1
|
Venet-Kelma L, Morvan Y, Romain AJ, Mendy M, Meslier M, Thoisy I, Mulin E, Chirio-Espitalier M, Dadi G, Moualla M, Amado I, Kern L. Effect of an adapted physical activity program on stress, anxiety, depression in patients with schizophrenia: study protocol of a randomized-controlled trial. Eur Arch Psychiatry Clin Neurosci 2024; 274:891-902. [PMID: 37670161 DOI: 10.1007/s00406-023-01689-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Abstract
Physical activity (PA) is recommended to optimize well-functioning in people with schizophrenia. PA has been found to improve quality of life, general symptomatology, depression, anxiety and stress symptoms, global and social functioning. In PA research, most of the interventions are based on one-on-one interventions but there is poor information about group-based PA interventions. Using a randomized controlled, clinician-blinded trial, subjects are randomized into two arms: the PA group or control group. Our first objective is about to evaluate the effects of a multimodal 6 week collective PA intervention on depression, anxiety, and stress symptoms in people with schizophrenia. Our second objective is about to evaluate these effects on secondary outcomes especially smoking, well-being, physical fitness and on care utilization. All participants are evaluated before and after the 6 week intervention period, and only participants in the PA group are called in a follow-up interview 3 and 6 months after the intervention.Trial registration Individual Protection Committee of Ile-de-France II, n ID RCB: 2018- A00583-52. Registered on 8 April 2018.
Collapse
Affiliation(s)
- Lucie Venet-Kelma
- University of Montreal, Montreal, QC, Canada. lucie.venet--
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada. lucie.venet--
| | | | - Ahmed Jérôme Romain
- University of Montreal, Montreal, QC, Canada
- Research Center of the University Institute of Mental Health of Montreal, Montreal, Canada
| | - Mauricette Mendy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Marjorie Meslier
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Thoisy
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
| | - Emmanuel Mulin
- Korian Val du Fenouillet Psychiatric Clinic, La Crau, France
| | - Marion Chirio-Espitalier
- Reference Center for Therapeutic Education and Cognitive Remediation, University Hospital of Nantes, Nantes, France
| | - Ghita Dadi
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Mona Moualla
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Isabelle Amado
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
- Resource Center for Cognitive Remediation and Psychosocial Rehabilitation (C3RP), Paris, France
| | - Laurence Kern
- University of Paris Nanterre, Nanterre, France
- Paris University Hospital Group Psychiatry & Neurosciences, Paris, France
| |
Collapse
|
2
|
Addleman JS, Lackey NS, DeBlauw JA, Hajduczok AG. Heart Rate Variability Applications in Strength and Conditioning: A Narrative Review. J Funct Morphol Kinesiol 2024; 9:93. [PMID: 38921629 PMCID: PMC11204851 DOI: 10.3390/jfmk9020093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/23/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Heart rate variability (HRV) is defined as the fluctuation of time intervals between adjacent heartbeats and is commonly used as a surrogate measure of autonomic function. HRV has become an increasingly measured variable by wearable technology for use in fitness and sport applications. However, with its increased use, a gap has arisen between the research and the application of this technology in strength and conditioning. The goal of this narrative literature review is to discuss current evidence and propose preliminary guidelines regarding the application of HRV in strength and conditioning. A literature review was conducted searching for HRV and strength and conditioning, aiming to focus on studies with time-domain measurements. Studies suggest that HRV is a helpful metric to assess training status, adaptability, and recovery after a training program. Although reduced HRV may be a sign of overreaching and/or overtraining syndrome, it may not be a sensitive marker in aerobic-trained athletes and therefore has different utilities for different athletic populations. There is likely utility to HRV-guided programming compared to predefined programming in several types of training. Evidence-based preliminary guidelines for the application of HRV in strength and conditioning are discussed. This is an evolving area of research, and more data are needed to evaluate the best practices for applying HRV in strength and conditioning.
Collapse
Affiliation(s)
- Jennifer S. Addleman
- College of Osteopathic Medicine, Touro University California, Vallejo, CA 94592, USA
| | - Nicholas S. Lackey
- Center for Applied Biobehavioral Sciences (CABS), Alliant International University, San Diego, CA 92131, USA;
| | - Justin A. DeBlauw
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY 12866, USA
| | - Alexander G. Hajduczok
- Department of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
| |
Collapse
|
3
|
Silişteanu SC, Antonescu E, Duică L, Totan M, Cucu AI, Costea AI. Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities. Healthcare (Basel) 2024; 12:853. [PMID: 38667615 PMCID: PMC11050304 DOI: 10.3390/healthcare12080853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
Collapse
Affiliation(s)
- Sînziana Călina Silişteanu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Andrei Ionuţ Cucu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Andrei Ioan Costea
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| |
Collapse
|
4
|
Zang W, Zhu J, Xiao N, Fang M, Li D, Li H, Yan J, Jing H, Wang S. Effects of aerobic exercise on children's executive function and academic performance: A systematic review and meta-analysis. Heliyon 2024; 10:e28633. [PMID: 38586404 PMCID: PMC10998207 DOI: 10.1016/j.heliyon.2024.e28633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024] Open
Abstract
Objective To investigate the effects of exercise on executive function in children, providing an evidence-based foundation to inform future research in school physical education and health education. Methods We searched ten databases: Cochrane Library, Scopus, OVID, Web of Science, PubMed, EBSCOhost, SPORTDiscus, PsycINFO, CNKI, WANFANG DATA, VIP, and SinoMed, and eight articles were included. Applying the revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2), funnel plots and Egger regression analysis were integrated with R meta-analysis to screen for publication bias. The quality of the evidence was appraised using the Grading system. Results The included literature contained 2655 participants, with 1308 in the experimental group and 1347 in the control group. The results indicated that the aerobic exercise group considerably improved inhibitory control in children compared to the control group [SMD = 0.29, 95% CI (0.05, 0.54), P = 0.018]; working memory [SMD = 0.25, 95% CI (0.07, 0.42), P = 0.005]; and cognitive flexibility [SMD = 0.36, 95% CI (0.17, 0.54), P < 0.001]. However, the findings indicated that only aerobic exercise interventions extending beyond 50 weeks positively influenced academic performance in children [SMD = 1.19, 95% CI (0.34, 2.04), P = 0.006]. The results of an Egger regression analysis revealed that the p-values for inhibitory control, working memory, cognitive flexibility, and academic performance were more significant than 0.1. The Grade system said that the quality of evidence was all low regarding the level of evidence. Conclusion Aerobic exercise enhanced executive function but only aerobic exercise interventions extending beyond 50 weeks demonstrated a significant effect on the academic performance of children. Due to the low quality of evidence presented in this study, additional high-quality randomized controlled trials are needed to confirm these findings.
Collapse
Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Jinyi Zhu
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Ningkun Xiao
- Department of Psychology, Ural Federal University, Yekaterinburg, Russia
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Dong Li
- Department of International Culture Education, Cho dang University, Republic of Korea
| | - Haiming Li
- Institution of Physical Education, China University of Mining and Technology, 221116, Xuzhou, China
| | - Jin Yan
- School of Physical Education and Sports, Soochow University, Suzhou, China
| | - Hongying Jing
- Department of Sports Science, University of Harbin Sport, Harbin, China
| | - Su Wang
- Department of Sports Science, University of Harbin Sport, Harbin, China
| |
Collapse
|
5
|
Wibowo S, Sunarno, Gasjirin J, Christian M, Indriyarti ER. Psychological and Organizational Factors Impacting Job Satisfaction during the COVID-19 Pandemic: A Study on Similar Exposure Groups in Indonesia. ACTA MEDICA PHILIPPINA 2024; 58:72-82. [PMID: 38966612 PMCID: PMC11219536 DOI: 10.47895/amp.vi0.3688] [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] [Indexed: 07/06/2024]
Abstract
Introduction The COVID-19 pandemic has impacted technical workers who work more often in the field (e.g., engineering, mechanical, health safety environment (HSE), quality control, and production workers) with increasingly complex workloads and work pressures. Few studies have yet to examine the job satisfaction of such workers using a combination of psychological and organizational factors during difficult times, such as the current COVID-19 pandemic. Objective This study aims to explain whether psychological and organizational factors affect employee job satisfaction as a result of the COVID-19 pandemic. Methods This quantitative research uses Partial Least Square-Structural Equation Modeling. A survey with a questionnaire was used to collect data in this study. Using the non-probability sampling technique, data from 103 respondents spread throughout four Similar Exposure Groups (SEGs) in Indonesia were collected. Data analysis in this study used SmartPLS 3.0. Results Male workers in this study constituted more than 90% of the respondents, the majority with a long working period (more than five years). Worker experience was directly proportional to worker age; most workers were between 41 and 56 years old. The results, with a majority of SEGs from engineering, found that out of five hypotheses (H1-H5), four are accepted while one is rejected. Employee job satisfaction during this pandemic is influenced by the feeling of safety (H1) and work pressure (H3). Work pressure is further influenced by the feeling of safety at work (H2). Moreover, work pressure acts as a mediator on the feeling of safety and job satisfaction (H4). However, job satisfaction is not influenced by management commitment (H5). Conclusion Management commitment to work safety during pandemic situations must be adjusted, especially regarding policies to ensure the availability of additional standards on health protocols to prevent the spread of COVID-19 in the workplace. In addition, the guarantee that the company is committed to ensuring that workers feel safe will be covered if exposed to COVID-19. Occupational safety and health standards are no longer fully focused on work equipment or facilities. The feeling of safety and work pressure during a pandemic require attention from companies in accordance with their existing limitations and capabilities.
Collapse
Affiliation(s)
- Suryo Wibowo
- Psychological Science Doctoral Programme, Universitas Persada Indonesia YAI, Jakarta, Indonesia
| | - Sunarno
- Psychological Science Doctoral Programme, Universitas Persada Indonesia YAI, Jakarta, Indonesia
| | - Juliana Gasjirin
- Psychological Science Doctoral Programme, Universitas Persada Indonesia YAI, Jakarta, Indonesia
| | - Michael Christian
- Faculty of Social Sciences and Humanities, Universitas Bunda Mulia, Jakarta, Indonesia
| | | |
Collapse
|
6
|
Cox C, Yates J, O’Brien F, Pajon L, Farrell A, Ward M, McCabe P, James A, McNamara-Catalano I. Wearable Technology: A Wellbeing Option for Serving Police Officers and Staff? A Comparison of Results of a Pilot Study with Firearms Officers and a Group of Mixed Officers and Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:186. [PMID: 38397677 PMCID: PMC10888460 DOI: 10.3390/ijerph21020186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/17/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
The high-stress nature of policing contributes to deterioration of officer health and wellbeing as well as high levels of absenteeism and attrition. Wearable technology (WT) has been identified as a potential tool that can help in improving officer health and wellbeing. This pilot study aimed to give initial insight into acceptability and engagement with WT amongst officers. The study also aimed to uncover any notable areas for exploration in future research within the domain of officer health and wellbeing. Two groups were observed, firearms officers and a mixed group of officers. Participants wore the WT for an extended period, completed a variety of health and wellbeing questionnaires and discussed their experience in focus groups. Firearms officers and mixed group officers displayed similar sleep efficiency, but firearms officers have worse sleep consistency and sleep performance. Firearms officers appear to have higher HRV and a slightly lower resting heart rate. Both groups display reasonable acceptance of the use of WT, speaking favorably during the focus groups of how monitoring the data had improved their quality of life in terms of their understanding of sleep, wellbeing and how they had consequently completed lifestyle modification. WT offers some promise in managing officer health and wellbeing; studies with larger sample sizes are needed to confirm this.
Collapse
Affiliation(s)
- Carol Cox
- Liverpool Centre for Advanced Policing Studies, Liverpool John Moores University, Liverpool L3 5UX, UK; (J.Y.); (F.O.); (L.P.); (A.F.); (M.W.); (P.M.); (A.J.); (I.M.-C.)
| | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Tuominen PPA, Mayor P. Motivation, stress, recovery, and physical activity of teachers: discoveries with the Reiss Motivation Profile ® and the Firstbeat ® measurement. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-11. [PMID: 36718231 PMCID: PMC9879234 DOI: 10.1007/s10389-023-01828-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023]
Abstract
Aim Teaching is known as a high-stress occupation. Managing fatigue and promoting work engagement, teachers' expectations and perceptions can impact work-related stress-recovery-balance and physical activity levels. The main objective of the current study was to investigate the relationship between intrinsic motivational factors and the autonomic nervous system, such as heart rate and heart rate variability regulation, sleep, and physical activity levels. Methods The research included 66 primary and high school teachers in Tampere, Finland, in 2020-2021. The Reiss Motivation Profile® (RMP) was selected as an instrument to provide a practical approach to understanding people's intrinsic motivators and the effects of those on the Firstbeat®-measured heart rate and heart rate variability, and accelerometry. Stepwise multiple linear regression models were used to assess whether the RMP motives reflected Firstbeat®-measured outcomes. Results Motives such as Acceptance, Eating, Family, Physical Activity, Power, Tranquillity, and Vengeance were found to have a relationship with Firstbeat®-measured outcomes. An increase in the Physical Activity motive was related to lower stress and less light physical activity. Furthermore, an increase in the Physical Activity motive showed a relationship with better recovery and a higher amount of vigorous physical activity. However, the statistical analysis of heart rate and heart rate variability showed only low explanatory power (R2 = 0.111-0.140) for stress, recovery, and sleep. On the contrary, the explanatory power of measurements related to physical activity and sedentary behavior was higher (R2 = 0.171-0.298). In addition, the need for Acceptance as an important intrinsic motive that may prevent people from vigorous physical activity deserves further research. Conclusion The results indicated that there are several factors affecting the autonomous nervous system but also behavior. The basic desires explained sedentary and physical activity behavior better than the functioning of the autonomic nervous system. The 16 life motives can serve as a valuable theory for understanding better how to encourage people to have healthier habits.
Collapse
Affiliation(s)
- Pipsa P. A. Tuominen
- Tampere University of Applied Sciences, Social Services and Health Care, Physiotherapy degree program, Kuntokatu 3, P1-13, 33520 Tampere, Finland
| | - Päivi Mayor
- Tampere University of Applied Sciences, Business and Media, International Business, Master’s in Educational Leadership degree program, Tampere, Finland
| |
Collapse
|
8
|
Sinha MK, K V, Maiya AG, K N S, U S, N RS. Association of physical activity and heart rate variability in people with overweight and obesity: A systematic review. F1000Res 2023; 12:156. [PMID: 36875496 PMCID: PMC9982191 DOI: 10.12688/f1000research.124707.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2022] [Indexed: 02/12/2023] Open
Abstract
Background: Obesity is a major public health issue globally which is intrinsically linked to reduced heart rate variability (HRV). Physical inactivity and reduced resting HRV are linked to an increased risk of coronary heart disease, while athletes have a greater HRV. However, the exact correlation between physical activity and HRV remains uncertain. This systematic review aims to collect, report, and critically assess the current scientific literature about the association between physical activity and HRV in individuals with higher weight and obesity. Methods: A systematic search was carried out in electronic databases (Medline/PubMed, SCOPUS and CINAHL Plus) to retrieve studies that evaluated the relationship between physical activity and HRV in individuals with higher weight and obesity. Case-control, longitudinal/cohort, cross-sectional and observational studies were included. Using a critical narrative approach, information about the HRV, and physical activity was extracted and synthesized. The study was registered in PROSPERO: CRD42020208018 on October 9 2020. Results: After removing duplicates, 980 title/abstract records were checked for eligibility, and 12 papers were finally included in the narrative synthesis. The included studies contained physical activity as well as HRV in adults with higher weight or obesity with or without comorbidities. A negative relationship between moderate to vigorous physical activity and HRV indices had been found in two studies. There was also a negative relationship between sedentary time and HF (p = 0.049) and LF/HF (p = 0.036), as well as a positive relationship between sedentary time and LF (p = 0.014). Also dose-response association was found between vigorous exercise and higher SDNN, LF power, and HF power in one of the studies. Conclusions: This systematic review revealed a wide range of responses to physical activity and HRV; however, the current evidence uses a variety of approaches to objectively assess physical activity and measure HRV with different equipment.
Collapse
Affiliation(s)
- Mukesh Kumar Sinha
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Vaishali K
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Arun G Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shivashankar K N
- Department of Medicine, Kasturba Medical college, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shashikiran U
- Department of Medicine, Dr. TMA Pai Hospital, Udupi, MMMC, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ravi Shankar N
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, Delhi, India
| |
Collapse
|
9
|
Occupational Burnout Is Linked with Inefficient Executive Functioning, Elevated Average Heart Rate, and Decreased Physical Activity in Daily Life - Initial Evidence from Teaching Professionals. Brain Sci 2022; 12:brainsci12121723. [PMID: 36552182 PMCID: PMC9775632 DOI: 10.3390/brainsci12121723] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Burnout is becoming a global pandemic jeopardizing brain health, with a huge impact on quality of life, available workforce, and the economy. Knowledge of the impact of burnout on cognition, physiology, and physical activity (PA) in daily life allows for an improved understanding of the health consequences and everyday ramifications of burnout. Twenty-eight volunteers participated in a three-day recording of daily physiology and PA, including heart rate (HR) and daily steps, with a wearable device. They filled in questionnaires screening for burnout (BBI-15), depression (BDI), and executive functions (EFs) in daily life (BRIEF-A). The subjects with burnout had more challenges in EFs, higher average HRs and lower numbers of steps in daily life than those without it. The BBI-15 scores correlated positively with the BDI scores and BRIEF-A indices and negatively with the awake HR variability (HRV) and daily steps. The metacognition index correlated negatively with the HRV. In conclusion, burnout is linked with compromised EFs along with alterations in cardiac physiology and PA in daily life. Such alterations may be easily detected with wearable devices, opening possibilities for novel biomarkers of burnout and other neuropsychiatric disorders. We suggest that physical activity and heart and brain health are intimately intertwined and that burnout interacts with each of them bidirectionally.
Collapse
|
10
|
Dėdelė A, Chebotarova Y, Miškinytė A. Motivations and barriers towards optimal physical activity level: A community-based assessment of 28 EU countries. Prev Med 2022; 164:107336. [PMID: 36334682 DOI: 10.1016/j.ypmed.2022.107336] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/18/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Regular physical activity (PA) is one of the most important determinants of a healthy lifestyle and improved physical and mental well-being. Despite the health benefits of regular PA, the studies show low levels of PA among European adolescents and adults. An increase in physical inactivity has been associated with different personal and environmental factors. This study aimed to investigate positive motivation and barriers to community-based PA. Face-to-face interviews were conducted to collect data on PA, positive motivation and barriers to PA, demographic, and socioeconomic factors. Moderate and vigorous levels of PA were assessed. Regression analysis was applied to estimate the associations for positive and negative reasons for meeting PA recommendations. Data were available for 28,031 adults with a mean age of 48.3 (SD = 18.8) and 51.8% women. Significant variations in individual characteristics were seen between different types of communities. The percentage of participants who reported achieving recommended levels of PA was the lowest in rural areas (44.3%). Regression models showed that most motivational factors had a strong positive association with meeting PA recommendations. We observed the effects of interactions between making acquaintances, having fun and the type of community on meeting PA recommendations. The effects of interactions between the type of community and barriers to PA such as price, risk of injury, disability / illness, and a lack of motivation on PA recommendations were observed. In conclusion, the motivational factors and barriers to PA are associated with the physical environment, and community-based programs and policies for encouraging PA participation are needed.
Collapse
Affiliation(s)
- Audrius Dėdelė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Akademija 53361, Kaunas district, Lithuania
| | - Yevheniia Chebotarova
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Akademija 53361, Kaunas district, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Akademija 53361, Kaunas district, Lithuania.
| |
Collapse
|
11
|
Tsioras PA, Khooshdohbat M, Nikooy M, Naghdi R, Heidari M. The Impact of Body Posture on Heart Rate Strain during Tree Felling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11198. [PMID: 36141462 PMCID: PMC9517601 DOI: 10.3390/ijerph191811198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/28/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
Tree felling is recognized as one of the most difficult and physically demanding work phases in motor-manual wood harvesting, during which maintaining good posture can avert unnecessary loadings to the spine and the consequent musculoskeletal disorders to forestry professionals. This study aimed to (a) quantify the impact of posture selection by means of heart rate measurements and (b) analyze its interactions with the anthropometric and personal information of study subjects. Thirteen forest workers were asked to fell thirty trees in each of the four most common body postures during motor-manual forest operations: (i) stooping, (ii) flexed stooping, (iii) squatting, and (iv) half kneeling. Posture had a significant impact on the amount of heart strain measured as mean heart rate during work (HRwork), heart rate increase over resting heart rate (ΔHR), and relative heart rate index (HRR). The most popular position among the forest workers was flexed stooping, which also caused the most damage, compared with the least physiologically damaging position, half kneeling: HRwork by 12.40 bpm, ΔHR by 10.24 bpm, and HRR by 11.51. On the contrary, overweight and older subjects experienced lower heart rate strain, a finding that has to be further investigated.
Collapse
Affiliation(s)
- Petros A. Tsioras
- Lab of Forest Utilization, School of Forestry and Natural Environment, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Mahmoud Khooshdohbat
- Forestry Department, Faculty of Natural Resources, University of Guilan, Sowmeh Sara 96196-43619, Iran
| | - Mehrdad Nikooy
- Forestry Department, Faculty of Natural Resources, University of Guilan, Sowmeh Sara 96196-43619, Iran
| | - Ramin Naghdi
- Forestry Department, Faculty of Natural Resources, University of Guilan, Sowmeh Sara 96196-43619, Iran
| | - Mahmoud Heidari
- Department of Occupational Health, School of Health, Guilan University of Medical Sciences, Rasht 41446-66949, Iran
| |
Collapse
|
12
|
Block A, Bonaventura K, Grahn P, Bestgen F, Wippert PM. Stress Management in Pre- and Postoperative Care Amongst Practitioners and Patients in Cardiac Catheterization Laboratory: A Study Protocol. Front Cardiovasc Med 2022; 9:830256. [PMID: 35845056 PMCID: PMC9285119 DOI: 10.3389/fcvm.2022.830256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/01/2022] [Indexed: 11/24/2022] Open
Abstract
Background As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization. Methods The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis. Discussion This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines.
Collapse
Affiliation(s)
- Andrea Block
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus – Senftenberg, Potsdam, Germany
- *Correspondence: Andrea Block
| | - Klaus Bonaventura
- Department of Cardiology and Angiology, Ernst von Bergmann Hospital, Potsdam, Germany
| | - Patricia Grahn
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Felix Bestgen
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Pia-Maria Wippert
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Faculty of Health Sciences Brandenburg, Joint Faculty of the University of Potsdam, the Brandenburg Medical School Theodor Fontane and the Brandenburg University of Technology Cottbus – Senftenberg, Potsdam, Germany
| |
Collapse
|
13
|
Magal N, Rab SL, Goldstein P, Simon L, Jiryis T, Admon R. Predicting Chronic Stress among Healthy Females Using Daily-Life Physiological and Lifestyle Features from Wearable Sensors. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2022; 6:24705470221100987. [PMID: 35911618 PMCID: PMC9329827 DOI: 10.1177/24705470221100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/29/2022] [Indexed: 12/22/2022]
Abstract
Background Chronic stress is a highly prevalent condition that may stem from different
sources and can substantially impact physiology and behavior, potentially
leading to impaired mental and physical health. Multiple physiological and
behavioral lifestyle features can now be recorded unobtrusively in
daily-life using wearable sensors. The aim of the current study was to
identify a distinct set of physiological and behavioral lifestyle features
that are associated with elevated levels of chronic stress across different
stress sources. Methods For that, 140 healthy female participants completed the Trier inventory for
chronic stress (TICS) before wearing the Fitbit Charge3 sensor for seven
consecutive days while maintaining their daily routine. Physiological and
lifestyle features that were extracted from sensor data, alongside
demographic features, were used to predict high versus low chronic stress
with support vector machine classifiers, applying out-of-sample model
testing. Results The model achieved 79% classification accuracy for chronic stress from a
social tension source. A mixture of physiological (resting heart-rate,
heart-rate circadian characteristics), lifestyle (steps count, sleep onset
and sleep regularity) and non-sensor demographic features (smoking status)
contributed to this classification. Conclusion As wearable technologies continue to rapidly evolve, integration of
daily-life indicators could improve our understanding of chronic stress and
its impact of physiology and behavior.
Collapse
Affiliation(s)
- Noa Magal
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Sharona L Rab
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | | | - Lisa Simon
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Talita Jiryis
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Roee Admon
- School of Psychological Sciences, University of Haifa, Haifa, Israel.,The Integrated Brain and Behavior Research Center (IBBRC), University of Haifa, Haifa, Israel
| |
Collapse
|
14
|
Physical Activity under Stress: A Perspective of HAPA and Individual Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212144. [PMID: 34831897 PMCID: PMC8619980 DOI: 10.3390/ijerph182212144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
Aims: Physical activity is an effective way for people to cope with stress. However, people often decrease their physical activity in response to stressors. Therefore, we aimed to understand the relationship between perceived stress and physical activity from an outcome expectancies perspective and investigated the moderating role of future orientation in this relationship. Methods: This study recruited 425 students who completed a three-wave survey at six-week intervals. A moderated mediation model was used to examine the mediating effects of outcome expectancies and the moderating effects of future orientation. Results: The results indicated that outcome expectancies mediated the relationship between perceived stress and physical activity. This relationship was moderated by future orientation. In particular, the mediating effects were significant for people with a high future orientation, but not for those with a low future orientation. Conclusion: Our results demonstrate the adaptive function of future orientation in response to general stress. Importantly, the link between perceived stress and reduced physical activity could be mitigated by encouraging people to focus on future consequences. Future studies should consider developing intervention strategies that help those struggling with stressful contexts.
Collapse
|
15
|
Marín-Farrona MJ, León-Jiménez M, García-Unanue J, Gallardo L, Liguori G, López-Fernández J. Influence of Non-Occupational Physical Activity on Burnout Syndrome, Job Satisfaction, Stress and Recovery in Fitness Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189489. [PMID: 34574412 PMCID: PMC8465796 DOI: 10.3390/ijerph18189489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed (1) to analyse the effect of non-occupational physical activity (NOPA) on the stress levels of fitness professionals, and (2) to apply a questionnaire to workers measuring burnout syndrome, working conditions and job satisfaction, and to compare the results with physiological stress and recovery measured objectively through heart rate variability (HRV). METHODS The HRV of 26 fitness instructors was recorded during 2-5 workdays using Firstbeat Bodyguard 2. Participants also completed a questionnaire (CESQT) measuring working conditions and job satisfaction variables and occupational burnout syndrome. RESULTS NOPA showed a negative association with both the percentage of stress (p < 0.05) and stress-recovery ratio (p < 0.01), and a positive association with the percentage of recovery (p < 0.05). Better work conditions (working hours, salary satisfaction and length of service) were associated with lower stress in fitness professionals. CONCLUSION NOPA appears to improve the stress levels of fitness instructors in this study cohort. Self-reported burnout levels measured through the CESQT questionnaire do not coincide with the physiological stress responses measured through HRV. Better working conditions appear to reduce the stress response in fitness professionals.
Collapse
Affiliation(s)
- María Jesús Marín-Farrona
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (M.J.M.-F.); (M.L.-J.); (L.G.)
| | - Manuel León-Jiménez
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (M.J.M.-F.); (M.L.-J.); (L.G.)
| | - Jorge García-Unanue
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (M.J.M.-F.); (M.L.-J.); (L.G.)
- Correspondence: ; Tel.: +34-653-86-65-48
| | - Leonor Gallardo
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (M.J.M.-F.); (M.L.-J.); (L.G.)
| | - Gary Liguori
- College of Health Sciences, University of Rhode Island, 55 Lower College Road, Kingston, RI 02881, USA;
| | - Jorge López-Fernández
- Centre for Sport, Exercise and Life Sciences (CSELS), Coventry University, Coventry CV1 5FB, UK; or
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| |
Collapse
|
16
|
Optimal artificial neural network-based data mining technique for stress prediction in working employees. Soft comput 2021. [DOI: 10.1007/s00500-021-06058-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
17
|
Lucini D, Pagani E, Capria F, Galliano M, Marchese M, Cribellati S. Evidence of Better Psychological Profile in Working Population Meeting Current Physical Activity Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178991. [PMID: 34501580 PMCID: PMC8430491 DOI: 10.3390/ijerph18178991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
Workplace Health Promotion (WHP) may improve health, productivity and safety and reduce absenteeism. However, although desirable, it is difficult to design tailored (and thus effective) WHP programs, particularly in small-medium companies, which rarely have access to sufficient economic and organizational resources. In this study, 1305 employees filled out an online anonymous lifestyle questionnaire hosted on the website of a non-profit organization, which aims to promote a healthy lifestyle among workers. The data show gender differences regarding stress perception and, in the working population meeting current physical activity recommendations (threshold = 600 MET·min/week), they point out the evidence of a better psychological and nutrition profile, a perception of better job performance, and improved sleep and health quality. Moreover, a unitary index (ranging from 0-100 (with higher scores being healthier)), combining self-reported metrics for diet, exercise and stress, was significantly higher in active employees (67.51 ± 12.46 vs. 39.84 ± 18.34, p < 0.001). The possibility of assessing individual lifestyle in an easy, timely and cost-effective manner, offers the opportunity to collect grouped data useful to drive tailored WHP policies and to have metric to quantify results of interventions. This potentiality may help in creating effective programs and in improving employees' and companies' motivation and attitude towards a feasible WHP.
Collapse
Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano IRCCS, 20135 Milan, Italy
- Correspondence: or ; Tel.: +39-02-619-112-808
| | | | | | | | | | | |
Collapse
|
18
|
Bellamy R, Ring H, Watson P, Kemp A, Munn G, Clare IC. The effect of ambient sounds on decision-making and heart rate variability in autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2209-2222. [PMID: 34132124 PMCID: PMC7614480 DOI: 10.1177/13623613211014993] [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: 11/16/2022]
Abstract
LAY ABSTRACT Many autistic people report difficulties making decisions during everyday tasks, such as shopping. To examine the effect of sounds on decision-making, we developed a supermarket task where people watched a film shown from the shopper's perspective and were asked to make decisions between different products. The task was divided into three sections and participants completed each section in a different auditory environment: (1) no sounds, (2) non-social sounds (e.g. fridges humming) and (3) social sounds (e.g. people talking). Thirty-eight autistic and 37 neurotypical adults took part. We measured decision-making by examining how long it took to make a decision and how consistent people were with their decisions. We also measured heart rate variability because this biological response provides a measure of anxiety. After the supermarket shopping task, participants told us in their own words about their experiences. Autistic participants said that they found the non-social and social sound conditions more difficult than the no sound condition, and autistic participants found the social sound condition more negative than neurotypical participants. However, decision-making and heart rate variability were similar for autistic and neurotypical participants across the sound conditions, suggesting that these measures may not have been sensitive enough to reflect the experiences the autistic participants reported. Further research should consider alternative measures to explore the experiences reported by autistic people to help us understand which specific aspects of the environment autistic people are sensitive to. This, in turn, may enable more specific and evidence-based autism-friendly changes to be made.
Collapse
Affiliation(s)
| | - Howard Ring
- University of Cambridge, UK.,Cambridgeshire & Peterborough NHS Foundation Trust, UK
| | | | | | | | - Isabel Ch Clare
- University of Cambridge, UK.,Cambridgeshire & Peterborough NHS Foundation Trust, UK.,NIHR ARC East of England at Cambridgeshire & Peterborough NHS Foundation Trust, UK
| |
Collapse
|
19
|
Tonani ECF, Fernandes EV, Dos Santos Junior RB, Weber MG, Andreato LV, Branco BHM, De Paula Ramos S. Association of heart rate and heart rate variability with an anaerobic performance test and recovery of Brazilian jiu-jitsu athletes. INT J PERF ANAL SPOR 2021. [DOI: 10.1080/24748668.2021.1896828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Eduardo Carlos Ferreira Tonani
- Center of Biological Science, Study Groups on Tissue Regeneration, Adaptation, and Repair. State University of Londrina, Londrina, Brazil
| | - Eduardo Vignoto Fernandes
- Department of Anatomy, Study Groups on Tissue Regeneration, Adaptation, and Repair. State University of Jataí, Jataí, Brazil
| | - Rubens Batista Dos Santos Junior
- Center of Biological Science, Study Groups on Tissue Regeneration, Adaptation, and Repair. State University of Londrina, Londrina, Brazil
| | - Martim Gomes Weber
- Center of Biological Science, Study Groups on Tissue Regeneration, Adaptation, and Repair. State University of Londrina, Londrina, Brazil
| | - Leonardo Vidal Andreato
- Department of Physical Education , State University of Santa Catarina, Florianópolis, Brazil
| | | | - Solange De Paula Ramos
- Center of Biological Science, Study Groups on Tissue Regeneration, Adaptation, and Repair. State University of Londrina, Londrina, Brazil
| |
Collapse
|
20
|
Strüven A, Holzapfel C, Stremmel C, Brunner S. Obesity, Nutrition and Heart Rate Variability. Int J Mol Sci 2021; 22:ijms22084215. [PMID: 33921697 PMCID: PMC8072942 DOI: 10.3390/ijms22084215] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
Heart rate variability (HRV) represents the activity and balance of the autonomic nervous system and its capability to react to internal and external stimuli. As a measure of general body homeostasis, HRV is linked to lifestyle factors and it is associated with morbidity and mortality. It is easily accessible by heart rate monitoring and gains interest in the era of smart watches and self-monitoring. In this review, we summarize effects of weight loss, training, and nutrition on HRV with a special focus on obesity. Besides weight reduction, effects of physical activity and dietary intervention can be monitored by parameters of HRV, including its time and frequency domain components. In the future, monitoring of HRV should be included in any weight reduction program as it provides an additional tool to analyze the effect of body weight on general health and homeostasis. HRV parameters could, for example, be monitored easily by implementation of an electrocardiogram (ECG) every two to four weeks during weight reduction period. Indices presumibly showing beneficial changes could be a reduction in heart rate and the number of premature ventricular complexes as well as an increase in standard deviation of normal-to-normal beat intervals (SDNN), just to name some.
Collapse
Affiliation(s)
- Anna Strüven
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany;
| | - Christopher Stremmel
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
| | - Stefan Brunner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University Munich, Marchioninistr. 15, 81377 Munich, Germany; (A.S.); (C.S.)
- German Center for Cardiovascular Research (DZHK), Partner Site: Munich Heart Alliance, Marchioninistr. 15, 81377 Munich, Germany
- Department of Medicine I, University Hospital Munich, Ziemssenstrasse 1, 80336 Munich, Germany
- Correspondence: ; Tel.: +49-89-4400-52248; Fax: +49-89-4400-75251
| |
Collapse
|
21
|
Heart Rate Variability and Physical Demands of In-Season Youth Elite Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041391. [PMID: 33546227 PMCID: PMC7913319 DOI: 10.3390/ijerph18041391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Monitoring fatigue and performance is important for adjusting training loads in soccer. Therefore, knowing the status of the player when applying a training stimulus is key to optimizing the players' development. This study aims to evaluate the interaction between internal and external load, during training and matches, in an elite youth soccer team. METHODS seventeen youth players of the highest Spanish category were monitored with GPS devices during training and matches, as well as recording their nocturnal heart rate variability (HRV). We employed a linear mixed model to assess the physical demands between training and matches, and to compare the HRV variables. RESULTS a higher total distance (+2993.35-5746.56 m; ES = 1.4), distance at high intensity (+641.24-1907 m; ES = 1.5), sprint distance (+350.46-795.05 m; ES = 2.1), number of sprints (+18.38-41.58; ES = 1.9), and number of repeated sprints (+5.91-15.30; ES = 1.7) (all p < 0.001), but not in the number of accelerations, were reported during the matches when compared to the training sessions during the 11 weeks. The analysis of the HRV variables showed no significant differences between the accumulated values during a training week, providing similar results pre-match or post-match (p > 0.05). The LF/HFRATIO showed a negative influence on the total distance ran, distance at high intensity, distance in sprint, number of sprints, and repeated sprint. RRMEAN was positively related to the sprint number. CONCLUSION the results of the present study suggest that nocturnal HRV variables are not different between pre-match and post-match. Furthermore, it suggests that LF/HFRATIO and RRMEAN during pre-match can determine the external load that the player will be able to complete during the match.
Collapse
|
22
|
Ambulatory Heart Rate Variability in Schizophrenia or Depression: Impact of Anticholinergic Burden and Other Factors. J Clin Psychopharmacol 2021; 41:121-128. [PMID: 33605645 PMCID: PMC7919703 DOI: 10.1097/jcp.0000000000001356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Heart rate variability (HRV) has been found reduced in patients with schizophrenia and depression. However, there is a lack of knowledge on how demographic, lifestyle, and pharmacological factors contribute to the reduction in HRV in these patients. METHODS We recruited 37 patients with schizophrenia, 43 patients with unipolar depression, and 64 healthy controls. A combined chest-worn HRV and accelerometer device was used in an ambulatory measurement. Age, sex, anticholinergic burden of medication, nicotine use, body mass index, and ongoing physical activity were assessed in multiple regression models regarding their influence on HRV, measured as the standard deviation of all the RR intervals (SDNN). RESULTS In the fully adjusted model, schizophrenia (β = -0.23, P = 0.019), depression (β = -0.18, P = 0.028), age (β = -0.34, P < 0.000), ongoing physical activity (β = -0.23, P = 0.001), and anticholinergic burden (β = -0.19, P = 0.025) influenced SDNN negatively. Sex, nicotine use, and BMI had negligible effects on SDNN. CONCLUSIONS We show for the first time that a quantified score of anticholinergic burden of medication has a negative relationship to HRV in patients with schizophrenia or depression, but that the diagnoses themselves still exhibit an effect on HRV.
Collapse
|
23
|
Tremblay M, Albert WJ, Fischer SL, Beairsto E, Johnson MJ. Physiological responses during paramedics' simulated driving tasks. Work 2020; 66:445-460. [PMID: 32568158 DOI: 10.3233/wor-203184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Most ambulance collisions happen in emergency driving conditions and are caused by human factors. OBJECTIVE This study investigated the influence of human factors associated with time pressure, patient-care intervention, and health status on the physiological responses of simulated emergency driving tasks. METHODS A cohort of seventeen experienced paramedics performed a battery of three simulated diving tasks. The driving tasks were a non-urgent and two urgent driving simulations (one to the scene and one to the hospital). The second urgent driving task was preceded by a patient-care simulation (unstable cardiac patient with cardiopulmonary resuscitation). RESULTS The physiological responses between the three driving tasks were not significantly different due to time pressure and patient-care intervention. It is postulated that the physiological response of experienced paramedics was influenced by the fact that they are accustomed to handling stressful situations daily. Furthermore, it was observed that paramedics with health conditions were more physiologically aroused during the urgent driving scenarios (pre and post-intervention), suggesting they might have an elevated risk of collision when they drive with urgency. Paramedics with health conditions also had higher physiological responses for the post-intervention baseline, leading to a longer recovery time period, which might represent an elevated risk of developing chronic health problems or amplifying existing ones. CONCLUSIONS The findings of this research suggest that experienced paramedics manage the influence of time pressure and the impact of challenging patient-care well. Paramedics with health conditions represent an elevated risk of collision.
Collapse
Affiliation(s)
- Mathieu Tremblay
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada.,Department of Health Sciences, Université du Québec à Rimouski, Rimouski (QC), Canada
| | - Wayne J Albert
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo (ON), Canada
| | - Eric Beairsto
- New Brunswick EMS, Medavie Health Services, Moncton (NB), Canada
| | - Michel J Johnson
- School of Kinesiology and Leisure, Université de Moncton, Moncton (NB), Canada
| |
Collapse
|
24
|
Marin-Farrona M, Leon-Jimenez M, Garcia-Unanue J, Gallardo L, Crespo-Ruiz C, Crespo-Ruiz B. Transtheoretical Model Is Better Predictor of Physiological Stress than Perceived Stress Scale and Work Ability Index among Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4410. [PMID: 32575454 PMCID: PMC7345331 DOI: 10.3390/ijerph17124410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
Physical activity impacts positively on stress and anxiety. Working conditions affect the quality of life by increasing stress levels, which can affect job performance and work absence. The Perceived Stress Scale (PSS), Work Ability Index (WAI), Transtheoretical Model (TTM), as well as heart rate variability (HRV) have been applied to monitor the state of workers in their job. The aim of this study was to analyze PSS, WAI, and TTM classifications, and to find out how are they linked to physiological stress (HRV). One hundred and thirteen office workers responded to the three questionnaires and their HRV was monitored for at least two full days. Groups were set up according to TTM (Stage 1, Stage 2, Stage 3-4, Stage 5), WAI (weak WAI, medium WAI, good WAI), and PSS (low PSS, medium PSS, high PSS). Results obtained from the test were related to stress values measured by HRV with a Bodyguard2 device. The Stage 5 group from TTM had better HVR and stress levels than the other groups for both women and men (p < 0.05). Participants in the good WAI group and low PSS group had better results than weak WAI and high PSS, but the differences with respect to medium WAI and medium PSS were less clear. Finally, TTM seemed to be the best tool to discriminate physiological stress in office workers with regard to other questionnaires.
Collapse
Affiliation(s)
- Maria Marin-Farrona
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Manuel Leon-Jimenez
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Jorge Garcia-Unanue
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | - Leonor Gallardo
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| | | | - Beatriz Crespo-Ruiz
- IGOID Research Group, Department of Physical Activity and Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain
| |
Collapse
|
25
|
The Effects of Psychological Factors on Perceptions of Productivity in Construction Sites in Japan by Worker Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103517. [PMID: 32443446 PMCID: PMC7277847 DOI: 10.3390/ijerph17103517] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 01/02/2023]
Abstract
The construction industry is a work environment that poses many dangers to workers, with many hidden factors that affect work awareness. It is important for construction companies to ensure a balance between productivity and safety in the work environment. The purpose of this study was to identify relationships between the feeling of safety in the work environment, proactive work behavior, job satisfaction, work skills, team performance, and health risk indicators, such as heart rate, among construction workers of different ages. Based on previous research, we examined the hypothetical perception model. We then administered a questionnaire survey to construction workers (N = 357) employed at a Japanese construction company. Using structural equation modeling (SEM), we investigated the impact of health risk indicators on worker perceptions among young and older workers. The results showed that workers’ heart rate and body mass index (BMI) had a negative effect on the feeling of safety and proactive work behavior among older workers, but showed no significant relationship among young workers. However, regardless of workers’ age, it was clear that the feeling of safety affects job satisfaction, and that work skills and proactive work behaviors affect perceptions regarding team performance.
Collapse
|
26
|
Manjarres J, Narvaez P, Gasser K, Percybrooks W, Pardo M. Physical Workload Tracking Using Human Activity Recognition with Wearable Devices. SENSORS 2019; 20:s20010039. [PMID: 31861639 PMCID: PMC6982756 DOI: 10.3390/s20010039] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 01/28/2023]
Abstract
In this work, authors address workload computation combining human activity recognition and heart rate measurements to establish a scalable framework for health at work and fitness-related applications. The proposed architecture consists of two wearable sensors: one for motion, and another for heart rate. The system employs machine learning algorithms to determine the activity performed by a user, and takes a concept from ergonomics, the Frimat's score, to compute the corresponding physical workload from measured heart rate values providing in addition a qualitative description of the workload. A random forest activity classifier is trained and validated with data from nine subjects, achieving an accuracy of 97.5%. Then, tests with 20 subjects show the reliability of the activity classifier, which keeps an accuracy up to 92% during real-time testing. Additionally, a single-subject twenty-day physical workload tracking case study evinces the system capabilities to detect body adaptation to a custom exercise routine. The proposed system enables remote and multi-user workload monitoring, which facilitates the job for experts in ergonomics and workplace health.
Collapse
|
27
|
Niemelä M, Kiviniemi A, Kangas M, Farrahi V, Leinonen A, Ahola R, Tammelin T, Puukka K, Auvinen J, Korpelainen R, Jämsä T. Prolonged bouts of sedentary time and cardiac autonomic function in midlife. TRANSLATIONAL SPORTS MEDICINE 2019. [DOI: 10.1002/tsm2.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Maisa Niemelä
- Research Unit of Medical Imaging, Physics and Technology University of Oulu Oulu Finland
- Infotech University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Antti Kiviniemi
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Research Unit of Internal Medicine University of Oulu Oulu Finland
| | - Maarit Kangas
- Research Unit of Medical Imaging, Physics and Technology University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Vahid Farrahi
- Research Unit of Medical Imaging, Physics and Technology University of Oulu Oulu Finland
| | - Anna‐Maiju Leinonen
- Research Unit of Medical Imaging, Physics and Technology University of Oulu Oulu Finland
- Infotech University of Oulu Oulu Finland
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation Oulu Finland
| | | | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health Jyväskylä Finland
| | - Katri Puukka
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry University of Oulu Oulu Finland
| | - Juha Auvinen
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Center for Life Course Health Research University of Oulu Oulu Finland
| | - Raija Korpelainen
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation Oulu Finland
- Center for Life Course Health Research University of Oulu Oulu Finland
| | - Timo Jämsä
- Research Unit of Medical Imaging, Physics and Technology University of Oulu Oulu Finland
- Infotech University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
- Diagnostic Radiology Oulu University Hospital Oulu Finland
| |
Collapse
|
28
|
Executive Stress Management: Physiological Load of Stress and Recovery in Executives on Workdays. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122847. [PMID: 30551638 PMCID: PMC6313794 DOI: 10.3390/ijerph15122847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/16/2018] [Accepted: 12/02/2018] [Indexed: 01/04/2023]
Abstract
Objective: The use of high-performance sports technology to describe the physiological load of stress and the quality of recovery in a population of executives during the workday. Methodology: Heart rate variability values were recorded during 48 h from which the relationship between stress/recovery quality (stress balance) was obtained for three differentiated time slots: work, after work, and night in a workday. Results: We observed a negative stress balance during the 24 h of measurement in the course of a workday, being negative at work and after work, and positive at night. The stress generated or maintained outside working hours correlates significantly with a lower quality of recovery during the 24 h workday. Conclusions: It is necessary to prioritize strategies that help improve stress management in executives through the improvement of tools and strategies that mainly promote greater relaxation outside working hours.
Collapse
|
29
|
Kiviniemi AM, Perkiömäki N, Auvinen J, Niemelä M, Tammelin T, Puukka K, Ruokonen A, Keinänen-Kiukaanniemi S, Tulppo MP, Järvelin MR, Jämsä T, Huikuri HV, Korpelainen R. Fitness, Fatness, Physical Activity, and Autonomic Function in Midlife. Med Sci Sports Exerc 2018; 49:2459-2468. [PMID: 29135784 DOI: 10.1249/mss.0000000000001387] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Although low cardiorespiratory fitness (CRF), physical inactivity, and obesity are associated with impaired autonomic function, they are also extensively interrelated. The present study aimed to assess the extent to which they contribute to autonomic function independently of each other. METHODS At the age of 46 yr, 1383 men and 1761 women without cardiorespiratory diseases and diabetes underwent assessments of vagally mediated heart rate (HR) variability (root mean square of successive differences in R-R interval (rMMSD)), peak HR during a submaximal step test (CRF), and 60-s HR recovery (HRR). Moderate-to-vigorous physical activity (MVPA; ≥3.5 METs, 2 wk) was measured by wrist-worn accelerometer and body fat percentage (Fat%) by bioimpedance. RESULTS In men, CRF and Fat% were significantly associated with higher rMSSD (standardized β = 0.31 and -0.16) and HRR (β = 0.19 and -0.18), whereas higher MVPA was linked with higher HRR (β = 0.13) when including CRF, MVPA, and Fat% in the initial regression. After adjustments for other lifestyle and cardiometabolic factors, CRF remained significantly associated with rMMSD (β = 0.24) and HRR (β = 0.14), as did MVPA with HRR (β = 0.11). In women, CRF was associated with rMSSD (β = 0.23) and HRR (β = 0.15), and MVPA (β = 0.17) and Fat% (β = -0.07) with HRR, when CRF, MVPA, and Fat% were adjusted for each other. After further adjustments, CRF remained a significant determinant of rMSSD (β = 0.20) and HRR (β = 0.13), as did MVPA with HRR (β = 0.15). The final models explained 23% and 21% of variation in rMSSD and HRR in men, and 10% and 12% in women, respectively. CONCLUSIONS CRF was a more important determinant of cardiac autonomic function than MVPA and body fat. Furthermore, MVPA but not body fat was independently associated with cardiac autonomic function in both men and women.
Collapse
Affiliation(s)
- Antti M Kiviniemi
- 1Research Unit of Internal Medicine, University of Oulu, Oulu, FINLAND; 2Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, FINLAND; 3Center for Life Course Health Research, University of Oulu, Oulu, FINLAND; 4Unit of Primary Care, University of Oulu, Oulu, FINLAND; 5Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FINLAND; 6LIKES Research Centre for Physical Activity and Health, Jyväskylä, FINLAND; 7NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, FINLAND; 8Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UNITED KINGDOM; 9Biocenter Oulu, University of Oulu, Oulu, FINLAND; 10Diagnostic Imaging, Oulu University Hospital, Oulu, FINLAND; and 11Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, FINLAND
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Assaf AM, Al-Abbassi R, Al-Binni M. Academic stress-induced changes in Th1- and Th2-cytokine response. Saudi Pharm J 2017; 25:1237-1247. [PMID: 29204074 PMCID: PMC5688230 DOI: 10.1016/j.jsps.2017.09.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 09/23/2017] [Indexed: 11/30/2022] Open
Abstract
Psychological stress stimulates physiological responses releasing catecholamines and corticoids, which act via corresponding receptors on immune cells, producing a shift in the cytokine balance. These responses are variable depending on the nature of stressors. The effect of the academic stress on the production of the Th1-cytokines (TNF-α, IFN-γ, IL-1β, IL-2, IL-6 and IL-8) and Th2-cytokines (IL-1ra, IL-4, IL-5 and IL-10) on 35 medical/health sciences students after completing their questionnaires was investigated. Blood samples were taken at three stages; baseline stage at the beginning, midterm and final academic examination stages. Plasma cortisol and cytokines were measured during the three stages. The last two stages were compared with the baseline non-stress period. Results of the stress induced during the final examination stage were the highest with a significant increase in cortisol release, IL-4, IL-5 and IL-1ra release with a shift in Th1:Th2 cytokines balance towards Th2. Whereby, the midterm stage did not show significant reduction in Th1-cytokines except for TNF-α, with an increase in IFN-γ level that was reduced in the third stage. Th2 cytokine, IL-1ra, had positive correlations with Th1 cytokines; IL-2 and IFN-γ in the second stage and IL-6 cytokine in the third stage. Cortisol was positively correlated with IL-8 in the last stage and heart rates had negative correlation with IL-10 in the first and last stages. Findings of this study indicate that exam stress down-regulates Th1 with a selective up-regulation of Th2-cytokines. In conclusion, Cortisol might have a role in suppressing the release of Th1- mediated cellular immune response which could increase the vulnerability among the students to infectious diseases.
Collapse
Affiliation(s)
- Areej M Assaf
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Reem Al-Abbassi
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| | - Maysaa Al-Binni
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
| |
Collapse
|