s)
- L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France.,University Brest, LIEN, Brest, France
| | - B Cochener
- Department of Ophtalmology, University Hospital of Brest, Brest, France
| | - E Brenaut
- Department of Dermatology, University Hospital of Brest, Brest, France.,University Brest, LIEN, Brest, France
| | - S Séité
- La Roche-Posay Dermatological Laboratories, Levallois-Perret, France
| | - C Taieb
- EMMA, Fontenay-sous-Bois, France.,Santé Publique, Hôpital Necker Enfants Malades, Paris, France
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