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Konkol M, George EL, Scott PW, Imes CC. Examining Nurses' Perception of Shift Work and Evaluating Supportive Interventions. J Nurs Care Qual 2024; 39:10-17. [PMID: 36917831 DOI: 10.1097/ncq.0000000000000704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
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.
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Affiliation(s)
- Megan Konkol
- University of Pittsburgh Medical Center Presbyterian Shadyside, Pittsburgh, Pennsylvania (Ms Konkol and Dr George) and University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (Drs Scott and Imes)
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Mul Fedele ML, López Gabeiras MDP, Simonelli G, Diez JJ, Bellone GJ, Cagliani J, Larrateguy L, Eiguchi K, Golombek DA, Cardinali DP, Pérez-Chada D, Vigo DE. "Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach". BMC Public Health 2023; 23:2317. [PMID: 37996804 PMCID: PMC10666331 DOI: 10.1186/s12889-023-17130-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors. METHODS This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed. RESULTS Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00-1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16-3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10-2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1-4.3] vs 14.5% [95% CI, 5.9-23.0]; p = 0.01) in the actigraphic recording. CONCLUSIONS Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees' sleep and wellbeing, increasing in turn their own and patients' safety.
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Affiliation(s)
- Malena Lis Mul Fedele
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina
| | | | - Guido Simonelli
- Centre d'études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de L'Île-de-Montréal, Montreal, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Joaquín José Diez
- Pan-American Institute of Sleep Medicine and Chronobiology, Buenos Aires, Argentina
| | - Giannina Julieta Bellone
- Pontifical Catholic University of Argentina, Buenos Aires, Argentina
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
| | - Joaquín Cagliani
- Anesthesiology Department, North Shore University Hospital, Manhasset, NY, USA
| | - Luis Larrateguy
- Private Center of Respiratory Medicine of Paraná, Entre Ríos, Argentina
| | | | - Diego Andrés Golombek
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
- Interdisciplinary Time Lab, San Andrés University, Buenos Aires, Argentina
| | | | | | - Daniel Eduardo Vigo
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina.
- Katholieke Universiteit Leuven, Leuven, Belgium.
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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Imes CC, Tucker SJ, Trinkoff AM, Chasens ER, Weinstein SM, Dunbar-Jacob J, Patrician PA, Redeker NS, Baldwin CM. Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs. Nurs Adm Q 2023; 47:E38-E53. [PMID: 37643236 DOI: 10.1097/naq.0000000000000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.
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Affiliation(s)
- Christopher C Imes
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Imes, Chasens, and Dunbar-Jacob); College of Nursing, The Ohio State University, Columbus (Dr Tucker); School of Nursing, University of Maryland, Baltimore (Dr Trinkoff); School of Nursing, Purdue University Global, West Lafayette, Indiana (Ms Weinstein); School of Nursing, The University of Alabama at Birmingham (Dr Patrician); School of Nursing, University of Connecticut, Storrs (Dr Redeker); and Edson College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Baldwin)
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Hulsegge G, Coenen P, Gascon GM, Pahwa M, Greiner B, Bohane C, Wong IS, Liira J, Riera R, Pachito DV. Adapting shift work schedules for sleep quality, sleep duration, and sleepiness in shift workers. Cochrane Database Syst Rev 2023; 9:CD010639. [PMID: 37694838 PMCID: PMC10494487 DOI: 10.1002/14651858.cd010639.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Shift work is associated with insufficient sleep, which can compromise worker alertness with ultimate effects on occupational health and safety. Adapting shift work schedules may reduce adverse occupational outcomes. OBJECTIVES To assess the effects of shift schedule adaptation on sleep quality, sleep duration, and sleepiness among shift workers. SEARCH METHODS We searched CENTRAL, PubMed, Embase, and eight other databases on 13 December 2020, and again on 20 April 2022, applying no language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) and non-RCTs, including controlled before-after (CBA) trials, interrupted time series, and cross-over trials. Eligible trials evaluated any of the following shift schedule components. • Permanency of shifts • Regularity of shift changes • Direction of shift rotation • Speed of rotation • Shift duration • Timing of start of shifts • Distribution of shift schedule • Time off between shifts • Split shifts • Protected sleep • Worker participation We included studies that assessed sleep quality off-shift, sleep duration off-shift, or sleepiness during shifts. DATA COLLECTION AND ANALYSIS Two review authors independently screened the titles and abstracts of the records recovered by the search, read through the full-text articles of potentially eligible studies, and extracted data. We assessed the risk of bias of included studies using the Cochrane risk of bias tool, with specific additional domains for non-randomised and cluster-randomised studies. For all stages, we resolved any disagreements by consulting a third review author. We presented the results by study design and combined clinically homogeneous studies in meta-analyses using random-effects models. We assessed the certainty of the evidence with GRADE. MAIN RESULTS We included 11 studies with a total of 2125 participants. One study was conducted in a laboratory setting and was not considered for drawing conclusions on intervention effects. The included studies investigated different and often multiple changes to shift schedule, and were heterogeneous with respect to outcome measurement. Forward versus backward rotation Three CBA trials (561 participants) investigated the effects of forward rotation versus backward rotation. Only one CBA trial provided sufficient data for the quantitative analysis; it provided very low-certainty evidence that forward rotation compared with backward rotation did not affect sleep quality measured with the Basic Nordic Sleep Questionnaire (BNSQ; mean difference (MD) -0.20 points, 95% confidence interval (CI) -2.28 to 1.89; 62 participants) or sleep duration off-shift (MD -0.21 hours, 95% CI -3.29 to 2.88; 62 participants). However, there was also very low-certainty evidence that forward rotation reduced sleepiness during shifts measured with the BNSQ (MD -1.24 points, 95% CI -2.24 to -0.24; 62 participants). Faster versus slower rotation Two CBA trials and one non-randomised cross-over trial (341 participants) evaluated faster versus slower shift rotation. We were able to meta-analyse data from two studies. There was low-certainty evidence of no difference in sleep quality off-shift (standardised mean difference (SMD) -0.01, 95% CI -0.26 to 0.23) and very low-certainty evidence that faster shift rotation reduced sleep duration off-shift (SMD -0.26, 95% CI -0.51 to -0.01; 2 studies, 282 participants). The SMD for sleep duration translated to an MD of 0.38 hours' less sleep per day (95% CI -0.74 to -0.01). One study provided very low-certainty evidence that faster rotations decreased sleepiness during shifts measured with the BNSQ (MD -1.24 points, 95% CI -2.24 to -0.24; 62 participants). Limited shift duration (16 hours) versus unlimited shift duration Two RCTs (760 participants) evaluated 80-hour workweeks with maximum daily shift duration of 16 hours versus workweeks without any daily shift duration limits. There was low-certainty evidence that the 16-hour limit increased sleep duration off-shift (SMD 0.50, 95% CI 0.21 to 0.78; which translated to an MD of 0.73 hours' more sleep per day, 95% CI 0.30 to 1.13; 2 RCTs, 760 participants) and moderate-certainty evidence that the 16-hour limit reduced sleepiness during shifts, measured with the Karolinska Sleepiness Scale (SMD -0.29, 95% CI -0.44 to -0.14; which translated to an MD of 0.37 fewer points, 95% CI -0.55 to -0.17; 2 RCTs, 716 participants). Shorter versus longer shifts One RCT, one CBA trial, and one non-randomised cross-over trial (692 participants) evaluated shorter shift duration (eight to 10 hours) versus longer shift duration (two to three hours longer). There was very low-certainty evidence of no difference in sleep quality (SMD -0.23, 95% CI -0.61 to 0.15; which translated to an MD of 0.13 points lower on a scale of 1 to 5; 2 studies, 111 participants) or sleep duration off-shift (SMD 0.18, 95% CI -0.17 to 0.54; which translated to an MD of 0.26 hours' less sleep per day; 2 studies, 121 participants). The RCT and the non-randomised cross-over study found that shorter shifts reduced sleepiness during shifts, while the CBA study found no effect on sleepiness. More compressed versus more spread out shift schedules One RCT and one CBA trial (346 participants) evaluated more compressed versus more spread out shift schedules. The CBA trial provided very low-certainty evidence of no difference between the groups in sleep quality off-shift (MD 0.31 points, 95% CI -0.53 to 1.15) and sleep duration off-shift (MD 0.52 hours, 95% CI -0.52 to 1.56). AUTHORS' CONCLUSIONS Forward and faster rotation may reduce sleepiness during shifts, and may make no difference to sleep quality, but the evidence is very uncertain. Very low-certainty evidence indicated that sleep duration off-shift decreases with faster rotation. Low-certainty evidence indicated that on-duty workweeks with shift duration limited to 16 hours increases sleep duration, with moderate-certainty evidence for minimal reductions in sleepiness. Changes in shift duration and compression of workweeks had no effect on sleep or sleepiness, but the evidence was of very low-certainty. No evidence is available for other shift schedule changes. There is a need for more high-quality studies (preferably RCTs) for all shift schedule interventions to draw conclusions on the effects of shift schedule adaptations on sleep and sleepiness in shift workers.
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Affiliation(s)
- Gerben Hulsegge
- The Netherlands Organization for Applied Scientific Research, TNO, Leiden, Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gregg M Gascon
- OhioHealth, Columbus, Ohio, USA
- Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Manisha Pahwa
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Birgit Greiner
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Imelda S Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Juha Liira
- Department of Occupational Health, University of Turku, Turku, Finland
| | - Rachel Riera
- Cochrane Brazil Rio de Janeiro, Cochrane, Petrópolis, Brazil
- Center of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil
- Núcleo de Ensino e Pesquisa em Saúde Baseada em Evidência, Avaliação Tecnológica e Ensino em Saúde (NEP-Sbeats), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniela V Pachito
- Prossono Centro de Diagnóstico e Medicina do Sono, Ribeirão Preto, São Paulo, Brazil
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D King G, Pan E, Millin MG. Wilderness First Responder Medical Clearance - A Scoping Review with Recommendations. PREHOSP EMERG CARE 2023; 28:50-75. [PMID: 36595615 DOI: 10.1080/10903127.2022.2162650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Due to environmental extremes, as well as the nature of the work itself, wilderness first responders are at risk of incurring medical events in the line of duty. There currently do not exist standardized and scientifically supported methods to screen for a wilderness first responder's risk of incurring a medical event. METHODS We performed multiple scoping reviews using PubMed and CINAHL. The reviews covered six medical screening criteria based on previous recommendations from the National Fire Protection Association (NFPA) and the US Forest Service, and we grouped our reviews into two categories: articles that addressed objective screening criteria, and articles that addressed subjective findings with the first responder. RESULTS Of the objective criteria, our reviews identified 21 articles addressing the ability to screen for risk of incurring a medical event by evaluation of a first responder's heart rate, 12 by blood pressure assessment, and 56 by assessment of body temperature. Of the subjective criteria we identified 19 articles focused on self-assessment, 34 articles on the use of standardized tools to assess for fatigue and sleepiness, and two articles on assessment of a first responder's urine to determine level of dehydration. We also identified seven additional articles through a hand search. Overall, there were 151 articles identified in our scoping reviews. These articles were largely of low quality, consisting mostly of case series without comparison groups. CONCLUSION There is a dearth of high-quality research into the medical assessment of first responders. We recommend that this paper, and measures discussed within it, be used as a starting point in the development of an evidence-based assessment protocol for wilderness first responders. We also recommend the development of a national database of medical events incurred by wilderness first responders to facilitate higher-quality research of screening protocols in this community.
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Affiliation(s)
- Gregory D King
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Erik Pan
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Michael G Millin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
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Keller E, Hittle BM, Smith CR. Tiredness Takes Its Toll: An Integrative Review on Sleep and Occupational Outcomes for Long-Term Care Workers. J Gerontol Nurs 2023; 49:27-33. [PMID: 36594911 DOI: 10.3928/00989134-20221206-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Poor sleep quality and duration among health care professionals have negative impacts on worker safety, work readiness, and well-being. However, the consequences of impaired sleep among long-term care (LTC) workers remain understudied. The current integrative review sought to explore associations between sleep and occupational outcomes in LTC workers. Multiple database searches yielded 1,543 articles; nine articles met inclusion criteria. Results synthesized from included articles revealed sleep-associated occupational outcomes across three themes, Burnout/Fatigue, Mental and Physical Health, and Well-Being, which may affect performance measures and predict injuries/errors. Exploring outcomes of poor sleep quality and duration among LTC workers has highlighted the needs of this population and may inform future intervention development. LTC organizations should consider implementing strategies to better support the sleep quality of their workforce. In addition, further research is needed to explore how impaired sleep contributes to negative worker outcomes and patient care quality. [Journal of Gerontological Nursing, 49(1), 27-33.].
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Moreno CRC, Raad R, Gusmão WDP, Luz CS, Silva VM, Prestes RM, Saraiva SP, Lemos LC, Vasconcelos SP, Nehme PXSA, Louzada FM, Marqueze EC. Are We Ready to Implement Circadian Hygiene Interventions and Programs? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16772. [PMID: 36554651 PMCID: PMC9781949 DOI: 10.3390/ijerph192416772] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Circadian hygiene, a concept not to be confused with the notion of public or social hygiene, should be discussed among experts and society. Light-dark cycles and other possible synchronizers of the human circadian timing system affect ways of life, including sleeping, eating, working and physical activity. Some of these behaviors have also been investigated individually as synchronizers (e.g., eating times). Therefore, the knowledge held today about circadian rhythms, and their implications for health, allows future perspectives in this field to be mapped. The present article summarizes the latest knowledge on factors influencing circadian rhythms to discuss a perspective for the future of health promotion based on circadian hygiene. However, it is important to highlight that circadian hygiene is the product of an imbrication of individual and societal involvement. First, it is important to adopt practices and devise public health policies in line with circadian hygiene. Second, individual healthy habits require internal rhythms to be examined. Last, the research agenda on circadian hygiene can be developed on a public as well as individual level, raising the question as to how much society is willing to embrace this change.
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Affiliation(s)
- Claudia R. C. Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| | - Rose Raad
- Department of Technology of Architecture, School of Architecture and Urbanism, University of São Paulo, São Paulo 05508-080, Brazil
| | - Waléria D. P. Gusmão
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Cristina S. Luz
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Victor M. Silva
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Renilda M. Prestes
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Susy P. Saraiva
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Lucia C. Lemos
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Suleima P. Vasconcelos
- Public Health Graduate Program, Federal University of Acre, Rio Branco 69920-900, Brazil
| | - Patrícia X. S. A. Nehme
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Fernando M. Louzada
- Department of Physiology, Federal University of Paraná, Curitiba 81531-980, Brazil
| | - Elaine C. Marqueze
- Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, Santos 11015-001, Brazil
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Vymyslický P, Pavlů D, Pánek D. Effect of Mental Task on Sex Differences in Muscle Fatigability: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13621. [PMID: 36294199 PMCID: PMC9603675 DOI: 10.3390/ijerph192013621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Previous research demonstrated that there are observable sex differences in developing muscle fatigue when mental task during fatiguing activity is present; however, there is no available review on this matter. Therefore, this review aimed to summarize the findings of previous studies investigating the effect of mental task on muscle fatigue in men and women. To conduct the review, we utilized searches using the electronic databases Web of Science, PubMed, Scopus, and EBSCO Cinahl Ultimate. The studies included had no limited publication date and examined the effects of mental task on muscle fatigue in a healthy adult population of any age. The evaluation was performed using the following criteria: time to failure, or subjective scale in various modifications (visual analog scale-VAS, rate of perceived effort-RPE, rate of perceived fatigue-RPF, rate of perceived discomfort-RPD). A total of seven studies met the set criteria, which were subsequently analyzed. Heavy mental task (more demanding math tasks) can reduce the time to failure for both men and women, with the reduction being more pronounced for women than for men. For light mental task (simple math tasks), no reduction in time to failure was observed to a great extent. The mental task in any of the included studies did not affect the subjective perception of fatigue, effort, discomfort, or pain. Although the studies investigating the effect of mental task on sex differences in muscle fatigability are limited, based on our findings we can assume that in jobs requiring heavier mental task, women may be more prone to the faster development of muscle fatigue; thus, employers might consider paying attention to the possibility of adequate rest.
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Kowalski KL, Tierney BC, Christie AD. Mental fatigue does not substantially alter neuromuscular function in young, healthy males and females. Physiol Behav 2022; 253:113855. [PMID: 35609724 DOI: 10.1016/j.physbeh.2022.113855] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 10/18/2022]
Abstract
The neuromuscular mechanisms leading to impaired motor performance after mental fatigue (MF) are not well-understood and little is known of sex-specific differences in the neuromuscular response to MF. The purpose of this study was to investigate sex-related differences in the impact of MF on neuromuscular function. Thirty young, healthy adults (15F, 15M) performed the Psychomotor Vigilance Task (PVT) to induce MF and watched the Earth documentary (control) for 30 min in a random and counterbalanced order. Before and after each task, measurements of neuromuscular function during submaximal dorsiflexion contractions were obtained. At the end of the PVT, females and males had a slower reaction time (p<0.001, η2p=0.41) and reported higher fatigue (p<0.001, η2p=0.50), suggesting the PVT induced MF. After the PVT, females and males demonstrated a decline in force during 10% maximum voluntary contractions (MVC) (p=0.006, η2p=0.24), slower motor unit firing rate during 20% MVC (p=0.04, η2p=0.15) and a longer cortical silent period (p=0.01, η2p=0.22). However, similar changes were observed in the control condition suggesting MF is unlikely to substantially alter neuromuscular function during submaximal isometric contractions in young, healthy adults. Results also suggest neuromuscular function after a MF task is similar between young, healthy females and males. Further research is required to investigate populations with higher fatigue, such as multiple sclerosis or chronic fatigue syndrome.
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Affiliation(s)
- Katie L Kowalski
- School of Kinesiology, Western University, London, Ontario, Canada
| | | | - Anita D Christie
- School of Kinesiology, Western University, London, Ontario, Canada.
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Huyett P, Bhattacharyya N. The association between sleep disorders on employment and income among adults in the United States. J Clin Sleep Med 2022; 18:1967-1972. [PMID: 35499281 PMCID: PMC9340609 DOI: 10.5664/jcsm.10040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES To examine the association between sleep disorders, employment status, and income among US adults aged 18-64 years. METHODS The 2018-2019 Medical Expenditure Panel Survey medical conditions file was queried for adults aged 18-64 years with a diagnosis of a sleep disorder (International Classification of Diseases, 10th Revision, code G47.x) and linked to the household dataset. Comparisons in rates of wage, supplemental, and social security income as well as mean wage income were made between those with and without sleep disorders. Multivariate analyses, adjusting for demographics and comorbidities, were conducted. RESULTS A sleep disorder was diagnosed in 4.4% ± 0.2% of the study population (approximately 8.8 ± 0.4 million adults aged 18-64 years in the United States; mean age 46.9 years, 55.8% female). Adults with sleep disorders were less likely to have wage income from employment (adjusted odds ratio 0.5, 95% confidence interval 0.4-0.6, P < .001) and more likely to have Supplemental Security (1.8, 1.4-2.4, P < .001) and Social Security income (2.0, 1.6-2.4, P < .001) compared with those without sleep disorders. Among wage-earning adults, those with sleep disorders had $2,496 less mean annual wage income compared with those without a sleep disorder ($20,445 vs $22,941, P = .007), adjusting for demographics and comorbidities. CONCLUSIONS There are significantly higher indirect costs associated with sleep disorders. This study specifically demonstrates lower employment rates, lower wages, and higher welfare income utilization among those with sleep disorders despite using a very conservative estimate of sleep disorder prevalence. CITATION Huyett P, Bhattacharyya N. The association between sleep disorders, employment, and income among adults in the United States. J Clin Sleep Med. 2022;18(8):1967-1972.
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Affiliation(s)
- Phillip Huyett
- Division of Sleep Medicine and Surgery, Department of Otolaryngology- Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
| | - Neil Bhattacharyya
- Department of Otolaryngology- Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA
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