Rest Breaks Research Articles

Understanding the effect of occupational stress on sleep quality in firefighters: the modulating role of depression and burnout.

Sleep quality of firefighters can be negatively affected by occupational stressors. A cross-sectional investigation was conducted to understand how work-related stress, post-traumatic stress, burnout and depression collectively contribute to sleep quality. Professional firefighters in Northern Iran completed a survey comprised of demographic information, the Pittsburgh Sleep Quality Index, HSE's Stress Indicator Tool, the Posttraumatic Stress Disorder Checklist, Maslach's Burnout Inventory, and the Beck Depression Inventory during a work rest break. Data were analysed using structural equation modelling. Mean age of the 2339 firefighters who completed the survey was 32.30 (5.74) years. Most experienced poor sleep quality, scoring above the established cut-off of 5. Levels of work-related stress, post-traumatic stress, burnout and depression were high. Fit indices of the final theoretical model were all adequate: the obtained and adjusted goodness-of-fit indices were 0.925 and 0.917 respectively. Comparative, and incremental fit indices were 0.946 and 0.948 respectively. Root mean squared error of approximation was 0.061. Post-traumatic stress was directly and indirectly related to sleep quality through eight paths, modulated by burnout variables and depression. Work-related stress was negatively related to sleep quality through four paths modulated, by burnout variables and depression. The findings illustrate the complex relationships of work-related stress and post-traumatic stress and sleep quality. High levels of poor sleep quality in this occupation emphasise the need to develop targeted and sustainable interventions to manage occupational stressors, burnout and depression to improve sleep quality in firefighters.

Prevalence and Impact of Work-Related Musculoskeletal Disorders Among Dental Students in Iran: A Systematic Review and Meta-Analysis

Background: For medical students, maintaining physical health is crucial for effective practice, but these students are often exposed to both physical and mental health challenges, including work-related musculoskeletal disorders (WMSDs). Dental students are particularly vulnerable due to the physically demanding nature of their training, which involves repetitive movements, heavy workloads, and inadequate rest breaks. These disorders can lead to chronic pain, impairing quality of life and professional productivity. Methods: This systematic review and meta-analysis examined the prevalence of WMSDs among dental students in Iran. Searches were conducted in several domestic and international databases, and articles published between 2000 and 2024 were included if they reported data on the prevalence of musculoskeletal pain in dental students. A total of 289 articles were initially identified, with 4 meeting the inclusion criteria. Data were extracted and analyzed using Comprehensive Meta-Analysis (CMA) software to evaluate WMSD prevalence rates. Results: The meta-analysis revealed that 22.6% of dental students experienced back pain, 38.8% had neck pain, 25.2% reported shoulder pain, and 15.2% experienced hand/elbow pain. Overall, 72.0% of dental students reported pain in at least one part of the body. These findings align with similar global studies, with variations in prevalence possibly due to differences in sample sizes, study designs, and geographical factors. Conclusion: The study highlights a high prevalence of musculoskeletal disorders, particularly in the neck, back, and shoulders, among dental students in Iran. The findings underscore the need for preventive interventions focused on improving ergonomics and occupational health to reduce the risk of WMSDs and enhance the well-being of dental students.

Managing the work stress of inpatient nurses during the COVID-19 pandemic: a systematic review of organizational interventions

BackgroundDuring the coronavirus disease 2019 (COVID-19) pandemic, inpatient nurses faced various work stressors. Little is known about organizational interventions that can mitigate the negative consequences of pandemic-related stressors.ObjectiveThe aim was to provide a synopsis of the literature concerning the types and outcomes of organizational interventions performed during the COVID-19 pandemic that directly (re)organized the work structures of inpatient nurses to address pandemic-related work stressors or to increase nurses’ ability to cope.MethodsWithin this preregistered systematic literature review, we searched four databases (PubMed, PsycINFO, PsycARTICLES, CINAHL) and two preprint databases (MedRxiv, PsyArXiv) for interventional studies of organizational interventions published between 01/2020 and 03/2023 (k = 990 records). We included 12 primary studies after title-abstract and full-text screening. A synthesis of results without meta-analysis was conducted. Risk of bias was assessed with the Cochrane risk-of-bias tool for randomized trials – version 2 (RoB-2) and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tool.ResultsAll interventions were implemented in hospitals. The reasons given for implementation included pandemic-related work stressors such as a high workload, understaffing, and a lack of medical resources. To respond to the various work stressors, half of the studies took a multilevel approach combining organizational and person-oriented interventions (k = 6). Most studies (k = 8) took a secondary prevention approach, focusing on the organization of rest breaks (k = 5). With respect to outcomes, the studies examined nurse-related stress and resilience, turnover intention, job satisfaction, and other factors. Risk-of-bias analyses revealed that conclusions about the effectiveness of the interventions are limited due to confounding factors and self-selection.ConclusionsThe identified interventions provide a basis for future research to draw conclusions on the effectiveness of organizational interventions during pandemics. The promotion of adequate work breaks could be useful if the work stressors associated with strain and negative consequences cannot be changed directly. However, the same stressors (e.g., high workload) can hinder nurses from participating in offered interventions. This emphasizes the importance of directly addressing inpatient nurses’ work stressors.RegistrationProspero-ID CRD42023364807 (March 2023).

Examining Management and Employees' Perceptions of Occupational Heat Exposure and the Effectiveness of a Heat Stress Prevention Intervention on Safety and Well-Being among Natural Gas Construction Workers: A Qualitative Field-Based Study.

Numerous risk factors have been identified as significantly influencing outdoor workers' risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. To advance construction workers' safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments. Note: in this study, the terms 'worker' and 'employee' are used interchangeably.

Mitigating the Adverse Effects of Night Shifts: A Review of Strategies for Enhancing Health Outcomes in Shift Workers

Introduction and PurposeShift work, essential for continuous operation in industries like healthcare, transportation, and security, disrupts circadian rhythms and adversely affects health. This review consolidates findings on the multifaceted impacts of night shift work, emphasizing interventions to mitigate these effects and improve worker health and well-being. Brief Description of the State of KnowledgeNight shift work disrupts circadian rhythms, leading to cognitive decline, sleep disorders, mental health risks, cardiovascular issues, metabolic disturbances, and cancer susceptibility. Effective interventions include limiting shift lengths and frequency, incorporating rest breaks and napping, aligning meal times with circadian rhythms, using melatonin supplementation and light therapy to improve sleep quality, engaging in regular aerobic exercise, and employing stress management techniques. Summary Implementing proposed interventions can mitigate the adverse health effects of night shift work, enhancing worker well-being, efficiency, and job satisfaction. Tailoring strategies to different age groups optimizes effectiveness, with structured approaches beneficial for older workers and flexible options suitable for younger workers. Further research should explore long-term intervention effects and develop personalized strategies for diverse populations. This review provides comprehensive guidelines for managing the health impacts of night shift work, supporting improved patient safety, reduced accidents, and enhanced work performance across various industries.

Factors associated with sleep quality among Afghan healthcare workers.

Sleep is a complex physiological process during which the body and mind enter a period of rest. For a healthy lifestyle, different cohort groups can be affected in different ways. One such cohort is healthcare workers (HCWs)-an unexplored group in Afghanistan. Therefore, the present study examined the association between a range of sociodemographic factors including having night shift work and sleep quality among Afghan HCWs. A cross-sectional survey was administered in January 2023 among HCWs (N = 342) in the Herat province of Afghanistan. The survey examined sleep quality and its association with a range of sociodemographic factors among HCWs. Logistic regression models were used to examine the association of sleep quality with sociodemographic characteristics among HCWs. The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality among HCWs. A total of 342 HCWs participated in the present study with an age range of 18 to 60 years. The mean age of the participants was 28.90 years (SD ± 8.10). Just over half of the participants were male (50.3%). Of the 342 participants, 58.5% reported poor sleep quality. Being married status, having higher number of children, not being a doctor, having low economic status, working night shifts, and having a traumatic event occur during past month were among the main variables associated with sleep quality among Afghan HCWs. Multiple regression analysis indicated that having high income [negatively] (AOR = 4.132, p = 0.002), working night shifts [positively] (AOR = 0.288, p < 0.001), and having a traumatic event occur during past month [positively] (AOR = 0.504, p = 0.007) were significantly associated with sleep quality. The study suggests the need for Afghan health employers to create a healthy work environment that prioritizes the well-being of their employees by limiting overtime hours, providing rest breaks during long shifts, and ensuring that HCWs have access to necessary resources for coping with work-related stressors. These policies would promote the overall health and well-being of the workforce and would likely lead to better patient care outcomes.

Trajectory of Telework in a Brazilian Labor Court During the COVID-19 Pandemic: A Longitudinal Study of Working and Health Conditions According to Work Modality.

This study aimed to compare ergonomic and psychosocial risks and the prevalence of musculoskeletal problems and common mental disorders during the coronavirus disease 2019 pandemic according to work modality. A longitudinal study was carried out with 659 employees between 2021 and 2022. The data were collected via web with self-administered questionnaires. The Wilcoxon and repeated-measure analysis of variance tests were used. The participants who started teleworking during the pandemic showed significant improvements in their workstations and worsening of the risks associated with rest breaks after returning to face-to-face work. Employees in telework presented a significant reduction in the intensity of musculoskeletal complaints in the last 7 days compared to those who returned to face-to-face work. Although there was a reduction in the ergonomic risk after returning to face-to-face work, telework was related to better working and health conditions.

Assessing Decision Fatigue in General Practitioners' Prescribing Decisions Using the Australian BEACH Data Set.

General practitioners (GPs) make numerous care decisions throughout their workdays. Extended periods of decision making can result in decision fatigue, a gradual shift toward decisions that are less cognitively effortful. This study examines whether observed patterns in GPs' prescribing decisions are consistent with the decision fatigue phenomenon. We hypothesized that the likelihood of prescribing frequently overprescribed medications (antibiotics, benzodiazepines, opioids; less effortful to prescribe) will increase and the likelihood of prescribing frequently underprescribed medications (statins, osteoporosis medications; more effortful to prescribe) will decrease over the workday. This study used nationally representative primary care data on GP-patient encounters from the Bettering the Evaluation and Care of Health program from Australia. The association between prescribing decisions and order of patient encounters over a GP's workday was assessed with generalized linear mixed models accounting for clustering and adjusting for patient, provider, and encounter characteristics. Among 262,456 encounters recorded by 2,909 GPs, the odds of prescribing antibiotics significantly increased by 8.7% with 15 additional patient encounters (odds ratio [OR] = 1.087; confidence interval [CI] = 1.059-1.116). The odds of prescribing decreased significantly with 15 additional patient encounters by 6.3% for benzodiazepines (OR = 0.937; CI = 0.893-0.983), 21.9% for statins (OR = 0.791; CI = 0.753-0.831), and 25.0% for osteoporosis medications (OR = 0.750; CI = 0.690-0.814). No significant effects were observed for opioids. All findings were replicated in confirmatory analyses except the effect of benzodiazepines. GPs were increasingly likely to prescribe antibiotics and were less likely to prescribe statins and osteoporosis medications as the workday wore on, which was consistent with decision fatigue. There was no convincing evidence of decision fatigue effects in the prescribing of opioids or benzodiazepines. These findings establish decision fatigue as a promising target for optimizing prescribing behavior. We found that as general practitioners progress through their workday, they become more likely to prescribe antibiotics that are reportedly overprescribed and less likely to prescribe statins and osteoporosis medications that are reportedly underprescribed.This change in decision making over time is consistent with the decision fatigue phenomenon. Decision fatigue occurs when we make many decisions without taking a rest break. As we make those decisions, we become gradually more likely to make decisions that are less difficult.The findings of this study show that decision fatigue is a possible target for improving guideline-compliant prescribing of pharmacologic medications.

Optimised break scheduling vs. rest breaks in collective agreements under fatigue and non preemption

Collective agreements provide all workers with identical break schedules, irrespective of their individual differences in susceptibility to fatigue and recovery speed. In addition, companies tend to limit breaks which is also detrimental to productivity. We consider workers performing a repetitive task, each endowed with an individual fatigue and recovery function. Fatigue slows down the unit processing time which can be restored by appropriate breaks, therefore allowing for the daily production amount to be optimised. The optimised production of each worker can actually be reached for a multitude of break schedules. We therefore develop an algorithm that lists all possible break schedules (enumeration), and selects those leading to the maximum daily output, and the maximum welfare. Welfare is defined by the break duration and their timing flexibility, since we allow breaks to be also taken at the beginning or end of the workday, enabling workers to spend less time in the workplace. Having a variety of schedules would help in meeting at best the workers’ preferences and facilitate a consensus on a specific schedule between managers and workers. The resulting optimised break schedules are compared with common break practices in collective agreements so as to assess their impact on productivity and on worker’s welfare. None of the break scheduling models in the literature considers the option of leaving the workplace earlier, which is nevertheless highly appreciated by workers, nor do these models provide a variety of optimised break schedules to best accommodate workers’ preferences.

Current State of Safe Pregnancy Policies for the US Surgical Trainee.

Define current practices and protocols in surgical training programs for pregnant trainees. Cross sectional. Academic surgical training programs in the United States. A validated 20-question survey was sent via email to program directors and coordinators of US surgical training programs, including otolaryngology head & neck surgery (OHNS), plastic surgery, vascular surgery, and general surgery. The survey was issued in November and December 2022 and data were collected until January 2023. This study was approved for exemption by the Minimal Risk Research IRB at the University of Wisconsin Madison (ID number 2022-1370). Surveys were emailed to 608 surgical programs, and the response rate was 23.5% (143/608) including 45 OHNS programs. When asked if their program has a policy in place for pregnant trainees, 84.4% responded yes, and 82.4% responded that they were satisfied with their policy. Subsequent questions addressed individual policies and risk factors facing pregnant trainees. 60.3% of programs report providing protected time off for miscarriages. Only 36.9% provide information to pregnant trainees regarding workplace exposures that pose a risk of fetal anomaly or miscarriage. Only 47.1% incorporate rest breaks for pregnant trainees, and only 20% protect the number of hours a pregnant trainee operates per week. 24.2% adjust overnight shifts or call schedules for pregnant trainees, and of those that adjust call shifts, 20% require pregnant trainees to "make up" these missed call shifts. Less than half (40%) of programs have a contingency plan in place for supporting nonchild-bearing residents who may take on the work of their colleagues during pregnancy or postpartum. While a majority of training programs report a pregnancy policy in place for trainees, most of these policies appear to be severely deficient in addressing critical aspects of surgical training that place both fetus and mother at significant risk of complications. This data indicates a need for a safe pregnancy protocol in order to protect both surgeon and fetus.

Exploring the concept and management strategies of caring stress among clinical nurses: a scoping review.

The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management. This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers. Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress. Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.

Physiological stress responses in horses participating in novice endurance rides

Horses participating in endurance events encounter enormous physical challenges. Heart rate (HR) and heart rate variability (HRV) have been reported before and after endurance rides, but these have not been determined during the rides. Moreover, the modulation in HRV and haematology in horses with different ride results (completed a course or disqualified due to irregular gait) have not been elucidated. Therefore, this study aimed to investigate changes in HR, HRV, and haematological parameters during novice endurance rides and to compare these parameters between horses that successfully completed the course (SC) or were disqualified for irregular gait (FTQ-GA). Beat-to-beat (RR) intervals of 16 healthy horses (aged 6–14 years) were recorded before and throughout the approximately 40 km endurance event. Blood samples were taken at the pre-ride inspection and after passing each veterinary inspection. HRV and haematology measures were determined from nine SC and seven FTQ-GA horses. Horses with different ride results demonstrated distinctive physiological stress responses. Increases in PCV, RBC, WBC and neutrophils after completing the ride were found only in SC horses, implying that they were ridden with greater effort than FTQ-GA horses. A reduction in HRV during warm-up, followed by a significant reduction during the first and second riding phases, was observed. HRV returned to baseline at the compulsory rest period of both phases. FTQ-GA horses experienced lower RR intervals, RR triangular index, modified deceleration capacity, very-low-frequency band, and parasympathetic nervous system index, coinciding with higher HR and sympathetic nervous system and stress indices than SC horses. These results indicated that endurance horses revealed a shift toward sympathetic activity during the ride. Lower parasympathetic activity in FTQ-GA horses suggests they were under more stress or discomfort than SC horses in novice endurance rides. These results have welfare implications, indicating the need for additional rest breaks in FTQ-GA horses.

Work-related musculoskeletal complaints: risk factors and impact on work productivity among university administrative employees

BackgroundWork-related musculoskeletal disorders (WMSDs) are a significant workplace problem leading to loss of productivity and disability. Administrative workers perform computer-based tasks for long periods. Consequently, they are at risk of developing musculoskeletal disorders. The objective of this study was to explore the frequency and risk factors of work-related musculoskeletal complaints and their impact on work productivity among administrative employees of Suez Canal University, Egypt.MethodsThis cross-sectional study was conducted on 300 administrative employees through simple random sampling. Data were collected by an interview questionnaire including sociodemographic, work-related data, ergonomic and psychological risk factors, the Nordic Musculoskeletal Questionnaire (NMQ), and the World Health Organization Health and Work Performance Questionnaire (HPQ).ResultsThe frequency of work-related musculoskeletal complaints in at least one anatomical region over the past year was 74.7%. Neck (47.1%), lower back (40.7%), and shoulder (36.3%) were the most reported sites of complaints. Risk factors significantly associated with work-related musculoskeletal complaints were gender, age, physical activity, work experience, workplace stress, sustained body position, awkward posture, and inadequate rest breaks. Logistic regression revealed that older age (OR = 1.039, p = 0.023), being female (OR = 2.175, p = 0.011), and not having adequate rest breaks (OR = 1.979, p = 0.019) were significant predictors for the occurrence of WMSDs. The risk factors of absenteeism include gender, age, marital status, educational level, physical activity, BMI, work experience, and musculoskeletal complaints.ConclusionMusculoskeletal problems were highly prevalent among administrative employees. Being female and not having adequate rest breaks were significant predictors for the occurrence of WMSDs. Ergonomic interventions and improvement of working conditions are recommended to reduce WMSDs.

Longitudinal Renal Function Degradation Among Florida Agricultural Workers.

This longitudinal study evaluated renal function and acute kidney injury (AKI) over time in US agricultural workers. We followed Florida agricultural workers from January 2020 to August 2022, collecting blood and urine preworkday and postworkday during five visits. Preworkday estimated glomerular filtration rate function in all participants was lower in summers but relatively consistent over time. In participants who worked almost exclusively in fernery operations (piece-rate compensation), we observed a high incidence of postworkday AKI in 2020 (21%) that increased to 43% by the end of the study. In comparison, 11% of nursery workers (hourly compensation) had AKI, and this rate was fairly stable. AKI risk over time differs according to the type of agricultural work. Piece rate workers who are incentivized to forgo rest breaks and hydration to earn higher wages demonstrate steadily increasing rates of AKI.

Ambient conditions of the operating theatre and its correlation with fatigue and sleep quality of operating room workers: a cross-sectional survey.

Anesthesia providers face numerous occupational hazards, including exposure to anesthesia gases, which can lead to fatigue. These professionals face challenges such as night shifts, OR stress, limited mobility and sunlight access, high workload, inadequate rest breaks. Health-related sociodemographic variables, such as smoking, sleep patterns, and obesity. Our research aims to explore various risk factors associated with fatigue among operating theatre workers including sleep quality. A cross-sectional study was conducted on 227 of operating room healthcare professionals from five tertiary hospitals in Saudi Arabia, for a period of 6 months, between January 1, 2023 to June 1, 2023. The study used a five-point Likert scale sheet and the FSS "fatigue severity scale" to analyze and measure fatigue and sleep quality. The questionnaire included all socio-demographic variables, work conditions, and fatigue severity scale items. The major findings revealed a significant correlation between fatigue severity scores and exposure to anesthesia gases. Socio-demographic variables such as smoking have showed major relevance to fatigue in the sample size, as (76.6%) of the participants that answered as regular smokers have showed result of positive correlation to fatigue and with a significant of (0.034). Out of the total sample, 76.1% were exposed to anesthesia gases once daily, showing a positive association with fatigue severity scores. Work-related factors like job experience and position also had a lower association with fatigue severity. p (0.031) Univariate logistic regression p (0.035). The study found that the work-related conditions like workload on Anesthesia technicians and technologists over 44 h per week and gas exposure is directly linked to fatigue severity and sleep quality so is the socio-demographic considerations. With poor sleep quality in younger staff which is documented in the study result a large-scale prospective analysis to understand the factors affecting OR staff's sleep quality and fatigue severity and what can be done to regulate working hours and break time and incorporate naps in to enhance patient safety and well-being for anesthesia providers in Saudi Arabia.

Mandated Rest Breaks and Occupational Injuries and Illnesses in Dallas County, Texas Construction Workers: A Quasi-Experimental, Comparative Interrupted Time Series Study.

We estimated associations of a rest break ordinance, implemented for construction workers in Dallas, Texas in 2016, with workplace injuries and illnesses. We used workers' compensation claims data to compare changes in rates of injuries and illnesses among Dallas County, Texas construction (ie, "treated") workers with changes in untreated workers, before (2013-2015) and after (2016-2018) a rest break ordinance was implemented. Immediately after the ordinance was implemented, rates of injuries/illnesses among treated workers were modestly lower than in comparison workers (rate ratio comparing postmandate vs premandate rates, treated vs comparison workers: 0.89, 95% confidence interval: 0.72-1.11). Postordinance versus preordinance slope trends were similar in the treated versus the comparison group. Ten-minute rest breaks were associated with modestly lower rates of workplace injury/illnesses. More comprehensive standards may be needed for protection.

Effect of Step Load Based on Time under Tension in Hypoxia on the ACL Pre-Operative Rehabilitation and Hormone Levels: A Case Study.

The aim of the study was to determine the effect of step load in hypoxia on the effectiveness of preoperative rehabilitation (PR) and hormone levels based on a case study. Introduction: We assessed the impact of variables such as rate of movement and time under tension (TUT) in normobaric hypoxia on the levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), and erythropoietin (EPO). Additionally, the impact of step load on the hypertrophy and strength of knee extensors and flexors was assessed. Methods: The work uses a case study, the research subject of which was a 23-year-old female professional handball player. The tests included an isokinetic assessment of the peak torque of knee extensors and flexors as well as body composition analysis. Results: The results showed a more than (10.81-fold) increase in GH after the microcycle with time under tension (TUT). The deficit between the lower limbs was also reduced. Conclusions: Using a hypoxic environment based on an appropriate altitude, combined with changes such as a short rest break between sets and a controlled tempo of movement with an eccentric phase, TUT may offer an alternative to the PR process, especially among athletes who care about fast RTS.

Vocal Fatigue and Its Relationship with Vocal Hygiene and Work-Related Factors in Professional and Nonprofessional Voice Users: A Multiple Linear Regression Model Study

To investigate vocal fatigue severity between professional voice users (PVUs) and nonprofessional voice users (NPVUs), and across different levels of voice users. Also to examine the relationship between vocal hygiene and work-related factors with vocal fatigue. This is a cross-sectional descriptive study. Four hundred one individuals from different professions were included in total. Participants were divided into four levels of voice users by classification of Koufman and Isaacson. The top three levels of voice users further identified as PVU, and level 4 voice users identified as NPVU. An online questionnaire which included vocal hygiene checklist, work-related factors, and Turkish version of vocal fatigue index (VFI) was submitted by the participants. Vocal fatigue severity of PVUs were found higher than NPVUs in all VFI scores (P<0.05). Level 2 voice users were found to have more vocal fatigue severity than all other levels of voice users. Call center workers (CCWs) had the highest means of vocal fatigue severity. Based on the multiple linear regression model vocal hygiene and the number of vocal rest breaks were found to have related with vocal fatigue the most (P<0.05). There was also a relation with some VFI scores (P<0.05) with voice usage duration at work and vocal rest duration. We found no relationship between working experience and vocal fatigue. The data suggests the relation between vocal fatigue and vocal hygiene, and work-related factors explain a small proportion of the association. However, in CCWs r2 was found 0.44. The change in vocal fatigue severity did not match with Koufman and Isaacson's classification of voice users. We suggest that there may be other contributing factors to vocal fatigue than vocal hygiene, vocal rest, and voice usage duration even those factors may differ from profession to profession.

ACUTE INTERMITTENT HEAT EXPOSURE WITH MORE FREQUENT AND SHORTER COOLING BREAKS ENHANCES PERFORMANCE AND ELICITS COMPARABLE PHYSIOLOGICAL RESPONSES TO CONTINUOUS HEAT EXPOSURE

INTRODUCTION &amp; AIMS Heat acclimation (HA) is critical to mitigate the adverse effects of heat on exercise performance. While these methods yield physiological adaptations to heat, it also results in greater internal training load. This can potentially compromise training quality and lead to overreaching. Therefore, there is a need for HA protocols that address situations where training quality is crucial, yet the heat stimulus is necessary. The aim of this study was to investigate the influence of shorter, more frequent rest breaks with per-cooling (PerC) as an alternative HA session on physiological, perceptual, and self-paced maximal cycling performance, compared to continuous heat exposure. METHODS Thirteen participants completed one continuous and three intermittent heat exposure (IHE) maximal self-paced cycling protocols matched for total exercise and rest duration, in a random order in heat (36°C, 80% relative humidity): 1 x 60-min exercise (CON), 3 x 20-min exercise with 7.5-min rest between sets (IHE-20), 4 x 15-min exercise with 5-min rest between sets (IHE-15), 6 x 10-min exercise with 3-min rest between sets (IHE-10). Mixed-method PerC (crushed-ice ingestion and cooling vest) was applied during rest periods of all IHE protocols. RESULTS Total distance completed was greater in IHE-10, IHE-15, and IHE-20 compared to CON (+11%, +9%, and +8%, respectively), with no difference observed between IHE protocols. Total time spent above 38.5°C core temperature (Tc) was longer in CON compared to IHE-15 and IHE-20 (+62% and +78%, respectively), but similar to IHE-10 (+5%). Furthermore, a longer time above 38.5°C Tc occurred in IHE-10 versus IHE-15 and IHE-20 (+54% and +69%, respectively). Sweat loss did not differ between conditions. CONCLUSION Intermittent heat exposure with PerC may be a viable alternative HA protocol in situations where training quality takes precedence over thermal stimulus, or when both factors hold equal priority.

Subjective perceived risk factors of exertional heat exhaustion-related symptoms in female collegiate athletes in Japan.

Associations of exertional heat exhaustion (EHE)-related symptoms with lifestyle habits and health factors specific to female athletes, ranked by relative risks from high to low, remain elusive. Addressing this issue would benefit athletes and coaches, ensuring safer practices during summer sports activities. To address this issue, we distributed paper-based questionnaires to seven universities in Japan, and 983 respondents completed our survey. The questionnaires covered various personal characteristics, lifestyle habits, perceived health factors, perceived athletic activity, and EHE-related symptoms. In this retrospective case-control study, we analyzed the relationships of EHE-related symptoms (objective variables) with lifestyle habits, health factors, and athletic activity conditions (explanatory variables) using the partial proportional odds model. The questionnaire responses revealed that perceived dehydration, sickness, loss of appetite, perceived accumulated fatigue, perceived mental stress, lack of ambient wind, and insufficient rest breaks were positively associated with EHE-related symptoms, with relative risks ranging from high to low. Using an air conditioner during sleep and having a sleep duration of ≥ 6h were associated with a reduced risk of EHE-related symptoms. The study results suggest that female athletes should be allowed to postpone exercise or reduce its intensity and volume based on their perceptions of dehydration, sickness, loss of appetite, accumulated fatigue, and mental stress in summer to prevent heat-related illnesses.