Fatigue Questionnaire Research Articles

Establishing the Validity of Using the COPD Assessment Test to Screen for Fatigue in People With Chronic Obstructive Pulmonary Disease Referred to Pulmonary Rehabilitation.

Fatigue is the second most prevalent symptom in chronic obstructive pulmonary disease (COPD), yet it is often undetected in pulmonary rehabilitation. The aim of this study was to assess the validity of using a health status questionnaire (COPD Assessment Test [CAT] and CAT-energy score) to detect fatigue in people with COPD referred to a pulmonary rehabilitation program. This study was a retrospective audit of people with COPD referred to pulmonary rehabilitation. The validity of the CAT-total score and CAT-energy score for detecting fatigue was analyzed compared to a validated fatigue questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Cut-off values defining fatigue included a CAT-total score ≥ 10, a CAT-energy score ≥ 2, and a FACIT-F score ≤ 43. Data were analyzed using 2 × 2 tables from which accuracy, sensitivity, specificity, and likelihood ratios were calculated. Data from 97 participants with COPD (age in years mean [SD] = 72 [9]; FEV1% predicted mean [SD] = 46% [18]) were used. The FACIT-F score ≤ 43 classified 84 participants (87%) as fatigued. A CAT-total score ≥ 10 yielded an accuracy of 0.87, sensitivity of 0.95, specificity of 0.31, and positive and negative likelihood ratios of 1.38 and 0.15, respectively. A CAT-energy score ≥ 2 yielded an accuracy of 0.85, sensitivity of 0.93, a specificity of 0.31, and positive and negative likelihood ratios of 1.34 and 0.23, respectively. The CAT-total score is an accurate and sensitive measure for fatigue, and the CAT could be an appropriate tool to screen for fatigue in people with COPD referred to pulmonary rehabilitation. Use of the CAT as a screening tool for fatigue has the potential to improve clinician awareness of fatigue, simplify the pulmonary rehabilitation assessment process by reducing survey burden, and inform fatigue management, which may subsequently reduce the symptomatic burden of fatigue in people with COPD.

A Comprehensive Evaluation of Multiple Sclerosis-Related Fatigue with a Special Focus on Fatigability.

Fatigue is the most common and disabling symptom in multiple sclerosis (MS), being reported by 55% to 78% of patients with MS (PwMS). Etiology of MS-related fatigue remains poorly understood, but an increased neuromuscular fatigability (i.e., greater loss of torque during exercise) could contribute to this phenomenon. This study aimed to characterize the correlates of MS-related fatigue in PwMS using a comprehensive group of physiological and psychosocial measures, with a particular focus on fatigability. Forty-two relapsing-remitting PwMS and 20 healthy subjects were recruited. PwMS were assigned in two groups (high (HF) and low (LF) fatigue) based on two fatigue questionnaires (Fatigue Severity Scale and Modified Fatigue Impact Scale). The main outcomes of this study are derived from incremental cycling completed to task failure (i.e., inability to pedal around 60 rpm). Maximal voluntary contraction (MVC), rating of perceived exertion, and central and peripheral parameters measured using transcranial magnetic and peripheral nerve stimulation were assessed in the knee extensor muscles before, during, and after the fatiguing task. Other potential correlates of fatigue were also tested. MVC torque decreased to a greater extent for the HF group than LF group after the third common stage of the incremental fatiguing exercise (-15.7% ± 6.6% vs -5.9% ± 13.0%, P < 0.05), and this occurred concurrently with a higher rating of perceived exertion for HF (11.8 ± 2.5 vs 9.3 ± 2.6, P < 0.05). Subjective parameters (depression, quality of life) were worse for HF compared with LF and healthy subjects ( P < 0.001). Moreover, MVC torque loss at the final common stage and maximal heart rate explained 29% of the variance of the Modified Fatigue Impact Scale. These results provide novel insight into the relationship between MS-related fatigue and fatigability among PwMS. The HF group exhibited greater performance fatigability, likely contributing to a higher perceived exertion than the LF group when measured during a dynamic task.

Development of an asthenopia survey questionnaire for general surveys

Objective: To design a visual fatigue questionnaire that can be used for population surveys. Methods: This was a cross-sectional study that involved three stages of subjects' recruitment. In the first stage, by convenience sampling, 150 individuals who complained of visual fatigue were selected at public places in Wenzhou City in May 2016. The 19-Item Asthenopia Survey Questionnaire (ASQ-19) was used to conduct the survey, and the questionnaire was adjusted. In the second stage, 200 outpatient participants were recruited from Wenzhou Medical University Affiliated Eye and Optometry Hospital from June 2016 to May 2017 and were divided into a visual fatigue group and a control group based on clinical diagnosis. The adjusted visual fatigue questionnaire was used for validation. In the third stage, 64 outpatient participants who met the inclusion criteria were continuously recruited from the Wenzhou Medical University Affiliated Eye and Optometry Hospital in July 2022. They were tested using the adjusted visual fatigue questionnaire and retested one week later. During the questionnaire adjustment stage, factor analysis and feedback were used to adjust the scoring method and items of the ASQ-19 questionnaire. The adjusted questionnaire was then analyzed for reliability, validity, accuracy, and subject acceptance during the validation and retest stages. Results: A total of 403 participants were included, and 456 questionnaires were distributed. Eventually, 432 valid questionnaires were collected from 379 participants, resulting in a valid response rate of 94.7%. During the questionnaire adjustment phase, there were 140 valid questionnaires from 140 participants consisting of 56 males and 84 females with an average age of (35.2±12.4) years. In the questionnaire validation phase, there were 186 valid questionnaires from 186 participants. Sixty-two participants had visual fatigue and 124 were controls. During the questionnaire retesting phase, 53 participants yielded 106 valid questionnaires. The group consisted of 20 males and 33 females with an average age of (22.8±4.9) years. After factor analysis, the symptom severity graded as none, mild, moderate, severe, and very severe was scored as 0, 1, 2, 3, and 4 points, respectively. The total score was 44, and the final questionnaire consisted of 11 items (numbered 1, 2, 3, 5, 6, 8, 10, 15, 17, 18, and 19). The 11-Item Asthenopia Survey Questionnaire (ASQ-11) had a Cronbach's α coefficient of 0.89, a split-half reliability of 0.82, and a test-retest Pearson correlation coefficient of 0.90 (P<0.001). The structural validity was 51.26%, and the discriminative validity was a t-value of 9.19 (P<0.001). On average, it took (2.82±0.43) minutes for participants to complete the questionnaire. The receiver operating characteristic curve had a cutoff value of 8.5, with a sensitivity of 74.19% and a specificity of 80.65%. Conclusion: The ASQ-11, with fewer items and a shorter completion time, is easy for participants to use and is suitable for screening or self-assessment of visual fatigue in the general population. Additionally, it is convenient for clinical and epidemiological studies related to visual fatigue.

Associations Between Fatigue and Endocrine and Non-endocrine Health Problems in Turner Syndrome: Cohort Study and Review.

Turner syndrome (TS) is a rare chromosomal disorder characterized by gonadal dysfunction, short stature, and heart defects, among other features. Women with TS often suffer from severe fatigue, for which they are typically referred to endocrinologists. The diagnostic work-up is generally time-consuming and invasive, and it rarely solves the problem. To prevent the personal and financial burden of unnecessary diagnostic procedures, it is crucial to understand fatigue in TS. To explore the association between fatigue and endocrine and non-endocrine comorbidities in a-for rare disorders-large group of women with TS. 170 genetically confirmed women with TS who attended the TS Reference Center underwent a systematic health screening, including a structured interview, complete physical examination, biochemical measurements, perceived stress and fatigue questionnaires, and additional tests when indicated. Median (interquartile range) age was 32.6 (23.9-41.4) years. Severe fatigue was experienced by 1 in 3 women with TS. Liver enzyme disturbances and body mass index were significantly associated with higher fatigue scores. Perceived stress was highly correlated with fatigue. There was no association between fatigue and most endocrine and non-endocrine disorders, which implies that fatigue is only partly explained by somatic disorders. The high correlation between perceived stress and fatigue suggests that TS-related neuropsychological processes may play an important role in the etiology of fatigue in women with TS. We provide a practical algorithm for the endocrine, non-endocrine, and psychological approach to fatigue in women with TS.

A safe and effective micro-choice based rehabilitation for patients with long COVID: results from a quasi-experimental study

At least 65 million people suffer from long COVID. Treatment guidelines are unclear, especially pertaining to recommendations of increased activity. This longitudinal study evaluated safety, changes in functional level and sick leave following a concentrated rehabilitation program for patients with long COVID. Seventy-eight patients (19–67 years) participated in a 3-day micro-choice based rehabilitation program with 7-day and 3-month follow-up. Fatigue, functional levels, sick leave, dyspnea and exercise capacity were assessed. No adverse events were reported and 97.4% completed the rehabilitation. Fatigue measured with Chalder Fatigue Questionnaire decreased at 7-days [mean difference (MD = − 4.5, 95% CI − 5.5 to − 3.4) and 3-month (MD = − 5.5, 95% CI − 6.7 to − 4.3). Sick leave rates and dyspnea were reduced (p < 0.001) and exercise capacity and functional level increased (p < 0.001) at 3-month follow-up regardless of severity of fatigue at baseline. Micro-choice based concentrated rehabilitation for patients with long COVID was safe, highly acceptable and showed rapid improvements in fatigue and functional levels, sustaining over time. Even though this is a quasi-experimental study, the findings are of importance addressing the tremendous challenges of disability due to long COVID. Our results are also highly relevant for patients, as they provide the base for an optimistic outlook and evidence supported reason for hope.

Determining the Psychometric Properties of the Turkish Version of the Nurses’ Alarm Fatigue Questionnaire

Objective: This study was conducted to examine the psychometric properties of the Nurses’ Alarm Fatigue Questionnaire. Materials and Methods: In this methodological study, the sample consisted of 142 nurses working in neonatal and pediatric intensive care. In order to test the psychometric properties of the scale, language equivalence, content and construct validity were used for validity analysis. The data were evaluated using descriptive and confirmative factor analyses, Cronbach's alpha, split-half, and item-total score correlation. Results: The total explained variance of the Turkish version of the Nurses' Alarm Fatigue Questionnaire consisting of a single sub-dimension and nine items was determined as 41%. The total factor loading was &amp;gt;0.30. In the confirmatory factor analysis, all the goodness of fit indexes were &amp;gt;0.90, and the root mean square error of approximation (RMSEA) was &amp;lt;0.08. The correlation between the two halves was 0.71, and the Guttman split-half and Spearman-Brown coefficients were 0.83. The Cronbach's alpha coefficient for the scale was found to be 0.80. Conclusion: The study’s findings suggest that the scale is a valid and reliable tool in determining the alarm fatigue of nurses working in newborn and pediatric intensive care units in Türkiye.

Fatigue in Patients with Newly Diagnosed Inflammatory Bowel Disease: Results from a Prospective Inception Cohort, the IBSEN III Study.

Although fatigue is common in inflammatory bowel disease [IBD], its pathogenesis remains unclear. This study aimed to determine the prevalence of fatigue and its associated factors in a cohort of patients newly diagnosed with IBD. Patients ≥18 years old were recruited from the Inflammatory Bowel Disease South-Eastern Norway [IBSEN III] study, a population-based, observational inception cohort. Fatigue was assessed using the Fatigue Questionnaire and compared with data from a Norwegian general population. Univariate and multivariate linear and logistic regression analyses were performed to evaluate the associations of total fatigue [TF; continuous score] and substantial fatigue [SF; dichotomized score ≥4] with sociodemographic, clinical, endoscopic, laboratory, and other relevant patient data. In total, 983/1509 [65.1%] patients with complete fatigue data were included (ulcerative colitis [UC], 68.2%; Crohn's disease [CD], 31.8%). The prevalence of SF was higher in CD [69.6%] compared with UC [60.2%] [p < 0.01], and in both diagnoses when compared to the general population [p < 0.001]. In multivariate analyses, depressive symptoms, pain intensity, and sleep disturbances were associated with increased TF for both diagnoses. In addition, increased clinical disease activity and Mayo endoscopic score were significantly associated with TF in UC, whereas all disease-related variables were insignificant in CD. Similar findings were observed for SF, except regarding the Mayo endoscopic score. SF affects approximately two-thirds of patients newly diagnosed with IBD. Fatigue was associated with depressive symptoms, sleep disturbances, and increased pain intensity in both diagnoses, while clinical and endoscopic activity were associated factors only in UC.

A study to determine the possible links between subjective (fatigue questionnaires) and objective (bio-mathematical fatigue prevention model) fatigue detection methods

Introduction: Application of objective fatigue detection tools in aviation bases is limited. This study was envisaged to conduct a systematic comparative analysis between a well-established objective method and short fatigue questionnaires which are used in fatigue research to employ them as a fatigue screening tool for aviation personnel. Material and Methods: Thirty-eight aviation personnel volunteered for this cross-sectional observational study. Work-rest/sleep data collected using actigraphy over 1 week were fed to a PC running Fatigue Avoidance Scheduling Tool. Objective fatigue parameters in the form of Fatigue Risk Time (FRT) and Fatigue Free Occupational Time (FFOT) were retrieved. Fatigue questionnaires Groningen Sleep Quality Scale (GSQS) for assessing sleep quality and Stanford Sleepiness Scale (SSS) to detect day-time sleepiness were used as subjective fatigue parameters. Comparative analysis was carried out using appropriate statistical tests. Results: A consistent Total Sleep Time (TST) ranging from 353 to 378 min in the week of the study with no statistically significant differences between the nights were recorded. The increasing trend of FRT and decreasing trend of FFOT over the week were observed. The GSQS, SSS (morning), and SSS (afternoon) also demonstrated a progressive increase in the scores, but only the increase from day 1 to day 2 was statistically significant. Conclusion: Gradual increase in FRT with a reciprocal decrease in FFOT, which was observed, in this study, could be attributed to a progressive increase in sleep debt over the week. A consistent TST of the duration, which is less than the optimal duration of 7–8 h for night sleep, can lead to a gradual increase in sleep debt. The regression equations computed for FFOT was: FFOT = 657 + (0.24 × TST in min) – {(27 × Morning GSQS) + (73 × Day factor)}. This regression equation could be used to extrapolate the fatigue free occupation time for aviation personnel. The study has confirmed the effectiveness of both GSQS and SSS as the fatigue prevention tool and their application in the field setup, especially in the absence of any objective fatigue detection tool.

STATUS GIZI, KEBIASAAN SARAPAN PAGI DAN KELELAHAN KERJA PADA PEKERJA KAPAL CEPAT (FAST FERRY) PT. BALI EKAJAYA

Fatigue is mental or physical fatigue that makes it difficult for a person to work comfortably and effectively. One of the factors contributing to reducing the level of work fatigue is by fulfilling worker nutrition so as to improve health. The risks of burnout include work-related stress, work-related illnesses and work-related accidents. This study aims to analyze the relationship between nutritional status, breakfast habits and work fatigue among employees of fast ferry shipping companies. This type of research used an analytic survey with a cross sectional study approach. This research was carried out at Sengig Port, West Lombok Regency, Nusa Tenggara. The sample of this research is the entire crew of the three fast boat fleets with a total of 41 samples. The research variables are nutritional status, breakfast habits and work fatigue. Nutritional status data is obtained by directly measuring body weight and height. Breakfast data was obtained by interviewing using a 24-hour recall form. Fatigue data was obtained using a fatigue questionnaire. The results showed that most of the workers used to have breakfast, almost 68.3%. Respondents who had normal nutritional status were 51.2% and workers who experienced mild fatigue were 58.5%. Statistical test results for breakfast with nutritional status obtained p = 0.01, statistical tests for breakfast with fatigue obtained p = 0.23, and statistical test results for nutritional status with fatigue obtained p = 0.37. there is a relationship between breakfast, nutritional status and fatigue in workers but there is a relationship between breakfast habits and nutritional status in fast boat company employees at Senggigi port

Additive benefit of rehabilitation on physical status, symptoms and mental health after hospitalisation for severe COVID-19 pneumonia

IntroductionThe potential additive benefits of rehabilitation beyond spontaneous recovery post-COVID-19 currently remain unknown.MethodsIn this prospective, interventional, non-randomised parallel assignment two-arm study, we investigated the effects of an 8-week rehabilitation programme...

Importance of patient related outcomes in diagnosing fatigue related to immunotherapy treatment in patients with lung cancer: A real life study.

e14709 Background: Lung cancer is a common cancer with a dismal prognosis that was improved with treatment with check-point inhibitors (CPI). Fatigue is the most frequent adverse event of CPI, often undervalued by physicians. Patient report outcomes may be a key to overcome underdiagnose of fatigue. Methods: The aim of this study is to identify whether the assessment Non-Small Cell Lung Cancer (NSCLC) patients report when answering the BFI questionnaire of fatigue is consistent with the one recorded by the clinical team at the pneumology consultation the during treatment with immunotherapy in monotherapy or in combination with chemotherapy. A prospective observational study was carried out during 8 months. The research was conducted through the collection of medical records from the patients clinical files and the application of the Brief Fatigue Inventory questionnaire before each one of the 4 treatment cycles. This questionnaire was validated and linguistically translated into Portuguese and assesses the severity and functional impact of fatigue in cancer patients. A 95% confidence interval was considered. Results: The 31 patients, 26 male (84%) and 5 female (16%) with a mean age of 68.5 years. The mean value of the BFI score before the first treatment, as well as in the following 3 evaluations, was higher for the participants who presented symptoms of asthenia/tiredness/fatigue recorded in the clinical files at the consultation and lower for those who did not. However, the differences were not statistically significant (pre 1st treatment - p=0.299, pre 2nd treatment - p=0.125, pre 3rd treatment - p=0.103 and pre 4th treatment - p=0.954). By comparing the BFI score with medical records, we found that fatigue remained underreported at the consultation in different assessment times (71% of sample participants were not identified as having fatigue at the 1st assessment time; 60% at the pre 2nd treatment visit; 54% at the pre 3rd treatment visit and 40% at the pre 4th treatment visit). Conclusions: In the present study, the BFI questionnaire allowed us to identify and stratify fatigue, showing greater sensitivity when compared to the medical records of the consultation alone.

(010) Correlates of Sexual Dysfunction in Young Adult Cancer Survivors: A Project REACH Study

Abstract Introduction Cancer treatment early in life contributes to a wide range of late effects such as sexual dysfunction, fatigue, sleep disturbances, and widespread pain. Although these concerns have been found to be related in older survivors, research is limited in young adult cancer survivors (YACS), particularly using validated measures of sexual dysfunction. Objective The current study aims to address this gap in research by describing relationships between sexual dysfunction and fatigue, sleep, and pain in YACS. Methods 164 young women (aged 18-39) previously treated for pediatric cancer completed self-report measures on sexual function, fatigue, sleep, and pain through Project REACH, a prospective cohort study. Sexual function was assessed using the Female Sexual Function Index (FSFI-6); participants were classified as experiencing significant sexual dysfunction if they scored ≤ 19 on this measure. Participants also completed the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and items adapted from the Brief Pain Inventory. Of note, lower FACIT-F, higher PSQI, and higher pain scores represent more impaired functioning. T-tests were used to compare participants with and without sexual dysfunction on fatigue (FACIT-F total score), sleep (PSQI total score), and pain (days of severe pain in the last week). A logistic regression was also performed to understand the effects of fatigue, sleep, and pain on the likelihood that participants would have sexual dysfunction. Results Over half (56%) of participants were classified as experiencing significant sexual dysfunction. Participants with sexual dysfunction had significantly more severe fatigue (p&amp;lt;.001), significantly worse sleep (p=.02), and significantly more days of severe pain (p=.006) than those without sexual dysfunction. The logistic regression model with fatigue, sleep, and pain was significant (p&amp;lt;.001) and correctly classified 69% of participants. In this model, more severe fatigue was significantly associated with an increased likelihood of having sexual dysfunction (OR=0.93, 95% CI [0.88-0.98]). More frequent severe pain was associated with an increased likelihood of having sexual dysfunction (OR=2.49, 95% CI [0.99-6.28]), although this finding was only marginally significant (p=.053). Sleep was not significantly associated with sexual dysfunction in the model. Conclusions As hypothesized, female YACS with sexual dysfunction had higher levels of fatigue, worse sleep, and more frequent severe pain than those without sexual dysfunction. However, when included in a logistic model, fatigue but not sleep was significantly associated with an increased likelihood of sexual dysfunction. This suggests that consistent with previous research on cancer survivors, fatigue in this population is more than simply the result of poor sleep. Fatigue may need to be directly addressed to improve sexual function in YACS. Although only marginally significant, overall pain may also contribute to sexual dysfunction in this population; as severe pain was infrequent and the sample small, future research should examine this relationship in larger samples. Additionally, as the current study examined general pain, more research is necessary to determine whether sexual or non-sexual pain is driving the potential relationship between sexual dysfunction and frequency of severe pain. Disclosure No

Effects of whole-body cryotherapy and static stretching are maintained 4 weeks after treatment in most patients with chronic fatigue syndrome

In the previous study, whole-body cryotherapy (WBC)+static stretching (SS) has been shown to reduce the severity of some symptoms in Chronic Fatigue Syndrome (CFS) noted just after the therapy. Here we consider the effects of treatment and explore the sustainability of symptom improvements at four weeks (one-month) follow-up. Twenty-two CFS patients were assessed one month after WBC + SS programme. Parameters related to fatigue (Chalder Fatigue Questionnaire (CFQ), Fatigue Impact Scale (FIS), Fatigue Severity Scale (FSS)), cognitive function (Trial Making test part A and B (TMT A and TMT B and its difference (TMT B-A)), Coding) hemodynamic, aortic stiffness (aortic systolic blood pressure (sBP aortic)) and autonomic nervous system functioning were measured. TMT A, TMT B, TMT B-A and Coding improved at one month after the WBC + SS programme. WBC + SS had a significant effect on the increase in sympathetic nervous system activity in rest. WBC + SS had a significant, positive chronotropic effect on the cardiac muscle. Peripheral and aortic systolic blood pressure decreased one month after WBC + SS in comparison to before. Effects of WBC + SS on reduction of fatigue, indicators of aortic stiffness and symptoms severity related to autonomic nervous system disturbance and improvement in cognitive function were maintained at one month. However, improvement in all three fatigue scales (CFQ, FIS and FSS) was noted in 17 of 22 patients. In addition, ten patients were treated initially but they were not assessed at 4 weeks, and are thus not included in the 22 patients who were examined on follow-up. The overall effects of WBC + SS noted at one month post-treatment should be interpreted with caution.

Post-Activation Performance Enhancement and Motor Imagery Are Efficient to Emphasize the Effects of a Standardized Warm-Up on Sprint-Running Performances.

Warm-up routines include various tasks focused on the peripheral contractile properties and nervous motor command. This present study was aimed at investigating the acute effects of different warm-up routines, emphasizing either peripheral (post-activation performance enhancement, PAPE) or central (motor imagery, MI) contributions on sport-specific tasks. Eleven young female athletes took part in this cross-over, randomized, controlled trial. They underwent three experimental sessions composed of a standardized warm-up followed by 10 min of (1) rest (CONTROL), (2) maximal concentric leg press (PAPE), or (3) mental repetitions of sprint tasks (MI). Post-tests consisted of reaction time, arrowhead agility test, 20 m sprint, repeated sprint ability, and NASA-TLX fatigue questionnaire. PAPE and MI significantly enhanced the arrowhead agility test (p < 0.001 and p = 0.012, respectively) and repeated sprint ability (p = 0.002 and p = 0.035, respectively) compared to CONTROL, without any difference between PAPE and MI. The 20 m sprint time was better after PAPE as compared to MI (p = 0.005) and CONTROL (p < 0.001), without any difference between MI and CONTROL. Reaction time and the NASA-TLX questionnaire were not affected by the warm-up modalities (p > 0.05). PAPE was the most efficient to optimize warm-up due to its greater peripheral contribution that would improve muscle contractility. MI specifically improved the imagined tasks mostly by central contribution.

Health Status, Quality of Life, Psychosocial Well-being, and Wearables Data of Patients With Active Ulcerative Colitis Receiving Filgotinib Therapy (FilgoColitis Study): Protocol for a Real-world Observational Study.

Filgotinib was approved in Germany for treating patients with moderate to severe active ulcerative colitis in November 2021. It represents a preferential Janus kinase 1 inhibitor. The FilgoColitis study began recruiting immediately after approval and aims to assess filgotinib effectiveness under real-world conditions with a particular focus on patient-reported outcomes (PROs). The novelty of the study design is the optional inclusion of 2 innovative wearables, which could provide a new layer of patient-derived data. The study investigates quality of life (QoL) and psychosocial well-being of patients with active ulcerative colitis during long-term exposure to filgotinib. PROs related to QoL and psychometric profiles (fatigue and depression) are collected alongside with disease activity symptom scores. We aim to evaluate physical activity patterns collected by wearables as an addition to traditional PROs, patient-reported health status, and QoL in different phases of disease activity. This is a prospective, single-arm, multicentric, noninterventional, observational study with a sample size of 250 patients. QoL is assessed with validated questionnaires: the Short Inflammatory Bowel Disease Questionnaire (sIBDQ) for the disease-specific QoL, the EQ-5D for the general QoL, and the fatigue questionnaire (Inflammatory Bowel Disease-Fatigue [IBD-F]). Physical activity data are collected from patients using wearables (SENS motion leg sensor [accelerometry] and smartwatch, GARMIN vívosmart 4). The enrollment started in December 2021 and was still open at the date of submission. After 6 months of study initiation, 69 patients were enrolled. The study is expected to be completed in June 2026. Real-world data for novel drugs are important to assess effectiveness outside of highly selected populations represented by randomized controlled trials. We examine whether patients' QoL and other PROs can be supplemented with physical activity patterns measured objectively. Use of wearables with newly defined outcomes represents an additional observational tool for monitoring disease activity in patients with inflammatory bowel disease. German Clinical Trials Register DRKS00027327; https://drks.de/search/en/trial/DRKS00027327. DERR1-10.2196/42574.

Dose-Escalated Radiation Alone or in Combination With Short-Term Total Androgen Suppression for Intermediate-Risk Prostate Cancer: Patient-Reported Outcomes From NRG/Radiation Therapy Oncology Group 0815 Randomized Trial.

To report patient-reported outcomes (PROs) of a phase III trial evaluating total androgen suppression (TAS) combined with dose-escalated radiation therapy (RT) for patients with intermediate-risk prostate cancer. Patients with intermediate-risk prostate cancer were randomly assigned to dose-escalated RT alone (arm 1) or RT plus TAS (arm 2) consisting of luteinizing hormone-releasing hormone agonist/antagonist with oral antiandrogen for 6 months. The primary PRO was the validated Expanded Prostate Cancer Index Composite (EPIC-50). Secondary PROs included Patient-Reported Outcome Measurement Information System (PROMIS)-fatigue and EuroQOL five-dimensions scale questionnaire (EQ-5D). PRO change scores, calculated for each patient as the follow-up score minus baseline score (at the end of RT and at 6, 12, and 60 months), were compared between treatment arms using a two-sample t test. An effect size of 0.50 standard deviation was considered clinically meaningful. For the primary PRO instrument (EPIC), the completion rates were ≥86% through the first year of follow-up and 70%-75% at 5 years. For the EPIC hormonal and sexual domains, there were clinically meaningful (P < .0001) deficits in the RT + TAS arm. However, there were no clinically meaningful differences by 1 year between arms. There were also no clinically meaningful differences at any time points between arms for PROMIS-fatigue, EQ-5D, and EPIC bowel/urinary scores. Compared with dose-escalated RT alone, adding TAS demonstrated clinically meaningful declines only in EPIC hormonal and sexual domains. However, even these PRO differences were transient, and there were no clinically meaningful differences between arms by 1 year.

Determining Factors of Alarm Fatigue among Nurses in Intensive Care Units-A Polish Pilot Study.

With the development of medical technology, clinical alarms from various medical devices, which are rapidly increasing, are becoming a new problem in intensive care units. The aim of this study was to evaluate alarm fatigue in Polish nurses employed in Intensive Care Units and identify the factors associated with alarm fatigue. A cross-sectional study. The study used the nurses' alarm fatigue questionnaire by Torabizadeh. The study covered 400 Intensive Care Unit nurses. The data were collected from February to June 2021. The overall mean score of alarm fatigue was 25.8 ± 5.8. Participation in training programs related to the use of monitoring devices available in the ward, both regularly (ß = -0.21) and once (ß = -0.17), negatively correlated with nurses' alarm fatigue. On the other hand, alarm fatigue was positively associated with 12 h shifts [vs. 8 h shifts and 24 h shifts] (ß = 0.11) and employment in Intensive Cardiac Surveillance Units-including Cardiac Surgery [vs. other Intensive Care Units] (ß = 0.10). Monitoring device alarms constitute a significant burden on Polish Intensive Care Unit nurses, in particular those who do not take part in training on the operation of monitoring devices available in their ward. It is necessary to improve Intensive Care Unit personnel's awareness of the consequences of overburdening and alarm fatigue, as well as to identify fatigue-related factors.

Sleep disorders and fatigue among truck and bus drivers in Mexico.

Fatigue and sleep disturbances are among the most common disorders suffered by transport drivers. To identify and analyze working conditions for Mexican federal transportation truck and bus drivers, and their connection with sleep disorders and fatigue. A cross-sectional, quantitative study was performed with a convenience sample of 172 drivers (84 truck and 88 bus) by applying the Survey Evaluation and Monitoring of Workers Health (PROESSAT in Spanish) and the Yoshitake Fatigue questionnaire. Night work and performing hazardous work increased the prevalence of sleep disorders (PR = 3.9 and PR = 6.9, respectively). Poor lighting and being paid per trip increased the prevalence of fatigue (PR = 2.8 and PR = 2.5, respectively). Several conditions were found to impact health, including long work shifts, strenuous physical effort, night work, little social support, being paid by distance, strict quality controls, and risk of crimes such as extortion, robbery, attacks, and kidnapping.

The relationship between alarm fatigue and burnout among critical care nurses: A cross-sectional study.

Alarm fatigue has significant negative impacts on nurses and patient safety. However, the relationship between alarm fatigue and burnout is still unclear. This study aimed to explore the relationship between alarm fatigue and burnout among critical care nurses. A descriptive-analytical cross-sectional study design was used. Data were collected from five hospitals in mainland China between January 2022 and March 2022. A general information questionnaire, the Chinese version of the Intensive Care Unit Nurse Alarm Fatigue Questionnaire, and the Chinese version of the Maslach Burnout Inventory were used. A total of 236 critical care nurses were enrolled in this study. The mean score of alarm fatigue among critical care nurses was 21.11 ± 6.83. The results showed that critical care nurses experienced moderate alarm fatigue levels, and most nurses had moderate to high levels of burnout. The multiple linear regression analyses showed that alarm fatigue was independently associated with emotional exhaustion, depersonalization dimensions, and reduced personal accomplishment dimension. Alarm fatigue was associated with burnout among critical care nurses. Reducing critical care nurses' alarm fatigue may help to alleviate burnout. Managers should provide comprehensive training for nurses and promote the application of artificial intelligence technology in alarm management to reduce alarm fatigue and improve burnout among critical care nurses.

Decision-making under ambiguity after frontal lobe resection for epilepsy

PurposeDecision-making is crucial to daily life and can impact our society as well as economic conditions. Although the frontal lobes have been identified as important for decision-making, this capacity has only been studied to a limited extent in frontal lobe epilepsy and not at all after frontal lobe resection (FLR) for epilepsy. This study aimed to explore decision-making under ambiguity after FLR for epilepsy. MethodsFourteen patients having undergone FLR for epilepsy completed the Iowa Gambling Task (IGT) which is a widely used tool to measure decision-making under ambiguity. Iowa Gambling Task scores included in the analysis were: total net score, separate scores from five blocks across the test, and a change score (last block of IGT minus first block). A group of healthy controls (n = 30) was used as a comparison. Associations between IGT and standardized neuropsychological methods for assessment of executive functions, self-rating questionnaires of mental health, fatigue, and behavior linked to frontal lobe dysfunction were also investigated. ResultsThe patient group performed inferior to controls at the final block of the IGT (p =.001).A group difference in IGT change scores was found (p =.005), reflectingthe absence of a positive change in performance over time for the FLR group compared to the control group. Correlations with tests of executive functions as well as self-rating scales were mainly statistically nonsignificant. ConclusionsThis study shows that patients having undergone FLR for epilepsy have difficulties with decision-making under ambiguity. The performance illustrated a failure to learn throughout the task. Executive as well as emotional deficits may impact decision-making processes in this patient group and need to be considered in further studies. Prospective studies with larger cohorts are needed.