Measures Of Fatigue Research Articles

Health-Related Quality of Life in FKRP-Related Limb-Girdle Muscular Dystrophy R9.

Limb-girdle muscular dystrophy R9 (LGMDR9) is a chronic progressive hereditary muscle disease, related to the Fukutin Related Protein (FKRP) gene, that may cause major disabilities, cardiomyopathy, and ventilatory failure. Knowledge of how LGMDR9 affects health-related quality of life (HRQoL) is relevant in treatment and care. To investigate HRQoL in the Norwegian LGMDR9 population over 14 months and relation to fatigue and sleep quality. Participants (16+ years) of the Norwegian LGMDR9 cohort study completed two HRQoL measures, i.e., Individualized Neuromuscular Quality of Life questionnaire (INQoL) and the 36-item Short Form (SF-36) at baseline, 8, and 14 months and measures of fatigue and sleep quality at 9 months. HRQoL response rate was 84/90 (75 c.826 C > A homozygotes and nine c.826 C > A compound heterozygotes). Compared to Norwegian normative data, all SF-36 domain scores were impaired (p≤0.006) except mental health in males (p = 0.05) and pain scores. During 14 months, perceived muscle weakness and the INQoL index (disease burden) worsened in c.826 C > A homozygotes. Compound heterozygotes reported more dysphagia and physical difficulties than homozygotes and showed a tendency towards worsening in weakness over time but some improvement on the INQoL index. Homozygous females reported generally poorer HRQoL and a higher burden than males. The INQoL index was related to perceived muscle weakness and fatigue, and fatigue to myalgia and mental distress. The prevalence of fatigue and poor sleep was 40% and 49%, respectively. The 14-month follow-up period shows a worsening of perceived weakness and burden in c.826 C > A homozygotes, which can then be expected. The prevalence and impact of fatigue indicate a need for awareness and treatment of fatigue. Myalgia and mental distress are potential targets in the treatment of fatigue, which future studies need to establish. Sleep issues and gender-specific care needs also require attention in LGMDR9.

Effect of Split Condition and Driving Duration on Fatigue Based on Changes in Brain Wave Signals when Driving a Train Simulator

One of the causes of train accidents is driver fatigue. Train driver fatigue can be caused by sleep factors, known as split sleep. This study aims to assess the impact of split sleep on train driver fatigue. A total of 12 male participants were asked to drive a train simulator for 2.5 hours after facing two sleep conditions, namely split sleep and baseline. The split sleep condition required participants to sleep in two segments at 05.00-10.00 and 12.00-15.00, while the baseline condition was conducted in one segment at 21.00-05.00. Fatigue was measured based on changes in brain wave signals via electroencephalogram (EEG) and Swedish Occupational Fatigue Inventory (SOFI). Fatigue measurements with EEG were conducted at the 10-minute start and end of the simulation, while fatigue measurements with SOFI were conducted before and after the simulation. The results of this study showed a higher level of subjective fatigue in split sleep compared to the baseline. However, the EEG signal change data and other dimensions of SOFI dimensions showed no difference between the two sleep states. Another result was an increase in fatigue after simulation in all dimensions of the SOFI. Therefore, split sleep should not be applied by drivers because it can increase subjective fatigue. However, if split sleep needs to be applied, it is necessary to fulfill sleep quantity (7-9 hours) and improve sleep quality. In addition, the company also needs to ensure that the train driver are awake at least 15 minutes.

Measurement of compassion fatigue in animal health care professionals: a systematic review of available instruments and their content validity.

Compassion fatigue (CF) refers to emotional or physical exhaustion and emotional reactions resulting from prolonged exposure to traumatic events, commonly experienced by professionals in caregiving roles. CF is prevalent among healthcare professionals, including those in animal care. Several Patient-Reported Outcome Measures (PROMs) were developed to measure CF, but their psychometric validity was not reviewed systematically. This study aims to identify and review the content validity of CF PROMs used in animal health care professionals. Literature was searched in PubMed, PsycINFO, and EMBASE (1973-2023). We included studies conducted in animal health care professionals, using a PROM to measure CF, reporting at least one psychometric property of this PROM, and published as original research. For each identified PROM, additional literature search was conducted to identify PROM development and content validation studies. Three independent reviewers evaluated the content validity of each PROM using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and summarized the quality of evidence using a modified GRADE approach. The protocol was registered in PROSPERO (CRD42023433982) and results reported following PRISMA guidelines. Initially, 1709 studies were identified. After a double screening, 17 eligible studies were included. CF was measured using six different PROMs or their modified versions. Only one PROM specifically targeted animal health care professionals: the ProQOL-5 Veterinary Medicine Version. This and three other original CF PROMs were reviewed. For all PROMs, the quality of content validity was rated as insufficient due to deficiencies in the concept and items elicitation, inadequate target population representation, and inadequate details on cognitive interview procedures. The overall evidence quality was rated as low due to a limited number of PROM validation studies, poor methodological and reporting quality, and indirect result. There is a scarcity of studies examining CF within the target population, and the quality of evidence for content validity of the reviewed PROMs for CF measurement is currently low. CF definition and construct description in PROM development studies suffer from vagueness and seem inadequately reflected by the content of the reviewed PROMs. Further research with a robust methodology seems necessary to address the identified flows. Measurement of compassion fatigue in people working with animals: protocol for a systematic review. PROSPERO 2023 CRD42023433982. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023433982.

Mental Fatigue in Parkinson's Disease: Systematic Review and Evaluation of Self-Reported Fatigue Scales.

Fatigue is a common and debilitating symptom affecting a significant proportion of individuals with Parkinson's disease (PD), often overshadowing even motor symptoms in its impact on quality of life. The accurate definition and assessment of mental fatigue in PD is crucial for both clinical management and research, yet it remains a challenge due to the subjective nature of the symptom and the heterogeneity of assessment scales. This systematic review examined the existing measures of self-reported mental fatigue in PD by searching through PubMed, Embase, and Scopus databases using specific keywords from 2001 to 2024. Out of the 4182 articles found, 40 met the inclusion criteria, and 14 different scales were identified to measure self-reported fatigue in PD patients. However, most of these scales lack a consistent definition of fatigue, indicating a need for validated combinations of unidimensional and multidimensional scales to accurately assess mental fatigue in PD. The review found that it is best to use Fatigue Severity Inventory (FSI) and Multidimensional Fatigue Inventory (MdFI) to screen for severity of PD mental fatigue and Neuro-QoL Item Bank v1.0 (Neuro-QoL) to evaluate its impact on patients' lives. Furthermore, multidimensional scales Parkinson's Disease Questionnaire (PDQ) and Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) are frequently coupled with Fatigue Severity Scale (FSS), Parkinson's Fatigue Scale (PFS), and/or Modified Fatigue Impact Scale (MFIS) due to their short length and holistic coverage of variables in patients' quality of life. Combining fatigue scales can be used for screening and scoring methods. The review also recommends validating fatigue scales translation and combining them with biomarkers to improve the accuracy and effectiveness of fatigue assessment in clinical practice. Future research should analyze correlations between fatigue scales, expand language types, and explore the link between fatigue scales and the pathophysiological basis of PD. Our findings underscore the need for a standardized approach to the measurement of fatigue in PD and set the stage for future research to consolidate assessment tools that can reliably guide treatment strategies and improve patient outcomes.

Reliability and Validity of the Japanese Version of the Fatigue Assessment Scale.

Objective General fatigue is one of the most frequent chief complaints in primary care, and an accurate assessment of fatigue has a direct impact on a patient's quality of life and treatment decisions. The Fatigue Assessment Scale (FAS), a measure of general fatigue, is useful for assessing fatigue in diverse cultures and diseases. However, there has been no study showing the reliability and validity of the scale in the Japanese context. The present study assessed the reliability and validity of the Japanese version of the FAS. Methods This study was conducted on 649 patients with long COVID who had a high frequency of general fatigue. To test the structural validity of the FAS, the patients were randomly divided into two groups: one in which an exploratory factor analysis (EFA) was conducted and one in which a confirmatory factor analysis (CFA) was conducted. Cronbach's alpha was calculated to assess internal consistency reliability. Results As 58 patients had missing values, we analyzed the data of 591 patients. The EFA led to an FAS comprising two factors. The CFA showed an acceptable fit for this two-factor model. The internal consistency was found to be good (Cronbach's alpha =0.89). Conclusion This study verified the structural validity and internal consistency and reliability of the Japanese version of the FAS. The results indicate that the Japanese version of the FAS is useful for assessing general fatigue in patients with long COVID in Japan.

Investigating a clinically informed sleep disturbance threshold for physical and mental health among Gulf War Illness veterans.

This study (1) assessed sleep quality and health in Gulf War veterans (GWV) meeting the Gulf War Illness (GWI) criteria and (2) compared health associations for both those meeting a "clinically disturbed sleep" threshold, and those below, as determined by the Pittsburgh Sleep Quality Index (PSQI) cutoff for military populations (≥10) on measures of physical, mental, and cognitive health. Participant data consisted of questionnaires and assessments completed prior to group assignment in a clinical trial. The sample consisted of 147 GWV, where 81.0% were males, and the median age was 53.4 years. The mean (SD) PSQI global score was 12.34 (4.00) with 61% of the sample qualifying as clinically disturbed sleepers according to the cutoff (global PSQI ≥ 10). GWI veterans with PSQI scores ≥10 did not differ from others in age (p = 0.20), sex (p = 0.19), or years of education (p = 0.87), but showed worse GW-related symptomology on the Gulf War Kansas questionnaire (p < 0.01), and poorer mental health on the Veterans Rand-36 (p < 0.01). Disturbed sleep was associated with measures of pain, fatigue, and cognitive health. Our results suggest that a previously determined clinical threshold for clinically disturbed sleep is useful when examining the health status of the study population. Given that GWI is associated with elevated PSQI scores and a high frequency of disturbed sleep, cutoffs determining sleep health should be sensitive to population exposures and health history to improve interpretability.

A Validation Study of the Mindfulness-Based Interventions Teaching Assessment Criteria for Assessing Mindfulness-Based Intervention Teacher Skill: Inter-Rater Reliability and Predictive Validity.

Prior data suggests the Mindfulness-Based Interventions: (MBI) Teaching Assessment Criteria (MBI:TAC) has good inter-rater reliability, but many raters knew teacher experience level. We sought to further evaluate the MBI-TAC's inter-rater reliability and obtain preliminary data on predictive validity. We videorecorded 21 MBSR teachers from academic and community settings. We trained 19 experienced MBI teachers in using the MBI:TAC. MBSR teachers were rated by three assessors; teachers and their assessors did not know one another. To assess predictive validity, MBSR students in courses taught by 18 of the MBSR teachers were invited to complete PROMIS-29 measures before the MBSR course, at the end of the course (month 2), and month 4. Intraclass correlation coefficients (ICCs) representing a single rater ranged from 0.33 to 0.56 on the 6 MBI:TAC domains. Using an average of two raters, ICC estimates ranged from 0.48 to 0.71 and ICCs generalizing to an average of three raters ranged from 0.6 to 0.8. Among n = 152 participating MBSR students, we found improvements from baseline to 2months and 4months in PROMIS measures of Anxiety, Depression, Fatigue, Sleep, and Social Role function (range in improvement 2.3 to 6.3, P < 0.0001 for all comparisons except Social Role at 2months, P = 0.007). Higher MBI:TAC ratings were associated with greater improvements in anxiety among MBSR students from baseline to 2months, with a -0.31 lower participant anxiety score per 1 unit increase in MBI:TAC composite teaching rating (95% CI -0.58, -0.05, P = 0.019), but we did not find statistically significant relationships with improvements in other PROMIS-29 domains. ICCs indicated good reliability using an average of three ratings, but inter-rater reliability was only fair using a single rater. We found initial validation that higher MBI:TAC ratings predicted greater improvements in anxiety symptoms in MBSR participants.

Treating insomnia in people who are incarcerated: a feasibility study of a multicomponent treatment pathway.

Around 60% of people who are incarcerated have insomnia; 6-10 times more prevalent than the general population. Yet, there is no standardized, evidence-based approach to insomnia treatment in prison. We assessed the feasibility of a treatment pathway for insomnia in a high-secure prison to inform a future randomized controlled trial (RCT) and initial efficacy data for sleep and mental health outcomes. We used a within-participants pre-post design. The stepped-care pathway included: self-management with peer support, environmental aids, and cognitive behavioral therapy for insomnia (CBTi). Assessment measures for insomnia, well-being, mood, anxiety, suicidality, overall health, sleepiness, fatigue, and cognitive functioning were administered at baseline and pathway exit. Feasibility criteria included eligibility to participate, CBTi uptake, and assessment completion. Forty-two adult males who are incarcerated were approached of which 95.2% were eligible. Of those deemed eligible, most participated (36/40, 90.0%). Most who completed baseline completed post-assessments (28/36, 77.8%) and of these, most showed improvements in their subjective sleep (27/28, 96.4%). Large reductions were found from pre- to posttreatment in insomnia severity (d = -1.81, 95% CI: 8.3 to 12.9) and 57.0% reported no clinically significant insomnia symptoms at post-assessment. There was no overall change in actigraphy-measured sleep. Large treatment benefits were found for depression, anxiety, well-being, and cognitive functioning, with a medium benefit on suicidal ideation. The treatment pathway for insomnia in prison was feasible and may be an effective treatment for insomnia in people who are incarcerated, with additional promising benefits for mental health. A pragmatic RCT across different prison populations is warranted. This paper is part of the Sleep and Circadian Health in the Justice System Collection.

Subjective fatigue in individuals with anxiety and mood disorders correlates with specific traits of obsessive-compulsive personality disorder

Fatigue is a common debilitating symptom in individuals with anxiety and mood disorders, also known as common mental disorders (CMD). Aspects of fatigue are seen to be independently associated with the presence of obsessive-compulsive personality disorder (OCPD) in individuals with CMD. However, the relationship between different traits of OCPD and fatigue is still under-researched. Therefore, the aim of our study was to examine the associations between individual OCPD traits and fatigue in those with CMD. This cross-sectional study investigated 203 individuals (76.8% female, mean age 40.8 ± 11.8) attending a stress-related disorders day care unit. Participants were evaluated for OCPD traits by using the Compulsive Personality Assessment Scale and completed the Multidimensional Fatigue Inventory-20. Out of 203 participants, 42 (20.7%) fulfilled operational criteria for OCPD (73.8% female). Participants with OCPD had greater reduced motivation, mental and physical fatigue scores than those without OCPD (13.2 ± 3.6 vs. 14.5 ± 3.6, p = 0.035; 14.4 ± 4.3 vs. 16.1 ± 3.5, p = 0.023; 13.5 ± 4.3 vs. 15.0 ± 4.3, p = 0.049, respectively). In individuals with OCPD, higher levels of rigidity correlated with physical fatigue (ρ = 0.463, p = 0.002) and reduced activity (ρ = 0.363, p = 0.018), while preoccupation with details was associated with reduced motivation (ρ = 0.437, p = 0.004). In conclusion, in individuals with CMD and comorbid OCPD, several OCPD traits were significantly related to subjective measures of fatigue. As traits are considered stable features, there results suggest they might play a causative role in generating subjective fatigue in CMD.

The evaluation of cEEGrids for fatigue detection in aviation.

Operator fatigue poses a major concern in safety-critical industries such as aviation, potentially increasing the chances of errors and accidents. To better understand this risk, there is a need for noninvasive objective measures of fatigue. This study aimed to evaluate the performance of cEEGrids, a type of ear-EEG, for fatigue detection by analyzing the alpha and theta power before and after sleep restriction in four sessions on two separate days, employing a within-participants design. Results were compared to traditional, highly validated methods: the Karolinska Sleepiness Scale (KSS) and Psychomotor Vigilance Task (PVT). After sleep restriction and an office workday, 12 participants showed increased alpha band power in multiple electrode channels, but no channels correlated with KSS scores and PVT response speed. These findings indicate that cEEGrids can detect differences in alpha power following mild sleep loss. However, it should be noted that this capability was limited to specific channels, and no difference in theta power was observed. The study shows the potential and limitations of ear-EEG for fatigue detection as a less invasive alternative to cap-EEG. Further design and electrode configuration adjustments are necessary before ear-EEG can be implemented for fatigue detection in the field.

A scoping review of olfactory interventions for fatigue relief: addressing occupational health hazards.

Fatigue poses risks to occupational health and safety, affecting individuals' work efficiency, physical health, and social security, as well as human wellbeing and quality of life. Olfactory interventions, due to their low interference, are considered promising strategies for mitigating fatigue and reducing occupational health hazards. The objective of this review is to bridge the current gaps in the literature by conducting a scoping review of olfactory interventions on human alertness. It aims to explore their application in various occupational settings and to provide comprehensive and practical guidance for the practical application of olfactory interventions in mitigating fatigue and reducing occupational risks. The literature research was conducted in English using electronic databases such as Web of Science. Keywords related to scent and fatigue and the review followed PRISMA Extension for Scoping Reviews and PICO framework. 28 studies were included in this work. Participant characteristics, fatigue measurement methods, and scent intervention methods, such as types of scents, intervention strategies, and scent presentation systems, are thoroughly investigated and discussed. Additionally, the study places a specific emphasis on the applications and research within the field of scent interventions for fatigue driving. Olfactory interventions have been applied to populations in various occupational fields, demonstrating beneficial effects on both physiological and psychological fatigue. Olfactory intervention is effective and promising for enhancing alertness and improving the occupational environment. To provide detailed and practical guidance for the actual application of olfactory intervention in fatigue relief and reducing occupational health and safety hazards, further research into the potential mechanisms, applications, and efficacy assessment systems of fatigue-related olfactory interventions is necessary.

Muscle fatigue tracking during dynamic elbow flexion-extension movements with a varying hand load

Muscle fatigue monitoring, an important element in a fatigue risk management process, can help optimize work intensity and reduce risks for musculoskeletal injuries. An experiment was conducted to determine whether myoelectric manifestations of muscle fatigue can reflect the pace of fatigue development associated with varying load intensity. Twenty male participants performed elbow flexion-extension movements with alternating hand loads (2 kg vs. 1 kg) for 16 min. The pace of fatigue in the biceps brachii in response to load variation was quantified by electromyographic (EMG) fatigue measures collected during the dynamic elbow flexion-extension movements and periodic submaximal isometric elbow flexion trials. The isometric and dynamic EMG measures, except for the amplitude of dynamic EMG, indicated fatigue development during the 2-kg isotonic movements and partial recovery with the 1 kg load. Study results suggest the potential of EMG measures for fatigue monitoring during dynamic work tasks with varying load intensity.

The measurement of fatigue in clinicians within hospital settings: A systematic review of measurement properties.

Medical staff fatigue leads to accidents and mistakes and puts patient safety at risk. A measure of fatigue in the workplace may help to quantify, predict, and manage fatigue. This review aimed to evaluate instruments used to measure fatigue in medical staff within hospitals. A systematic review following the JBI methodology was undertaken. A search for articles was conducted in 2021. Included articles (all validation studies) were assessed for methodological quality using the COSMIN checklist. Measurement property data was evaluated for Quality of Evidence using GRADE methodology. Ten studies representing five instruments were reviewed: Occupational Fatigue Exertion and Recovery scale (now superseded); Occupational Fatigue Exertion and Recovery scale (15-item); Multidimensional Fatigue Inventory; Need for Recovery Scale; and the Swedish Occupational Fatigue Inventory. Four instruments show promise for measuring fatigue in hospital medical staff, however, there is limited certainty in the measure property estimates. The Quality of Evidence for measurement properties for all instruments is insufficient. Further validation studies following the COSMIN standards are needed before recommendations for use can be made.

Fatigue analysis and design of a motorcycle online driver measurement tool using real-time sensors

Work fatigue is an important aspect and is very influential in determining the level of accidents, especially motorbike accidents. According to WHO, almost 30% of all deaths due to road accidents involve two- and three-wheel­ed motorized vehicles, such as motorbikes, mopeds, scooters and electric bicycles (e-bikes), and the number continues to increase. Motor­cycles dominate road deaths in many low- and middle-income countries, where nine out of ten traffic accident deaths occur among motorcyclists, as in Indonesia. However, until now, in Indonesia, there has been no monitor­ing system capable of identifying fatigue in motorbike drivers in the transportation sector. This research aims to determine fatigue patterns based on driver working hours and create a sensor system to monitor fatigue measurements in real-time to reduce the number of accidents. The research began with processing questionnaire data with Pearson correlation, which showed a close relationship between driver fatigue and driving time and a close relationship between fatigue and increased heart rate and sweating levels. From calibration tests with an error of 3% and direct measurements of working conditions, it was found that two-wheeled vehicle driver fatigue occurs after 2-3 hours of work. With a measurement system using the Box Whiskers analysis method, respondents' working conditions can also be de­ter­mined, which are divided into 4 zones, namely zone 1 (initial condition or good condition), zone 2 a declining condition, zone 3 a tired condition and zone 4 is a resting condition. Hopefully, this research will identify fati­gue zones correctly and reduce the number of accidents because it can iden­tify tired drivers so they do not have to force themselves to continue working and driving their motorbikes. As a conclusion from this research, a measure­ment system using two sensors, such as ECG and GSR can identify work fatigue zones well and is expected to reduce the number of accidents due to work fatigue.

Quantifying the effectiveness of a passive trunk-support exosuit at reducing erector spinae muscle fatigue during a quasi-static posture maintenance task

The objective of this study was to explore the effectiveness of a passive back-support exosuit at reducing low back muscle fatigue during an 18-minute trunk posture maintenance task. On two separate days sixteen participants performed an 18-minute trunk posture profile that reflected trunk flexion postures observed during a challenging vascular surgery procedure. On one day they performed the procedure with the support of the exosuit, on the other day without. Test contractions were performed every three minutes to capture the time-dependent electromyographic activity of the bilateral erector spinae muscles. Time domain (amplitude) and frequency domain (median frequency) measures of erector spinae muscle fatigue were assessed. Results revealed that the exosuit significantly reduced the measures of erector spinae muscle fatigue in terms of both amplitude (6.1%) and median frequency (5.3%), demonstrating a fatigue reduction benefit of the exosuit in a realistic surgical posture maintenance task.

Efficient assessment of brain fog and fatigue: Development of the Fatigue and Altered Cognition Scale (FACs)

Debilitating symptoms of fatigue and accompanying “brain fog” are observed among patients with various chronic health conditions. Unfortunately, an efficient and psychometrically sound instrument to assess these co-occurring symptoms is unavailable. Here, we report the development and initial psychometric properties of the Fatigue and Altered Cognition Scale (the FACs), a measure of self-reported central fatigue and brain fog. Traumatic brain injury (TBI) was chosen to model and develop the FACs due to research team expertise and established links between TBI and the symptom complex. Potential items were generated by researchers and clinicians with experience treating these symptoms, drawing from relevant literature and review of patient responses to measures from past and current TBI studies. The 20 candidate items for the FACs—ten each to assess altered cognition (i.e., brain fog) and central fatigue–were formatted on an electronic visual analogue response scale (eVAS) via an online survey. Demographic information and history of TBI were obtained. A total of 519 participants consented and provided usable data (average age = 40.23 years; 73% female), 204 of whom self-reported a history of TBI (75% reported mild TBI). Internal consistency and reliability values were calculated. Confirmatory factor analysis (CFA) examined the presumed two-factor structure of the FACs and a one-factor solution for comparison. A measurement invariance test of the two latent constructs (altered cognition, fatigue) among participants with and without TBI was conducted. All items demonstrated normal distribution. Cronbach’s alpha coefficients indicated good internal consistency for both factors (α’s = .95). Omega reliability values were favorable (α’s = .95). CFA supported the presumed two-factor model and item loadings which outperformed the one-factor model. Measurement invariance found the two-factor structure was consistent between the two groups. Implications of these findings, study limitations, and potential use of the FACs in clinical research and practice are discussed.

Biological Aspects of Fatigue: A Narrative Review

Introduction: Fatigue is among the most common symptoms in Primary Health-Care and it can be caused by several factors. It is prevailing in the general population and the aggravated condition of fatigue is named Chronic Fatigue Syndrome. This syndrome has a negative impact on the individual’s quality of life and it can lead to functional incapacity. Despite decades of research, Chronic Fatigue Syndrome remains a mysterious disease that needs to be highlighted.&#x0D; Objective: To describe biological aspects of fatigue regarding its definition, biological origin, the main etiologies of Chronic Fatigue Syndrome and its relation with the circadian cycle, as well as the main methods for measurement, diagnosis, complementary tests and treatment.&#x0D; Method: It is a narrative review, performed from 2019 to 2022, using the PubMed/MEDLINE database and a manual search for studies referred in selected articles from authors with notorious knowledge and specialized groups in the area. It was performed a combination of several search terms added to Fatigue and Fatigue Syndrome, Chronic through Boolean Operators AND, OR and NOT. Scientific articles that involved studies in humans were included in the research. The articles were available in full version for free, in Portuguese, English and Spanish, with no restriction related to the period of publication. The articles were selected by reading of titles and abstracts. The ones that did not fit the aim of this study were excluded. The remaining articles were read in full and selected according to their relevance and contribution to the topic.&#x0D; Results: Fatigue can be considered peripheral, physical, mental, intellectual and emotional, but there is no consensus regarding its definition. Its main biological origin is related to cytokines, however, fatigue’s measurement is still mostly conducted by self-reports of affected patients. There is no objective marker consistently associated to fatigue. Regarding Chronic Fatigue Syndrome, its etiology is still not very well-established, but it was observed that genetic, epigenetic, immunological, infectious, psychosocial, psychiatric and neurological factors can contribute to it. Since fatigue is multidimensional and multifactorial, it is important to associate multiple instruments for its investigation. A potent strategy for the measurement of fatigue is using instruments adapted to the realities, extensively tested in different populations considering socio-economic-cultural aspects. These instruments assess the cognitive function in order to measure several variables and when associated they can increase the accuracy of the investigative instruments. The treatments available include cognitive-behavioral therapy, gradual exercises, immunological treatment, corticosteroids and antidepressants, but they do not guarantee a full remission of symptoms in an isolated way. &#x0D; Conclusion: Even though there are well-defined biological factors it still lacks a precise marker for the measurement of fatigue. Considering fatigue as multidimensional and multifactorial, it is important to associate several instruments for its investigation. The treatments available have shown effectiveness, but they do not guarantee a full remission of symptoms in an isolated way. For this reason, it is necessary a bio-psycho-social care for these patients.

Impact of endocrine dysregulation on disability and non-motor symptoms in pediatric onset multiple sclerosis.

Pediatric onset multiple sclerosis (POMS) commonly occurs at the time of various endocrine changes. Evaluation of the impact of endocrine status on disease severity in POMS has not been previously explored. This study sought to evaluate if sex and stress hormones in children with POMS impact motor and non-motor diseases severity. A single-center case control study was performed. Individuals with POMS were compared to individuals without neurologic disease. Each individual had three blood draws assessing stress and sex hormones between 07:00 and 09:00. Measures of fatigue (Epworth sleepiness scale), depression (PHQ-9), and quality of life (PedsQL) assessed at each visit. Forty individuals with POMS and 40 controls were enrolled. Individuals with POMS had lower free testosterone (p = 0.003), cortisol (p < 0.001), and ACTH (p < 0.001) and had higher progesterone (p = 0.025) levels than controls. Relapses and EDSS were not impacted by endocrine variables. The POMS cohort had a significantly higher Epworth score (p < 0.001), PHQ-9 score (p < 0.001), and lower PQL score (p < 0.001) than controls. Non-motor measures were not associated with endocrine status. Free testosterone, cortisol, ACTH, and progesterone were abnormal in children with POMS although there was no association between endocrine status and markers of disease severity or non-motor symptoms of MS.

Associations Between Patient-Reported Outcome Measures of Physical and Psychological Functioning and Willingness to Share Social Media Data for Research Among Adolescents With a Chronic Rheumatic Disease: Cross-Sectional Survey.

Social media data may augment understanding of the disease and treatment experiences and quality of life of youth with chronic medical conditions. Little is known about the willingness to share social media data for health research among youth with chronic medical conditions and the differences in health status between sharing and nonsharing youth with chronic medical conditions. We aimed to evaluate the associations between patient-reported measures of disease symptoms and functioning and the willingness to share social media data. Between February 2018 and August 2019, during routine clinic visits, survey data about social media use and the willingness to share social media data (dependent variable) were collected from adolescents in a national rheumatic disease registry. Survey data were analyzed with patient-reported measures of disease symptoms and functioning and a clinical measure of disease activity, which were collected through a parent study. We used descriptive statistics and multivariate logistic regression to compare patient-reported outcomes between youth with chronic medical conditions who opted to share social media data and those who did not opt to share such data. Among 112 youths, (age: mean 16.1, SD 1.6 y; female: n=72, 64.3%), 83 (74.1%) agreed to share social media data. Female participants were more likely to share (P=.04). In all, 49 (43.8%) and 28 (25%) participants viewed and posted about rheumatic disease, respectively. Compared to nonsharers, sharers reported lower mobility (T-score: mean 49.0, SD 9.4 vs mean 53.9, SD 8.9; P=.02) and more pain interference (T-score: mean 45.7, SD 8.8 vs mean 40.4, SD 8.0; P=.005), fatigue (T-score: mean 49.1, SD 11.0 vs mean 39.7, SD 9.7; P<.001), depression (T-score: mean 48.1, SD 8.9 vs mean 42.2, SD 8.4; P=.003), and anxiety (T-score: mean 45.2, SD 9.3 vs mean 38.5, SD 7.0; P<.001). In regression analyses adjusted for age, sex, study site, and Physician Global Assessment score, each 1-unit increase in symptoms was associated with greater odds of willingness to share social media data, for measures of pain interference (Adjusted Odds Ratio [AOR] 1.07, 95% CI 1.001-1.14), fatigue (AOR 1.08, 95% CI 1.03-1.13), depression (AOR 1.07, 95% CI 1.01-1.13), and anxiety (AOR 1.10, 95% CI 1.03-1.18). High percentages of youth with rheumatic diseases used and were willing to share their social media data for research. Sharers reported worse symptoms and functioning compared to those of nonsharers. Social media may offer a potent information source and engagement pathway for youth with rheumatic diseases, but differences between sharing and nonsharing youth merit consideration when designing studies and evaluating social media-derived findings.

Abstract A106: Examining the role of social connection on allostatic load and quality of life in African American prostate cancer survivors

Abstract Background. Racial disparities in prostate cancer (PC) survivorship persist despite clinical advancements. Chronic stress may contribute to these disparities, with allostatic load (AL) considered a measure of such stress. Associations between AL and survivorship outcomes such as quality of life (QoL) are documented, yet less is known about factors influencing these relationships. Social connections (SC) (e.g., social networks, social support) are associated with improved QoL in survivors, yet which aspects of SC and which pathways linking SC to QoL remain unclear. Additionally, little is known about the SC of African American PC survivors (AAPCS) and how these relate to QOL, stress, and AL. This study explores the relationship between SC, stress (perceived and AL) and QOL in in 48 AAPCS enrolled in Men Moving Forward, a randomized trial to improve body composition through lifestyle change. Methods. At baseline, participants completed surveys including: the Cohen Social Network Index assessing 3 aspects of social networks: network size (# of ties with regular contact), diversity (# of roles with regular contact) and embeddedness (# of domains with 4 or more regular contacts); Patient-Reported Outcomes Measurement Information System (PROMIS) measures of social support (companionship, emotional and informational support); the perceived stress scale, and PROMIS measures of physical function, anxiety, depression, fatigue, sleep disturbance, social function, and pain intensity. The latter were used to generate summative physical (PQOL) and mental (MQOL) health standardized T-scores (U.S. population mean=50, SD=10). AL scores used 15 criterion reflecting neuroendocrine, cardiovascular, immune, and metabolic systems. Each criterion was assigned a score of 0 or 1: 1 if in the high-risk range based on clinical guidelines. An index score was generated by summing high-risk indicators. Pearson correlations were used to explore the relationship between aspects of SC and QOL and SC and stress variables. Results. The average AL score was 5.8 (SD ± 2.3) of a maximum 15. No significant correlations were found between any SC domains and AL. However, negative associations were identified between network size (r=-.313, p=0.030), emotional support (r=-.319, p = 0.027), companionship (r=-.313, p=0.030) and perceived stress. A positive association was found between loneliness and perceived stress (r=.521, p&amp;lt;0.000). MQOL was positively related to network size (r=.364, p=0.011), emotional support (r=.366, p=0.011), and companionship (r=.288, p=0.047). Loneliness was negatively associated with MQOL (r=-.626, p&amp;lt;0.000) and PQOL (r=-.407, p=0.006). Conclusions. These findings suggest SC has a positive impact on survivorship in AAPCS, and that structural and functional aspects of SC may be involved. Currently, limited resources are available for PC survivors, and even fewer are tailored for AAPCS. Future efforts to improve survivorship for AAPCS should consider assessing social networks and access to social support when initiating survivorship care. Citation Format: Iwalola A. Awoyinka, Kathryn Flynn, Deepak Kilari, Kathryn Bylow, Jennifer Knight, Jamila Kwarteng, Anjishnu Banerjee, Kirsten M. Beyer, Staci Young, Patricia Sheean, Paula Papanek, Melinda Stolley. Examining the role of social connection on allostatic load and quality of life in African American prostate cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A106.