The lifestyle appraisal questionnaire: A comprehensive assessment of health and stress

Fatigue factors and fatigue indices in SSVEP-based brain-computer interfaces: a systematic review and meta-analysis

Background

Fatigue is a serious challenge when applying a steady-state visual evoked potential (SSVEP)-based brain-computer interfaces (BCIs) in the real world. Many researchers have used quantitative indices to study the effect of visual stimuli on fatigue. According to a wide range of studies in fatigue analysis, there are contradictions and inconsistencies in the behavior of fatigue indicators.

New method

In this study, for the first time, a systematic review and meta-analysis were performed on fatigue indices and fatigue caused by stimulation paradigm. We queried three scientific search engines for studies published between 2000 and 2022. The inclusion criteria were papers investigating mental and visual fatigue from performing a visual task using electroencephalogram (EEG) signals.

Results

Attractiveness and variation are the most effective ways to reduce BCI fatigue. Therefore, zoom motion, Newton's ring motion, and cue patterns reduce fatigue. While the color of the cue could effectively reduce fatigue, its shape and background had no effect on fatigue. Additionally, the questionnaire and quantitative indicators such as frequency indices, signal-to-noise ratio (SNR), SSVEP amplitude, and multiscale entropy were utilized to assess fatigue. Meta-analysis indicated that when a person is fatigued, the spectrum amplitude of alpha, theta, and α + θ / β increase significantly, while SNR and SSVEP amplitude decrease significantly.

Conclusion

The outcomes of this study can be used to design more optimal stimulation protocols that cause less fatigue. Moreover, the level of fatigue can be quantitatively assessed with indicators without the participant's self-reports.

Cognitive Failure in Adults with Spinal Cord Injury: A Valuable Adjunct Measure for Enhancing Cognitive Assessment and Rehabilitation Outcomes

Cognitive impairment is common in persons with spinal cord injury (SCI), impacting their daily functioning and rehabilitation. This study assesses the extent of self-reported cognitive failures in everyday life in persons with SCI and its relationships with objective neurocognitive measures and psychosocial factors, including depressive mood, anxiety, perceived control, and fatigue. The differences between forty-one adults with a chronic SCI and forty-one able-bodied controls were examined. The participants completed the Cognitive Failures Questionnaire (CFQ) to assess cognitive failure and neurocognitive tests assessing attention and executive functions, as well as a psychosocial assessment. The SCI group reported higher cognitive failure rates than the able-bodied group (31.7% versus 19%, p > 0.05). Objective neurocognitive tests did not significantly correlate with the CFQ scores in either group. However, the CFQ scores were positively associated with most psychosocial factors, even after controlling for covariates. The CFQ scores were significantly associated with depressive mood in persons with SCI. These findings highlight the importance of incorporating self-reported cognitive measures into neurocognitive assessments and rehabilitation planning for adults with SCI. Self-reports capture everyday cognitive challenges that objective tests may miss. Additionally, this study highlights the strong connections between cognitive failures and psychosocial issues, particularly mood disorders, emphasizing the need for comprehensive rehabilitation and psychosocial support post-SCI, addressing both cognitive and emotional wellbeing.

Psychophysiology of Monotonous Driving, Fatigue and Sleepiness in Train and Non-Professional Drivers: Driver Safety Implications

Fatigue and sleepiness are complex bodily states associated with monotony as well as physical and cognitive impairment, accidents, injury, and illness. Moreover, these states are often characteristic of professional driving. However, most existing work has focused on motor vehicle drivers, and research examining train drivers remains limited. As such, the present study psychophysiologically examined monotonous driving, fatigue, and sleepiness in a group of passenger train drivers and a group of non-professional drivers. Sixty-three train drivers and thirty non-professional drivers participated in the present study, which captured 32-lead electroencephalogram (EEG) data during a monotonous driving task. Fatigue and sleepiness were self-evaluated using the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, the Karolinksa Sleepiness Scale, and the Checklist of Individual Strength. Unexpectedly, fatigue and sleepiness scores did not significantly differ between the groups; however, train drivers generally scored lower than non-professional drivers, which may be indicative of individual and/or industry attempts to reduce fatigue. Across both groups, fatigue and sleepiness scores were negatively correlated with theta, alpha, and beta EEG variables clustered towards the fronto-central and temporal regions. Broadly, these associations may reflect a monotony-associated blunting of neural activity that is associated with a self-reported fatigue state.

Re-assessing the Psychometric Properties of Stress Appraisal Measure in Ghana Using Multidimensional Graded Response Model

Despite the widespread use of the stress appraisal measure questionnaire in sport psychology literature, information on the psychometric properties of this survey instrument across different cultures and samples is still lacking. This study sought to validate the stress appraisal measure among male football players in the Ghana’s Premier League using the multidimensional item response theory. The descriptive cross-sectional survey design was adopted to recruit 424 footballers from the 2020/2021 Ghana Premier League season using the census approach. The 28-item Stress Appraisal Measure was used to assess six (6) appraisal mechanisms under primary and secondary cognitive appraisals. The ordered polytomous item response theory was used for analyzing the data. The study found that although some items were problematic, the majority of them were found to have good item parameters, effective scale option functioning, and provided adequate empirical information in the measurement of stress appraisal. This research concluded that the stress appraisal measure has promising applicability among male footballers who participated in the premier league in Ghana. Future researchers are encouraged to re-validate the stress appraisal measure with a different sample to contribute to the understanding of the applicability of the instrument in non-western populations.

Associations between Sleep Quality and Heart Rate Variability: Implications for a Biological Model of Stress Detection Using Wearable Technology

INTRODUCTION

The autonomic nervous system plays a vital role in the modulation of many vital bodily functions, one of which is sleep and wakefulness. Many studies have investigated the link between autonomic dysfunction and sleep cycles; however, few studies have investigated the links between short-term sleep health, as determined by the Pittsburgh Quality of Sleep Index (PSQI), such as subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction, and autonomic functioning in healthy individuals.

AIM

In this cross-sectional study, the aim was to investigate the links between short-term sleep quality and duration, and heart rate variability in 60 healthy individuals, in order to provide useful information about the effects of stress and sleep on heart rate variability (HRV) indices, which in turn could be integrated into biological models for wearable devices.

METHODS

Sleep parameters were collected from participants on commencement of the study, and HRV was derived using an electrocardiogram (ECG) during a resting and stress task (Trier Stress Test).

RESULT

Low-frequency to high-frequency (LF:HF) ratio was significantly higher during the stress task than during the baseline resting phase, and very-low-frequency and high-frequency HRV were inversely related to impaired sleep during stress tasks.

CONCLUSION

Given the ubiquitous nature of wearable technologies for monitoring health states, in particular HRV, it is important to consider the impacts of sleep states when using these technologies to interpret data. Very-low-frequency HRV during the stress task was found to be inversely related to three negative sleep indices: sleep quality, daytime dysfunction, and global sleep score.

The relationship between neurocognitive performance and HRV parameters in nurses and non-healthcare participants

Nurses represent the largest sector of the healthcare workforce, and it is established that they are faced with ongoing physical and mental demands that leave many continuously stressed. In turn, this chronic stress may affect cardiac autonomic activity, which can be non-invasively evaluated using heart rate variability (HRV). The association between neurocognitive parameters during acute stress situations and HRV has not been previously explored in nurses compared to non-nurses and such, our study aimed to assess these differences. Neurocognitive data were obtained using the Mini-Mental State Examination and Cognistat psychometric questionnaires. ECG-derived HRV parameters were acquired during the Trier Social Stress Test. Between-group differences were found in domain-specific cognitive performance for the similarities (p = .03), and judgment (p = .002) domains and in the following HRV parameters: SDNN_baseline, (p = .004), LF_preparation (p = .002), SDNN_preparation (p = .002), HF_preparation (p = .02), and TP_preparation (p = .003). Negative correlations were found between HF power and domain-specific cognitive performance in nurses. In contrast, both negative and positive correlations were found between HRV and domain-specific cognitive performance in the non-nurse group. The current findings highlight the prospective use of autonomic HRV markers in relation to cognitive performance while building a relationship between autonomic dysfunction and cognition.

Situational Embarrassment and Its Relationship to Social Anxiety in Adults Who Stutter

Purpose Adults who stutter (AWS) have increased risk of comorbid social anxiety about speaking in social contexts. AWS also report experiencing embarrassment in different social situations; however, research has rarely been conducted on embarrassment and its relationship to social anxiety in AWS. Method AWS (N = 200) reported their level of embarrassment on four 10-point Likert items when speaking in four situational contexts: at home, to an individual important to them, in social groups, and at work. Participants were also assessed for sociodemographic, stuttering, and anxiety variables. Construct validity for the four embarrassment items was examined, the extent of embarrassment established in the four contexts as a function of age and sex, and the relationship of embarrassment to social anxiety evaluated. Results Evidence of acceptable construct validity and reliability is presented for the four embarrassment Likert items. Sixty-five percent of the sample experienced high levels of embarrassment when speaking in groups or at work, while 35.5% experienced high levels when speaking at home or to an individual important to them. Participants were significantly more embarrassed (p < .01) when speaking at work or when socializing in groups. Embarrassment was lowest when speaking in the home. Younger females were significantly more embarrassed when speaking at work or when socializing in groups. Those with high embarrassment scores on all four items were more likely to have elevated social anxiety scores (p < .001). Conclusion These preliminary results suggest that the assessment of situational embarrassment could be an important clinical measure that may help improve stuttering treatment outcomes that also target social anxiety.

Associations Between Workplace Factors and Depression and Anxiety in Australian Heavy Vehicle Truck Drivers

INTRODUCTION

A number of health issues have been identified as prevalent within the Australian heavy vehicle driving population. Mental illnesses, such as depression and anxiety, are among those disorders that have been regularly reported, however, the contributing factors are yet to be elucidated.

METHODS

This study aimed to assess the associations between workplace factors such as years of employment, social interaction and shift length, with depressive and anxious symptomology in a cohort of 60 Australian heavy vehicle drivers.

RESULTS

Significant positive associations were identified between depression and alcohol use (P = 0.044), coffee consumption (P = 0.037), number of accidents during career (P = < 0.004), and number of hours driving per shift (P ≤ 0.001). Anxiety was found to be positively associated with a number of hours driving per week (P ≤ 0.001), and the number of accidents or near misses during a driving career (P = 0.039).

CONCLUSION

Several workplace factors were identified as being correlated to depression or anxiety within this cohort, suggesting potential changes to rostering systems and education regarding alcohol use may benefit the mental health of this driver population.

Electrophysiological Brain-Cardiac Coupling in Train Drivers during Monotonous Driving

Electrophysiological research has previously investigated monotony and the cardiac health of drivers independently; however, few studies have explored the association between the two. As such the present study aimed to examine the impact of monotonous train driving (indicated by electroencephalogram (EEG) activity) on an individual’s cardiac health as measured by heart rate variability (HRV). Sixty-three train drivers participated in the present study, and were required to complete a monotonous train driver simulator task. During this task, a 32 lead EEG and a three-lead electrocardiogram were recorded from each participant. In the present analysis, the low (LF) and high frequency (HF) HRV parameters were associated with delta (p < 0.05), beta (p = 0.03) and gamma (p < 0.001) frequency EEG variables. Further, total HRV was associated with gamma activity, while sympathovagal balance (i.e., LF:HF ratio) was best associated fronto-temporal delta activity (p = 0.02). HRV and EEG parameters appear to be coupled, with the parameters of the delta and gamma EEG frequency bands potentially being the most important to this coupling. These relationships provide insight into the impact of a monotonous task on the cardiac health of train drivers, and may also be indicative of strategies employed to combat fatigue or engage with the driving task.

High-Intensity Interval Aerobic Resistance Training to Counteract Low Relative Appendicular Lean Soft Tissue Mass in Middle Age: Study Protocol for a Randomized Controlled Trial

BACKGROUND

Sarcopenia is the age-related loss of skeletal muscle mass and function and may exist in early middle age. Previous research in this area has focused on resistance training in older individuals; however, there is a lack of intervention trials in middle-aged adults with low relative appendicular lean soft tissue mass who may be at risk for sarcopenia in older age.

OBJECTIVE

This randomized controlled trial aims to determine the effects of a high-intensity interval aerobic resistance training intervention on appendicular lean soft tissue mass in middle-aged adults with low relative appendicular lean soft tissue mass.

METHODS

We will conduct a 40-week, single-blinded randomized controlled trial in 84 middle-aged adults with low appendicular lean soft tissue mass in the wider Dunedin area, New Zealand. We will randomly allocate participants to receive either a group-based, 20-week high-intensity interval aerobic resistance training intervention program or a single, 60-minute education session on current exercise recommendations. After the first 20 weeks, both groups will be given a 20-week home program. The study will assess primary and secondary outcome measures, including body composition (regional and whole-body lean soft tissue mass, fat mass, percentage body fat, measured by dual x-ray absorptiometry), blood biomarkers (cortisol, creatinine, C-reactive protein, lipid profile, hemoglobin), physical fitness (maximum oxygen consumption, blood pressure), physical activity (accelerometry), physical function (handgrip strength, sit-to-stand, gait speed, quadriceps strength), and self-reported questionnaires (health outcomes, self-efficacy, perceived enjoyment of physical activity, and multifactorial lifestyle), at baseline, 20 weeks, and 40 weeks. Physical function and self-reported questionnaires will also be measured at 10 weeks. We will assess the primary outcome measure, total body lean soft tissue mass, at baseline, 20 weeks, and 40 weeks. Analyses will be performed using intention-to-treat principles, comparing the outcomes resulting from the intervention, using linear mixed models.

RESULTS

We obtained ethical approval for this study from The University of Otago Human Ethics Committee on December 10, 2018. Participant recruitment started on February 11, 2019 and was completed on May 14, 2019. Data collection started on February 25, 2019 and was completed on February 28, 2020. We expect to publish the results in January 2021.

CONCLUSIONS

High-intensity interval aerobic resistance training is a time-efficient form of exercise, enabling busy middle-aged adults to meet physical activity recommendations while maximizing training results. The findings can inform the development of future prevention-focused interventions aimed at counteracting the high prevalence of sarcopenia in the aging population.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12618001778279); https://tinyurl.com/y555z6fz.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/22989.

Electroencephalographic prediction of global and domain specific cognitive performance of clinically active Australian Nurses

OBJECTIVE

To investigate the relationship between EEG activity and the global and domain specific cognitive performance of healthy nurses, and determine the predictive capabilities of these relationships.

APPROACH

Sixty-four nurses were recruited for the present study, and data from 61 were utilised in the present analysis. Global and domain specific cognitive performance of each participant was assessed psychometrically using the Mini-mental state exam and the Cognistat, and a 32-lead monopolar EEG was recorded during a resting baseline phase and an active phase in which participants completed the Stroop test.

MAIN RESULTS

Global cognitive performance was successfully predicted (81%-85% of variance) by a combination of fast wave activity variables in the alpha, beta and theta frequency bands. Interestingly, predicting domain specific performance had varying degrees of success (42%-99% of the variance predicted) and relied on combinations of both slow and fast wave activity, with delta and gamma activity predicting attention performance; delta, theta, and gamma activity predicting memory performance; and delta and beta variables predicting judgement performance.

SIGNIFICANCE

Global and domain specific cognitive performance of Australian nurses may be predicted with varying degrees of success by a unique combination of EEG variables. These proposed models image transitory cognitive declines and as such may prove useful in the prediction of early cognitive impairment, and may enable better diagnosis, and management of cognitive impairment.

Negative Mental States and Their Association to the Cognitive Function of Nurses

Abstract. Nurses’ inherently stressful occupation leaves them at a higher risk of developing negative mental states (stress, anxiety, and depression). However, research examining the effect of negative mental states on these health professionals’ cognitive performance is sparse. Thus, the present study aimed to assess the link between negative mental states and cognitive performance in nurses ( n = 53). Negative mental state data was obtained using the Depression Anxiety Stress Scale, brain activity was measured using electroencephalography, and finally, cognitive performance was assessed using the Cognistat and the Mini-Mental State Examination. Significant negative correlations ( p < .05) were observed between anxiety and attention, and all three negative mental states and memory performance. Electroencephalographic changes indicated that increases in anxiety were significantly associated ( p < .05) with decreases in gamma reactivity at fronto-central sites. The current study suggests that higher levels of negative mental states are associated with domain-specific cognitive impairments, and variations in gamma reactivity; possibly reflecting less optimal cortical functioning.

Doctoral students' well-being: a literature review

Purpose: Doctoral student well-being is an important matter that shapes the well-being of academics throughout their careers. Given that well-being has been found to be closely related to employee productivity and efficiency, strategies associated with maintaining well-being during PhD studies might be crucial for higher education, its outcomes and—just as importantly—for a balanced life of PhD students.

Method: Based on 17 studies, this literature review critically assesses the literature on doctoral student well-being.

Results: Theoretical models, concepts of well-being, and methods applied are discussed, as are the results of the articles. The reviewed studies are then discussed based on a SWOT analysis addressing the strengths and weaknesses of the reviewed research as well as the identified opportunities and threats, which can be used as a basis for future research. Based on the review findings and the SWOT analysis, a multidimensional view of the well-being of doctoral students is proposed.

Conclusions: The study proposes a more student-centred approach to meeting doctoral students’ needs, and the enhancement of doctoral student well-being in order, as a long-term goal, to improve academics’ well-being and productivity.

Electroencephalography as a predictor of self-report fatigue/sleepiness during monotonous driving in train drivers

OBJECTIVE

In this study, electroencephalography activity recorded during monotonous driving was investigated to examine the predictive capability of monopolar EEG analysis for fatigue/sleepiness in a cohort of train drivers.

APPROACH

Sixty-three train drivers participated in the study, where 32- lead monopolar EEG data was recorded during a monotonous driving task. Participant sleepiness was assessed using the Pittsburgh sleep quality index (PSQI), the Epworth sleepiness scale (ESS), the Karolinksa sleepiness scale (KSS) and the checklist of individual strength 20 (CIS20).

MAIN RESULTS

Self-reported fatigue/sleepiness scores of the train driver cohort were primarily associated with EEG delta, theta, and alpha variables; however, some beta and gamma associations were also implicated. Furthermore, general linear models informed by these EEG variables were able to predict self-reported scores with varying degrees of success, representing between 48% and 54% of variance in fatigue scores.

SIGNIFICANCE

Self-reported fatigue/sleepiness scores of train drivers were predicted with varying degrees of success (dependent upon the self-reported fatigue/sleepiness measure) by alterations to monopolar delta, theta, and alpha band activity variables, indicating EEG as a potential indicator for fatigue/sleepiness in train drivers.

Mood state sub-types in adults who stutter: A prospective study

PURPOSE

Many adults who stutter have elevated negative mood states like anxiety and depressive mood. Little is known about how mood states change over time. The purpose of this study was to determine the trajectories or sub-types of mood states in adults who stutter over a 6 month period, and establish factors that contribute to these sub-types.

METHOD

Participants included 129 adults who stutter who completed an assessment regimen at baseline, including a measure of mood states (Symptom Checklist-90-Revised). Three mood states were assessed (interpersonal sensitivity or IS, depressive mood and anxiety) once a month over 6 months. Latent class growth mixture modeling was used to establish trajectories of change in these mood states over time. Logistic regression was then used to determine factors assessed at baseline that contribute to the IS trajectories.

RESULTS

Three-class trajectory models were accepted as the best fit for IS, depressive mood and anxiety mood sub-types. Stable and normal mood state sub-types were found, incorporating around 60% of participants. Up to 40% belonged to sub-types comprising elevated levels of negative mood states. The logistic regression was conducted only with the IS domain, and revealed four factors that significantly contributed to IS mood sub-types. Those with low perceived control, low vitality, elevated social fears and being female were more likely to belong to elevated IS classes.

CONCLUSIONS

This research revealed mood sub-types in adults who stutter, providing direction for the treatment of stuttering. Clarification of how much stuttering influences mood sub-types versus pre-existing mood is required.

The impact on human visual performance when viewing 2-D and 3-D movies

BACKGROUND AND OBJECTIVE:

To examine the human visual performance (wavefront aberration) and subjective questionnaire (SQ) of visual fatigue when viewing 2-D and 3-D movies.

METHODS:

Thirty healthy adults observed 2-D and 3-D movies on the same television from a 3m distances during 2D, 3D-A (with better 3D glasses), and 3D-B (with poorer 3D glasses) viewing conditions. Visual quality index, including modulation transfer function index (MTFI), higher order aberration root mean square (RMS), vertical coma (VC), horizontal coma (HC) and spherical aberration (SA), were assessed before and after each viewing condition. One-way repeated measures ANOVA was performed to assess the changes of each test variable before and after movie viewing.

RESULTS:

Participants watching movies with 3D-B conditions experienced higher change of MTFI, RMS, VC and HC but smaller SQ, compared with 2D and 3D-A (P< 0.05). Additionally, higher MTFI but smaller SQ was found for 3D-A compared with 2D viewing condition (P< 0.05).

CONCLUSIONS:

While prolonged viewing 2-D and 3-D movies would lead to poorer visual performance, 3-D glasses with better quality can play the major role in reducing visual ability for users. The change of human eye wavefront aberration might be useful for the evaluation of visual fatigue in the future.

The psychological impact of traffic injuries sustained in a road crash by bicyclists: A prospective study

OBJECTIVE

The objective of this study was to investigate the psychological impact of traffic injuries in bicyclists (cyclists) in comparison to car occupants who also sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated.

METHODS

An inception cohort prospective design was used. Participants included cyclists aged ≥17 years (mean age 41.7 years) who sustained a physical injury (n = 238) assessed within 28 days of the crash, following medical examination by a registered health care practitioner. Injury included musculoskeletal and soft tissue injuries and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury, and severe multiple fractures. Assessment also occurred 6 months postinjury. Telephone-administered interviews assessed a suite of measures including sociodemographic, preinjury health and injury factors. Psychological impact was measured by pain catastrophization, trauma-related distress, and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 years). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months postinjury.

RESULTS

Cyclists had significantly better psychological health (e.g., lower pain catastrophizing, lower rates of probable posttraumatic stress disorder [PTSD], and lower general distress levels) compared to car occupants at baseline and 6 months postinjury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer preinjury health, and greater amount of time in hospital after the injury.

CONCLUSIONS

These data provide insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery.

Stress and its Impact on the Neurocognitive Performance of Australian Nurses

Nurses function inside a particularly stressful occupation that requires the provision of continuous care to individuals who are often in great need. Stress has been shown to impair performance and specifically shown to impair nursing quality. However, we do not yet know how stress influences the cognitive performance of nurses, and hence, the present study investigated the associations between stress and cognitive performance in nurses using electroencephalography and administered cognitive assessments. Thirty-six nurses (34 women) of mean age 37.77 ± 11.40 years were recruited. Stress was examined using the Lifestyle Appraisal Questionnaire. Broad spectrum electroencephalogram activity at positions Fp1, Fp2, C3 and C4 was recorded for a 5-min baseline and active phase to physiologically assess cognitive performance. Additionally, the Mini-Mental State Exam and Cognistat were also used to measure cognitive performance. Assessed cognitive performance was not associated to stress, however, lifestyle factors, as well as a number of the examined cognitive electroencephalographic variables including changes in theta, alpha activity and gamma reactivity were. Definitively determining how stress affects the cognitive performance of nurses requires additional research; the present study forms a foundation from which future research can further expand the examination of stress exposure in nurses. Copyright © 2016 John Wiley & Sons, Ltd.

Electroencephalogram associations to cognitive performance in clinically active nurses

Cognitive impairment is traditionally identified via cognitive screening tools that have limited ability in detecting early or transitional stages of impairment. The dynamic nature of physiological variables such as the electroencephalogram (EEG) may provide alternate means for detecting these transitions. However, previous research examining EEG and cognitive performance is largely confined to samples with diagnosed cognitive impairments, and research examining non-impaired, and occupation specific samples, is limited. The present study aimed to investigate the associations between frontal pole and central EEG and cognitive performance in a sample of male and female nurses, and to determine the significance of these associations. Fifty seven nurses participated in the study, in which two lead bipolar EEG was recorded at positions Fp1 (frontal polar), Fp2, C3 (central) and C4 during a baseline and an active phase involving the common neuropsychological Stroop test. Participants' cognitive performance was assessed using the mini-mental state exam (MMSE) and Cognistat screening tools. Significant correlations between EEG beta activity and the outcome of MMSE and Cognistat were revealed, where an increased beta activity was associated to an increased global cognitive performance. Additionally, domain specific cognitive performance was also significantly associated to various EEG variables. The study identified potential EEG biomarkers for global and domain specific cognitive performance, and provides initial groundwork for the development of future EEG based biomarkers for detection of cognitive pathologies.

Blood Pressure, Sleep Quality and Fatigue in Shift Working Police Officers: Effects of a Twelve Hour Roster System on Cardiovascular and Sleep Health

Background: Police officers have been reported to exhibit a high incidence of pathologies, which present prematurely in an otherwise healthy population. Shift work has also been associated with an increased risk of cardiovascular and sleep disorders, attributable to its propensity for circadian rhythm dysfunction. However, contention exists as to whether shift work has a direct effect upon blood pressure (BP) regulation. Methods: This cross-sectional study sought to determine changes in BP and associations with the overall sleep quality and fatigue in 206 general duties police officers (n = 140 males) of the New South Wales Police Force in Australia. The subjects’ BP was assessed before and after their twelve hour shift, during which time they also completed the Lifestyle Appraisal Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale and Fatigue Severity Scale (FSS). Results: Poor sleep quality (PSQI) and fatigue severity (FSS) were found to predominate in the sample (69% and 51% respectively). Although there was no change in BP for male participants, female officers’ systolic blood pressure (SBP) was found to increase significantly across the shift (p < 0.001), but with no change found in females’ diastolic blood pressure (DBP). Finally, higher pre and post-shift SBP (r = −0.26, p = 0.001; r = −0.25, p = 0.001, respectively) and DBP (r = −0.26, p = 0.001; r = −0.26, p = 0.001, respectively) were significantly correlated with lower FSS scores after accounting for age, waist-hip ratio and lifestyle risk factors. Conclusions: Based on these preliminary findings, there was a significant increase in SBP of female police officers after shift work, while BP and fatigue levels in all police officers were strongly related. Moreover, the predominating poor sleep quality and impact of fatigue in this sample remain a concern. Further research is required to ensure the physiological welfare of police officers, while strategies must be implemented to manage the detrimental effects shift work may be having upon their cardiovascular and sleep health.

A model clarifying the role of mediators in the variability of mood states over time in people who stutter

PURPOSE

Elevated negative mood states such as social anxiety and depressive mood have been found in adults who stutter. Research is needed to assist in the development of a model that clarifies how factors like self-efficacy and social support contribute to the variability of negative mood states over time.

METHOD

Participants included 200 adults who stutter. A longitudinal design was employed to assess change in mood states over a period of five months. Hierarchical directed regression (path analysis) was used to determine contributory relationships between change in mood states and self-efficacy, social support, socio-demographic and stuttering disorder variables. Participants completed a comprehensive assessment regimen, including validated measures of mood states, perceived control (self-efficacy) and social support.

RESULTS

Results confirmed that self-efficacy performs a protective role in the change in mood states like anxiety and depressive mood. That is, self-efficacy cushioned the impact of negative mood states. Social support was only found to contribute a limited protective influence. Socio-demographic variables had little direct impact on mood states, while perceived severity of stuttering also failed to contribute directly to mood at any time point.

CONCLUSIONS

Mood was found to be influenced by factors that are arguably important for a person to cope and adjust adaptively to the adversity associated with fluency disorder. A model that explains how mood states are influenced over time is described. Implications of these results for managing adults who stutter with elevated negative mood states like social anxiety are discussed.

EDUCATIONAL OBJECTIVES

The reader will be able to describe: (a) the method involved in hierarchical (directed) regression used in path analysis; (b) the variability of mood states over a period of five months; (c) the nature of the mediator relationship between factors like self-efficacy and social support and mood states like anxiety, and (d) the contribution to mood states of socio-demographic factors like age and education and stuttering disorder variables like stuttering frequency and perceived severity.

Visual fatigue caused by watching 3DTV: an fMRI study

The objective of this study is to observe the visual fatigue caused by watching 3DTV using the method of functional magnetic resonance imaging (fMRI). The data of fMRI during three kinds of visual stimulation tasks were obtained from twenty subjects. At first, blood-oxygen-level dependent (BOLD) signal changes during stimuli of checkerboard task were compared before and after one-hour watching 3D/2DTV, and subjective evaluation was conducted based on the questionnaire simultaneously. Then 3D and 2D images were used to stimulate healthy individuals to measure brain activities that correlated with stereoscopic vision. Finally, the relationship between front or back depth of field images and visual fatigue was investigated. The results reveal that the 3D group shows more significant differences of brain activities in BA8, BA17, BA18 and BA19 than the 2D group during the checkerboard stimulation. BA5, BA6, BA7 and BA8 were testified to have close relationship with stereoscopic perception via the 2D/3D images stimulation. Furthermore, the front depth of field image was proven to impose a more serious impact on visual fatigue than the back one. These conclusions are useful for healthy and reasonable 3DTV watching as well as properly designing of 3D scenes.

Fatigue and tiredness in people with spinal cord injury

OBJECTIVE

Fatigue is a common symptom in people with neurological injury such as spinal cord injury (SCI), though its nature and occurrence in people with SCI are not well understood. The objective of this research was to investigate fatigue and its relationship to factors such as mood states and self efficacy in adult people with SCI compared to able-bodied controls.

METHODS

Participants included 41 adults with SCI living in the community and 41 able-bodied controls matched for age and sex ratios and education. All participants first completed a comprehensive psychological assessment and were then asked to take part in a 2-3 hour session composed of a regimen of cognitive tasks that required constant concentration and attention. Participants were assessed after completing this task.

RESULTS

The SCI group was found to have significantly elevated levels of fatigue, as well as elevated depressive mood, anxiety and poor self-efficacy. The SCI group was also found to suffer excessive levels of tiredness as a consequence of the 2-3 hour task. Factors such as depressive mood and poor self-efficacy were shown to increase the risk of excessive tiredness.

CONCLUSION

People with a neurological injury such as SCI have a high risk of having fatigue and are susceptible to experiencing excessive tiredness when performing extended tasks, and the presence of elevated depressive mood or poor expectations towards self management will increase this susceptibility. Implications for managing fatigue and improving social access in SCI populations are discussed.

Resilience and stuttering: factors that protect people from the adversity of chronic stuttering

PURPOSE

Chronic disorder can impose a significant negative mental health burden. This research was conducted to explore factors that may protect people from the adversity of chronic stuttering.

METHOD

The study employed a population group cohort design. Participants included 200 adults who have stuttered since childhood, and the sample was divided into those who were classified as resilient and nonresilient on the basis of their global psychopathology scores. Protective factor differences between the 2 groups were determined using multivariate analysis of variance and unique contributors to psychopathology were isolated using multiple regression.

RESULTS

Factors that significantly distinguished between groups included superior levels of health status, social support, vitality and social functioning, fewer physical limitations, and a greater sense of self-efficacy. Three unique contributors to adaptive outcomes were found: self-efficacy, social support, and healthy social functioning.

CONCLUSIONS

A number of factors were isolated that potentially protect individuals with chronic stuttering from developing psychopathology. The findings provide a better understanding of how people cope with a chronic fluency disorder.

Subjective distress associated with chronic stuttering

Stuttering is a chronic condition involving involuntary disruption to speech fluency. While elevated social anxiety has been found to be a risk factor for adults who have stuttered all their lives, it is unclear how stuttering influences other negative mood states such as interpersonal sensitivity and depressive mood. Consequently, controlled research was conducted that investigated negative affectivity across a number of domains in adults who stutter. Participants included 200 adults who have stuttered since childhood, with comparisons made to 200 non-stuttering controls of similar age and sex. The adults who stuttered were found to have significantly elevated levels of distress and negative mood states compared to the controls. As expected, significant differences were found for anxiety, however, significant and substantial differences were also found across a broad range of negative affect, including dimensions such as somatization, interpersonal sensitivity, depressive mood, hostility and paranoia. The implications of these findings for the better management of stuttering are discussed.

EDUCATIONAL OBJECTIVES

The reader will be able to describe: (a) the negative impact of a chronic disorder like stuttering on people who have stuttered all their life; (b) the factor structure of the SCL-90-R; (c) the negative affectivity construct, and (d) the difference between psychogenic theories of stuttering and neurological theories of stuttering.

Fluency disorders and life quality: subjective wellbeing vs. health-related quality of life

It seems intuitive that people with a fluency disorder, such as stuttering, must experience a low life quality. Yet this is not necessarily so. Whether measured life quality is lower depends on several factors, the most important of these being methodological. This is because the disciplines of medicine and the social sciences utilize quite different technologies to measure the construct. Within medicine, health-related quality of life (HRQOL) is measured through constellations of perceived symptoms. Thus, if the symptoms chosen to represent HRQOL match the pathological characteristics of the fluency disorder, the relationship is self-fulfilling. Psychology, on the other hand, uses subjective wellbeing to represent life quality. Here, the relationship between symptoms and perceived life quality is much less certain. It is proposed that this partial disconnection is due to the presence of a homeostatic system which manages subjective wellbeing in an attempt to keep it positive. The paper that follows examines the construct of life quality from both disciplinary perspectives, and then reports on the findings from each discipline in relation to fluency disorders. It is concluded there is no necessary link between fluency disorders and life quality provided subjective wellbeing is used as the indicator variable.

EDUCATIONAL OBJECTIVES

The reader will be able to describe: (i) contemporary issues in quality of life measurement; (ii) the relationship between fluency disorders and life quality; (iii) the conceptual limitations of health-related quality of life.

An investigation into the personal financial costs associated with stuttering

Stuttering has been found to deteriorate quality of life in psychological, emotional and social functioning domains. It is reasonable to assume then that stuttering would also be associated with economic consequences that may also challenge quality of life. Remarkably, the personal financial costs associated with stuttering in adults has rarely if ever been explored or investigated in the fluency disorders field. This study involved an assessment of the personal costs of stuttering and an investigation into determinants that may influence spending. Two hundred adults who stutter participated in this study. Findings indicated that the average total cost was around $5,500 (median cost $4,165) in 2007/08 Australian dollars over a 5-year period. Major financial items included costs of direct and indirect treatments for stuttering, self-help, stuttering related conferences, and technology. Financial costs were not significantly influenced by the sex of the person, annual income, or by how severe the person stuttered. However, those individuals younger than 60 years old spent significantly more on treatment related costs, while those with elevated levels of social anxiety spent significantly less than those with lower levels of social anxiety. Quality of life implications associated with stuttering are discussed.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) describe the method for assessing the direct financial costs of stuttering over a 5-year period; (b) describe the financial personal cost of stuttering for adults who stutter; (c) describe the relationship between factors like sex, age, severity of stuttering and financial costs; and (d) describe the relationship between social anxiety and the financial cost of stuttering.

Social anxiety disorder in adults who stutter

BACKGROUND

The nature and prevalence of social anxiety disorder (social phobia (SP)) in people who stutter is uncertain, and DSM-IV differential diagnosis guidelines make it difficult to classify an adult who stutters (AWS) with SP as it is assumed any social anxiety symptoms will be a consequence of their stuttering. The aim of this study was to determine the spot prevalence of SP in AWS and to investigate differences in social anxiety between AWS and controls who do not stutter.

METHODS

The study involved a comprehensive assessment of 200 AWS and 200 adults who do not stutter similar in age and sex ratio. Measures included stuttering severity, health status, self-report measures of social anxiety as well as a structured diagnostic interview for SP for randomly selected sub-group of 50 from each group.

RESULTS

The AWS were found to have significantly raised trait and social anxiety, as well as significantly increased risk of SP in comparison to the controls. Findings indicated a SP spot prevalence of at least 40% in AWS, and for them to be at high risk of having Generalized SP.

CONCLUSIONS

It is concluded that the DSM-IV diagnostic guidelines for diagnosing SP in AWS could result in professional confusion and have possible negative mental health ramifications. Implications for the psychological and medical treatment of AWS are discussed.

The impact of stuttering on the quality of life in adults who stutter

Stuttering is an involuntary fluency disorder that is not uncommon in society. However, the impact of stuttering on a composite measure such as quality of life has rarely been estimated. Quality of life (QOL) assesses the well-being of a person from a multidimensional perspective, and valid and reliable general QOL measures are available that can be used to estimate the impact of stuttering on QOL. This study involved the use of a general measure of QOL called the Medical Outcomes Study Short Form-36 (SF-36) in order to assess the impact of stuttering in 200 adults who stutter (AWS). Comparisons to 200 adults of similar age and sex ratio who do not stutter were made so that the unique contribution of stuttering on QOL could be estimated. Findings indicated that stuttering does negatively impact QOL in the vitality, social functioning, emotional functioning and mental health status domains. Results also tentatively suggest that people who stutter with increased levels of severity may have a higher risk of poor emotional functioning. These findings have implications for treatment such as the necessity to address the emotional and psychological aspects of QOL in AWS and the need for additional clinical resources to be invested in stuttering treatment.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) summarize the method used in quality of life assessment using the SF-36; (b) describe the impact of stuttering on the quality of life of adults who stutter; (c) compare the impact of stuttering to the quality of life of adults who do not stutter; (d) describe the relationship between frequency of stuttering and quality of life.

The Relationship Between Spectral Changes in Heart Rate Variability and Fatigue

Fatigue is a prevalent problem in the workplace and a common symptom of many diseases. However, its relationship with the autonomic nervous system, specifically with sympathetic arousal, needs clarification. The objective of this study was to determine the association between fatigue and heart rate variability (HRV). HRV is regarded as an indicator of the autonomic regulation activity of heart rate, specifically sympathetic and parasympathetic activity. Spectral changes in low-frequency (LF; 0.04–0.15 Hz) and high-frequency (HF; 0.15–0.4 Hz) components of HRV have been reported to be associated with distressing conditions such as hemorrhagic shock, acute myocardial infarction, elevated anxiety, and depressed mood. While HRV changes have been found in persons with chronic fatigue syndrome, its association with fatigue in healthy individuals still needs clarification. HRV was assessed in a total of 50 participants who were asked to perform a task until becoming fatigued. Low-frequency HRV activity increased, while indices of parasympathetic modulation such as RMSSD and pNN50 remained stable as participants experienced fatigue, suggesting that fatigue in healthy individuals may be associated with increased sympathetic arousal. In addition, employing multiple regression analyses, we could positively associate the change in LF/HF HRV ratio from baseline to fatigue with factors such as emotional stability, warmth and tension and negatively associate it with social boldness and self-reported levels of vigor.

Psychological, lifestyle and coping contributors to chronic fatigue in shift-worker nurses

AIM

This paper is a report of a study to assess the following in shift-worker nurses: (1) the relationships amongst chronic fatigue and psychological variables including anxiety, mood and locus of control; (2) the relationships amongst chronic fatigue and a number of lifestyle factors such as shiftwork, sleep and exercise; and (3) various coping behaviours that best predict chronic fatigue.

BACKGROUND

In the shift-working population, individual psychological, lifestyle and coping differences influence fatigue levels. However, some of these factors are somewhat unexplored and their relative contribution to fatigue remains poorly understood. Methods. An exploratory design was adopted with 111 eldercare shift-worker nurses. Data were collected during 2006. Nurses completed self-administered questionnaires examining fatigue, anxiety, mood disturbance, locus of control, sleep, work, lifestyle and coping characteristics.

FINDINGS

Multiple regressions showed that mood disturbance, locus of control and trait anxiety are statistically significant predictors of chronic fatigue. Poor sleep quality was the lifestyle factor which most strongly contributed to fatigue. Other lifestyle predictors included higher workload perception, lack of exercise and the non-availability of support. Whilst problem-focused coping behaviours were not associated with fatigue, coping by using alcohol, letting emotions out and avoiding the situation significantly predicted chronic fatigue.

CONCLUSION

The challenge for improving the fatigue outcomes requires further investigation of the profile of a nurse who is at a high risk of fatigue, and then integrating this profile into a fatigue management programme which considers relative contributions of the psychological, lifestyle and coping factors.

The psychophysiological determinants of fatigue

Driver fatigue is a major risk for road accidents that can often result in injury and death. However, considerable debate still exists concerning factors associated with driver fatigue. Because of the complex nature of fatigue, this paper reports a study that investigated both physiological and psychological determinants of fatigue. Three fatigue outcome measures were used, including a physiological, psychological and a combined physiological and psychological measure. Fifty participants performed a driving simulator task till they showed symptoms of fatigue and were assessed before and after the task. Significant factors associated with physiological fatigue included higher levels of baseline delta activity and an extraverted personality. Factors related to the psychological fatigue outcome measure included sleepiness, low healthy lifestyle status, an extraverted personality and tension-prone personality, and negative mood states. The combined fatigue outcome measure was associated with factors such as a tension-prone and extraverted personality, low systolic blood pressure, and negative mood states. The findings emphasize the importance of assessing fatigue using a range of outcome measures in order to achieve a thorough understanding of what factors contribute to fatigue and highlight the need to develop fatigue countermeasures that employ a broad range of measures.

Evaluating and Developing a Multidimensional, Dispositional Measure of Appraisal

Although theories of stress have emphasized the critical role of the appraisal process, the use of dispositional measures of appraisal have not been readily investigated. Using a large multiethnic sample, we examined the factorial validity and dimensionality of a dispositional version of the Stress Appraisal Measure (SAM; Peacock & Wong, 1990). Both exploratory and confirmatory factor analyses resulted in a 4-factor representation of dispositional appraisal fitting better than its originally proposed 6-factor representation. This 4-factor model was invariant across gender groups. Although the 6-factor model purported to measure 3 dimensions of primary appraisal and 3 dimensions of secondary appraisal, these factors were found to be highly unstable and had questionable internal consistency. In contrast, the more parsimonious 4-factor solution identified 4 relative distinct and reliable scales of appraisal: 3 primary (Challenge, Threat, and Centrality) and 1 secondary (Resources). These findings suggest that meaningful dispositional dimensions of appraisal can be derived and incorporated into trait-state models of the stress process.

A controlled investigation into the psychological determinants of fatigue

Driver fatigue is associated with risks of road accidents that result in injury and death. Research has been limited by several issues such as confusion over definitions, how best to measure fatigue, and the contribution of psychological factors to fatigue. This study addressed these limitations by investigating the relationship between psychological factors and fatigue. Participants were assessed and were required to perform a monotonous task till they tired. Results found few psychological factors to be related to physiological and performance decrement fatigue outcome measures. However, psychological factors were found to correlate consistently with self-reported fatigue. The results suggest that fatigue is associated with a predisposition to be anxious, depressive, less self-assured, more conscientious (rule bound), less socially bold, less adaptable and low vigour. The results indicate that future research should employ a range of fatigue outcome measures in order to best understand what factors contribute to fatigue.

The Health Status of Rural Caregivers

The purposes of this study were to examine the relationships among stress, caregiver burden, and the health status of rural caregivers and assess whether caregiver burden and stress predict the physical health status of caregivers in the rural setting. A descriptive-correlational design was used to explore the caregiver health status of 63 informal caregivers in rural Alabama and Mississippi. The relationships among stress, burden, and health status in rural caregivers were significantly related (p .000) and significant variance in health status (p .000) was accounted for by the model variables of stress and caregiver burden. Rural caregivers experienced difficulty with transportation to the hospital and their physicians, and complained of experiencing uncomfortable physical symptoms.

Developing and validating a stress appraisal measure for minority adolescents

Although there are a number of measures designed to assess the cognitive appraisal of stress in adult populations, currently there are no measures that are specifically designed to assess this important construct in adolescents. To overcome this limitation, the factorial validity and dimensionality of a dispositional measure of stress appraisal was examined in the current study. Using a multiethnic adolescent sample, both exploratory and confirmatory factor analyses resulted in a three-factor representation of appraisal. The three factors included two primary appraisal dimensions (Threat and Challenge) and one secondary appraisal dimension (Resources). This three-factor model, however, is inconsistent with four- and six-factor models found previously in adult samples. Thus, these findings suggest that the cognitive appraisals made by adolescents are less complex or differentiated than those of adults. Moreover, these findings suggest that dispositional measures are relevant for adolescent samples and should be incorporated into stress and coping paradigms.

Measuring job stress and family stress in Chinese working women: a validation study focusing on blood pressure and psychosomatic symptoms

Psychometric properties of a questionnaire measuring psychosocial work-related stress in terms of effort-reward imbalance and a short family stress scale were examined in a population sample of 421 working women from four work sites in Beijing, China. The internal consistency of the scales was satisfactory, and the theoretically postulated structure of scales of the work stress questionnaire was replicated. The criterion validity of the scales was tested using psychosomatic symptoms and blood pressure. Combined exposure to work and family- related stress was associated with an adjusted mean 6.4 mmHg increase in systolic blood pressure. Recurrent sleeping problems were also associated with the two stress measures. In conclusion, standardized measures of psychosocial stress in terms of effort-reward imbalance and of family stress can be used in occupational health research in China, with particular relevance for working women.

Computer usage and its relationship with adolescent lifestyle in Hong Kong

PURPOSE

To determine the patterns of computer usage among adolescents in Hong Kong and to examine whether computer usage is associated with less physical activity and social support among adolescents.

METHODS

A total of 2110 secondary school students (52% boys and 48% girls) in Hong Kong completed a set of questionnaires to measure their computer usage and lifestyle. Mean age of the respondents was 14.16 years (SD = 1.81 years). Computer usage was taped by asking the students to indicate how much time (in minutes) they spent on the computer each day for doing homework assignments; playing computer games; "surfing" the Internet; and communicating with others. The students also provided information on their social-physical lifestyle. Student's t-tests and analysis of variance were used to examine group differences. Pearson product moment correlations were used to explore relationships between computer usage and lifestyle.

RESULTS

Boys who use computers for doing homework, "surfing" the Internet, and communicating with others engage in more social-physical activities than others. Boys who use computers to play games tend to be more social-behaviorally inactive. For girls, patterns of computer usage are not related to lifestyle.

CONCLUSIONS

Computer users tended to engage in social-physical activities more frequently and had higher social support than nonusers. But among computer users, the amount of time spent daily on the computer was not associated with lifestyle. Instead, patterns of computer usage are more related to lifestyle and the relationship is moderated by gender.