Reduced Neuromuscular Performance in Night Shift Orthopedic Nurses: New Insights From a Combined Electromyographic and Force Signals Approach

Effect of acute meal and long-term intake of a Mediterranean Diet providing different amounts of carbohydrates on physical performance and biomarkers in non-professional strength athletes

The study aims to evaluate the effect of an acute meal and long-term intake of Mediterranean Diet (MD) on different parameters such as strength, physical performance, body composition and blood markers in a group of non-professional athletes who practice a strength activity. Thirteen volunteers completed two 8-week dietary interventions in a randomised, cross-over design. Also an acute study was performed. Subjects received a MD High in carbohydrates, characterised by at least five portions of pasta/week and an average 55-60% of daily energy derived from carbohydrates, versus an MD reduced in carbohydrates, with less than two portions of pasta/week and an average of 40-45% of daily energy provided by carbohydrates. Mainly, data did not show significant differences for the parameters analysed, except for Elbow Flexor maximum voluntary contraction (p = .039). Results enlighten that increasing total carbohydrates intake, as typically in the MD, does not negatively affect physical performance, body composition and strength.

Sleep restriction reduces voluntary isometric quadriceps strength through reduced neuromuscular efficiency, not impaired contractile performance

Acute sleep restriction (SR) reduces strength through an unknown mechanism.

PURPOSE

To determine how SR affects quadriceps contractile function and recruitment.

METHODS

Eighteen healthy subjects (9 M, 9F, age 23.8 ± 2.8y) underwent isometric (maximal and submaximal), isokinetic (300-60°·s-1), and interpolated twitch (ITT) assessment of knee extensors following 3d of adequate sleep (SA; 7-9 h·night-1), 3d of SR (5 h·night-1), and 7d of washout (WO; 7-9 h·night-1).

RESULTS

Compared to SA (227.9 ± 76.6Nm) and WO (228.19 ± 62.9Nm), MVIC was lesser following SR (209.9 ± 73.9Nm; p = 0.006) and this effect was greater for males (- 9.8 v. - 4.8%). There was no significant effect of sleep or sleep x speed interaction on peak isokinetic torque. Peak twitch torque was greater in the potentiated state, but no significant effect of sleep was noted. Males displayed greater potentiation of peak twitch torque (12 v. 7.5%) and rate of torque development (16.7 v. 8.2%) than females but this was not affected by sleep condition. ITT-assessed voluntary activation did not vary among sleep conditions (SA: 81.8 ± 13.1% v. SR: 84.4 ± 12.6% v. WO 84.9 ± 12.6%; p = 0.093). SR induced a leftward shift in Torque-EMG relationship at high torque output in both sexes. Compared to SA, females displayed greater y-intercept and lesser slope with SR and WO and males displayed lesser y-intercept and greater slope with SR and WO.

CONCLUSIONS

Three nights of SR decreases voluntary isometric knee extensor strength, but not twitch contractile properties. Sex-specific differences in neuromuscular efficiency may explain the greater MVIC reduction in males following SR.

Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions

BACKGROUND

Health care requires a delicate equilibrium of nurse health safety and patient safety outcomes. Shift work can disrupt this balance, resulting in poor outcomes for staff and patients.

PROBLEM

Limited evidence exists on nurses' perceptions of shift work, fatigue countermeasures use, and interest in risk-mitigating interventions.

METHODS

An online survey of nurses was conducted. Survey questions assessed perceptions of shift work, use of fatigue countermeasures, and potential interventions.

RESULTS

The participants perceived multiple differences between day and night shifts when asked about their ability to complete both work- and life-oriented tasks. Use of fatigue countermeasures was more common while working night shift. Potential interventions included the use of blackout curtains, an on-site exercise facility, consulting a nutritionist, and block scheduling.

CONCLUSIONS

Health care leaders should consider nurses' perceptions and interests when incorporating initiatives to mitigate the negative effects of shift work.

Biomechanical Assessments of the Upper Limb for Determining Fatigue, Strain and Effort from the Laboratory to the Industrial Working Place: A Systematic Review

Recent human-centered developments in the industrial field (Industry 5.0) lead companies and stakeholders to ensure the wellbeing of their workers with assessments of upper limb performance in the workplace, with the aim of reducing work-related diseases and improving awareness of the physical status of workers, by assessing motor performance, fatigue, strain and effort. Such approaches are usually developed in laboratories and only at times they are translated to on-field applications; few studies summarized common practices for the assessments. Therefore, our aim is to review the current state-of-the-art approaches used for the assessment of fatigue, strain and effort in working scenarios and to analyze in detail the differences between studies that take place in the laboratory and in the workplace, in order to give insights on future trends and directions. A systematic review of the studies aimed at evaluating the motor performance, fatigue, strain and effort of the upper limb targeting working scenarios is presented. A total of 1375 articles were found in scientific databases and 288 were analyzed. About half of the scientific articles are focused on laboratory pilot studies investigating effort and fatigue in laboratories, while the other half are set in working places. Our results showed that assessing upper limb biomechanics is quite common in the field, but it is mostly performed with instrumental assessments in laboratory studies, while questionnaires and scales are preferred in working places. Future directions may be oriented towards multi-domain approaches able to exploit the potential of combined analyses, exploitation of instrumental approaches in workplace, targeting a wider range of people and implementing more structured trials to translate pilot studies to real practice.

Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects

Physical performance could be negatively affected by sleep deficiency and fatigue. The present study assesses the role of sleep quality, fatigue and motivation on cardiovascular performance (VO₂peak, Wmax, and HRmax) in a sample of active young subjects. The current study is a cross-sectional design. Ninety-six university students (males 54.2%; 21.5 ± 2.9 yrs) completed an incremental exercise test on a bicycle ergometer. Sleep, fatigue, and motivation were assessed with the Pittsburgh Sleep Quality Index and two visual analogue scales, respectively. Differences in VO₂peak, Wmax, HRmax, self-perceived fatigue and motivation were compared between good and bad sleepers and sleep duration >/<7.5 h, while regression analysis defined the predictors of VO₂peak, Wmax, and HRmax_. In the male sample, good and bad sleepers' differences were significant only for self-perceived fatigue (p = 0.04). The female sample showed no statistically significant differences between good and bad sleepers and different sleep durations. In the male sample, linear regression analysis showed a significant inverse correlation between Wmax and the PSQI score (-0.4, p = 0.004). The stepwise regression model indicated that sleep (β = -0.3, p = 0.02) was a significant predictor of VO₂peak in males accounting for 20% of the variance, whereas physical performance seems more affected by fatigue (β = -0.4, p = 0.03) in females. In conclusion, chronic inadequate and self-reported sleep quality seems to be one of the factors compromising cardiovascular performance in males.

Effects of Shift Work in a Sample of Italian Nurses: Analysis of Rest-Activity Circadian Rhythm

Shift work can lead to circadian desynchronization due to temporary misalignment between working hours and physiological and behavioral functioning, resulting in compromised health, insomnia, worsening of sleep quality, reduced ability to work during waking hours, and increased cardiovascular risk. We evaluated the effects of shift work on the rest-activity circadian rhythm (RAR) and health status of Italian orthopaedic nurses. The study population was 59 nurses: 44 worked the night shift and 15 worked the day shift. All carried out continuous 5-day actigraphic monitoring to assess RAR, including both the working and the rest period. The rhythmometric analysis showed that, during the working period, the night shift nurses had a significantly lower amplitude than the day shift nurses (p < 0.001), and the acrophase was significantly different between the two groups (p < 0.01). When we stratified the two groups by median body mass index (<25 kg/m² normal weight and ≥25 kg/m² overweight), during the working period, we noted a significantly lower amplitude for both the normal weight and the overweight nurses who worked the night shift (p < 0.01 and p < 0.001, normal weight and overweight respectively). The current findings suggest the need for further study of the relationship between activity levels and shift work.

Fatigue and the Female Nurse: A Narrative Review of the Current State of Research and Future Directions

Background: The female nurse exhibits a multitude of personal and environmental characteristics that renders this population especially prone to fatigue. The consequences of fatigue in nurses are widespread and impactful at the personal, organizational, and societal levels. These include high injury rates and burnout in the nurse and poor patient and organizational outcomes. Objective: This article discusses the implications of fatigue in female nurses, including the impacts of fatigue across multiple entities (e.g., worker, patient, organization). It also reviews the current state of the research, including recent work on nurse fatigue and work schedule characteristics, and key areas for future work that would help empirically establish approaches to counter the detrimental and widespread effects of fatigue. Method: A narrative literature review was conducted resulting from an analysis of the literature limited to peer-reviewed studies. Results: A confluence of factors combines to elevate the prevalence and risk of fatigue in the female nurse. Numerous measures have established that performance-based fatigue results from nursing work schedules in nurses. Data also demonstrate that fatigue accumulates across successive shifts. Recent evidence supports the use of objective fatigue measures, including psychomotor reaction time and muscle function-related variables. Current gaps in the literature are delineated in the text. Conclusions: Strategic and well-designed research studies, as well as recent technological advances in fatigue tracking tools have the potential to help workers, administrators, and organizations develop fatigue management programs that could reduce the heavy burdens of fatigue on a multitude of health, safety, and economical outcomes.

Differences in Daytime Activity Levels and Daytime Sleep Between Night and Day Duty: An Observational Study in Italian Orthopedic Nurses

Working nonstandard work schedules is often associated with increased sedentary behavior and risk of sleep disorders. Night shift workers are prone to accumulating sleep debt, which they recover by sleeping during the day. The effect on daytime activity levels is unknown. The present study aims to objectively assess whether daytime sleep could affect daytime activity levels of shift worker nurses, resulting in an accumulation of their activity debt differently between working and rest periods. The study population (N = 37; mean age 41.7 ± 9.1 years) was composed of orthopedic nurses working on a rotating schedule, including either a night shift (NS) or only day/afternoon shift (DS). Actigraph monitoring lasted both on the working and the rest period. For the NS nurses, the working period recorded higher daytime activity levels than the rest period, while daytime sleep during the working and rest periods was similar. Conversely, DS nurses showed higher daytime activity levels and shorter daytime sleep during the working period. NS nurses were less active than DS nurses during the working period, probably because NS tended to have a longer daytime sleep. During the rest period, daytime activity levels for both groups were decreased. For NS nurses, sleep recorded the better sleep parameters during the rest period, while sleep parameters did not show significant differences between the working and the rest periods in DS. During the working period, NS nurses slept worse than the DS nurses. Both groups tended to accumulate a debt in daytime activity levels during the rest period. While daytime sleep may be an excellent way to counteract sleep debt and increase sleep duration over 24 h period, on the other hand, it makes nurses less active.

The Relationship between Childhood Trauma, Eating Disorders, and Sleep Quality among Registered Hospital Nurses in South Korea

This cross-sectional study examined the relationship between childhood trauma, eating disorders, and sleep quality among registered hospital nurses in South Korea. Self-report questionnaires were answered by 279 nurses from six general hospitals. Factors affecting sleep quality were analyzed with a linear regression analysis. The factors that influenced sleep quality included age, alcohol consumption, chronic disease, BMI, and emotional abuse in childhood trauma. Hospital nurses need to increase their sleep health knowledge to maintain a healthy lifestyle while working as a nurse. Therefore, hospital and nursing managers should consider strategies to prevent and intervene in the sleep quality threats attributed to the adverse childhood experiences of hospital nurses.