Self-reported Fatigue Research Articles

Fatigue After Daily Activities for Children with Traumatic Brain Injury and Typically-Developing Peers

<h3>Research Objectives</h3> Fatigue is one of the most persistent symptoms after acquired brain injury, but few studies have investigated the impact of daily activities (e.g., academic, social) on fatigue in children with traumatic brain injury (TBI). The primary aim of this study was to compare subjective parent- and self-reports of fatigue across daily activities between children with TBI and typically developing (TD) children. <h3>Design</h3> Cross sectional survey completed at two time points (i.e., after a school day; after a weekend day) within 30 days <h3>Setting</h3> self-administered, electronic survey in home/preferred setting. <h3>Participants</h3> 30 participants (15 children with TBI and 15 TD children) ages 8-14 years old. Participants in the TBI group experienced moderate-severe TBIs at 4.69 years (SD = 1.53) and were 5.37 years (SD = 1.53) post-injury at the time of survey participation. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> demographics and injury questionnaire; Pediatric Quality of Life Multi-Dimensional Fatigue Scale (PedsQL MFS). <h3>Results</h3> Participants in the TBI group were parent- and self-reported to have significantly greater levels of fatigue in all domains (i.e., sleep/rest, physical, cognitive, total) compared to TD participants (p < .001), after both a school day and a weekend day. Yet, all participants (i.e., TD and TBI groups) were parent- and self-reported to have similar levels of fatigue in all domains (p > .05) after a school day compared to after a weekend day. <h3>Conclusions</h3> The findings of this study support the chronic nature of fatigue after childhood TBI. Comparing fatigue between children with TBI and TD children and across daily activities highlights opportunities for rehabilitation professionals to refine their supports and services o improve the academic and social participation of children with TBI. <h3>Author(s) Disclosures</h3> Jessica Salley Riccardi has no financial or non-financial relationships to disclose.

Dynamics of Physiological, Biochemical and Psychological Markers during Single Session of Virtual Reality-Based Respiratory Biofeedback Relaxation.

Psychological stress exposure is associated with long-lasting health effects including memory problems, depression, aches and pains, eating disorders, and alcohol or drug use. Thus, there is a need to develop effective stress management strategies that are easy to learn and practice. Respiratory biofeedback is an evidence-based stress management technique presenting breathing-related information to help subjects learn specific breathing skills for relaxation. It is suggested that the use of biofeedback techniques in conjunction with virtual reality makes biofeedback training an even more effective tool for stress management. The current study aimed to investigate dynamics of distinct stress indicators before, after, as well as during one brief virtual reality-based respiratory biofeedback session. Thirty-nine healthy volunteers participated in the study. Individuals provided their saliva samples and evaluated their mood status, fatigue, and strain level before and after the session. The subjects' heart and respiratory rate, heart rate variability, and galvanic skin response measures were recorded during the session. The results showed that after single 12 min relaxation session, there was a significant decrease in salivary cortisol concentration, heart and respiratory rate, as well as decrease in skin conductance values. Self-reported strain, fatigue level, and mood status also significantly improved. VR-based respiratory-biofeedback-assisted relaxation sessions might serve as an effective stress management strategy, as even single session had positive effects on subjects' autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis activity, as well as self-reported fatigue, strain level, and mood status.

Components of the frailty phenotype as predictors of mortality among older adults after four years of hospital discharge

Objective: to verify the association between impairment of frailty phenotype components as predictors of mortality among older adults after four years of hospital discharge. Methodology: Prospective and longitudinal investigation, carried out with hospitalized older adults, at baseline, and followed up after hospital discharge. Of the 163 older adults included in the study, 43 died during follow-up and 92 completed the four-year follow-up. The following instruments were used: Mini Mental State Examination, a form for characterizing sociodemographic, economic and health data; and Fried's frailty phenotype. Survival analysis was performed using the Kaplan-Meier method and Cox regression to estimate the risk ratio (Hazard Ratio) of mortality among older adults with impairment in each component of the phenotype, considering p&lt;0.05. Results: The impairment in the components of the frailty phenotype slow gait speed (HR: 3.27; 95%CI: 1.655-6.475; p&lt;0.001); decreased muscle strength (HR:3.09; 95%CI: 1.605-5.959; p=0.001); self-reported exhaustion and/or fatigue (HR: 2.97; 95%CI: 1.508-5.853; p=0.002) and low level of physical activity (HR: 3.22; 95%CI: 1.693-6.138; p&lt;0.001) remained as predictors of mortality, after adjustment; and represented a lower probability of survival. Conclusion: Impairment in the components of gait speed, muscle strength, exhaustion and/or fatigue and physical activity at baseline represented a higher risk for mortality among the elderly at follow-up. Thus, there is the possibility of targeting interventions in risk groups to improve the condition of frailty and, consequently, increase survival.

Load and fatigue monitoring in musicians using an online app: A pilot study.

High occupational injury rates are reported in musicians, with a career prevalence of up to 89%. Fatigue and playing (over)load are identified as key risk factors for musicians' injuries. Self-report fatigue management strategies in sport have demonstrated preventive effects. A self-report fatigue management tool for musicians was developed based on a Delphi survey of international experts and hosted in an online app. The aims of this study are to evaluate the content validity and uptake of this new tool, and explore associations between collected performance quality, physical/psychological stress, pain, injury and fatigue data. University and professional musicians were asked to provide entries into the online app twice per week for 1-6 months. Entries into the app were designed to take 2-3 min to complete and consisted of the following: 6 questions regarding playing load over the previous 72 h; 5 questions regarding current levels in key physical/psychological stress domains (sleep, recovery, overplaying, pain, fitness); one question self-rating of performance quality over the previous day; one question regarding current musculoskeletal symptoms; a reaction time task to evaluate psychomotor fatigue. N = 96 participants provided an average of 2 app entries (range 0-43). Increased playing time, rating of perceived exertion (RPE), and feelings of having to "play too much" were consistently associated with increased self-rated performance quality (p ≤ 0.004; 6.7 <| t |< 2148.5). Increased ratings of feeling fit and recovering well were consistently associated with reduced pain severity (p < 0.001; 3.8 <| t |< 20.4). Pain severity was increased (6.5/10 vs. 2.5/10; p < 0.001) in participants reporting playing-related musculoskeletal disorders (PRMDs; symptoms affecting playing). The prospective value of regular individual self-report playing load, stress, and performance data collection in musicians is clear. However, limited uptake of the online fatigue management app piloted in this study indicates that new approaches to the collection of these data are needed to realize their potential impact.

Correlation of Preflight Risk Assessment Scores With First-Pass Intubation Success in a Critical Care Transport Environment

ObjectiveThe purpose of this study was to examine the impact of crew fatigue on the performance of a high-risk clinical skill in a clinical setting. MethodsThis was a retrospective analysis of first-pass intubation success comparing critical care providers with self-reported fatigue and those without fatigue in a transport environment. Results: No statistical difference was found in first-pass intubation between fatigued and nonfatigued practitioners. ConclusionFuture studies should determine the impact of fatigue on psychomotor and cognitive skills using validated methods of assessing the level of fatigue at the time of skill performance.

Assessment of cognitive function, structural brain changes and fatigue 6 months after treatment of neuroborreliosis

BackgroundComplete recovery after adequately treated neuroborreliosis is common, but studies report that some patients experience persistent symptoms like self-reported cognitive problems and fatigue. Persisting symptoms are often termed post-Lyme disease syndrome, of which etiology is not clearly understood. The aim of this study was to investigate cognitive function, possible structural changes in brain regions and level of fatigue. We have not found previous studies on neuroborreliosis that use standardized neuropsychological tests and MRI with advanced image processing to investigate if there are subtle regional changes in cortical thickness and brain volumes after treatment.MethodsWe examined 68 patients treated for neuroborreliosis 6 months earlier and 66 healthy controls, with a comprehensive neuropsychological test protocol, quantitative structural MRI analysis of the brain and Fatigue Severity Scale.ResultsWe found no differences between the groups in either cognitive function, cortical thickness or brain volumes. The patients had higher score on Fatigue Severity Scale 3.8 vs. 2.9 (p = 0.001), and more patients (25.4%) than controls (5%) had severe fatigue (p = 0.002), but neither mean score nor proportion of patients with severe fatigue differed from findings in the general Norwegian population.ConclusionThe prognosis regarding cognitive function, brain MRI findings and fatigue after adequately treated neuroborreliosis is favorable.

Assessing fatigue and sleep in chronic diseases using physiological signals from wearables: A pilot study.

Problems with fatigue and sleep are highly prevalent in patients with chronic diseases and often rated among the most disabling symptoms, impairing their activities of daily living and the health-related quality of life (HRQoL). Currently, they are evaluated primarily via Patient Reported Outcomes (PROs), which can suffer from recall biases and have limited sensitivity to temporal variations. Objective measurements from wearable sensors allow to reliably quantify disease state, changes in the HRQoL, and evaluate therapeutic outcomes. This work investigates the feasibility of capturing continuous physiological signals from an electrocardiography-based wearable device for remote monitoring of fatigue and sleep and quantifies the relationship of objective digital measures to self-reported fatigue and sleep disturbances. 136 individuals were followed for a total of 1,297 recording days in a longitudinal multi-site study conducted in free-living settings and registered with the German Clinical Trial Registry (DRKS00021693). Participants comprised healthy individuals (N = 39) and patients with neurodegenerative disorders (NDD, N = 31) and immune mediated inflammatory diseases (IMID, N = 66). Objective physiological measures correlated with fatigue and sleep PROs, while demonstrating reasonable signal quality. Furthermore, analysis of heart rate recovery estimated during activities of daily living showed significant differences between healthy and patient groups. This work underscores the promise and sensitivity of novel digital measures from multimodal sensor time-series to differentiate chronic patients from healthy individuals and monitor their HRQoL. The presented work provides clinicians with realistic insights of continuous at home patient monitoring and its practical value in quantitative assessment of fatigue and sleep, an area of unmet need.

P071 Actigraphy-Derived Rest-Activity Rhythms Predict Sleep-Related Self-Report Outcomes in Women Receiving Chemotherapy for Breast Cancer

Abstract Introduction Circadian rest-activity rhythms (RARs) disruption is common during chemotherapy for breast cancer, but little is known regarding its association with sleep and daytime functioning. In this study, we evaluated whether objectively-assessed RARs prospectively predict self-reported insomnia and fatigue symptoms, daytime sleep-related impairment, and sleep disturbance. Methods This is a secondary analysis of a trial. Participants (N=101) were randomized to cognitive behavioural plus light therapy or relaxation audios. Participants wore an actigraph continuously throughout the 6-week intervention. RAR indices (interdaily stability, intradaily variability, relative amplitude, least active 5h period [L5], most active 10h period [M10]) were calculated based on two weeks (4 &amp; 5). Self-reported outcomes were assessed at weeks 3 and 6. Self-reported outcomes at week 6 were predicted by RAR indices controlling for self-reported outcomes at week 3 and intervention condition. Results Lower L5 predicted lower self-reported insomnia and fatigue symptoms, sleep-related impairment, and sleep disturbance (all p&amp;lt;.05). With the exception of insomnia symptoms (p&amp;gt;.05), higher inter-daily stability predicted lower symptoms of fatigue, sleep-related impairment and sleep disturbance (all p&amp;lt;.05). Similarly, excluding sleep disturbance (p&amp;gt;.05), higher relative amplitude predicted fewer endorsed symptoms on self-reported measures (all p&amp;lt;.01). Neither M10 nor intradaily variability predicted self-reported outcomes (all p&amp;gt;.05). Discussion RAR disruption demonstrated the most reliable association with daytime sleep-related complaints. The entrainment of a robust diurnal rhythm may reflect a novel intervention target. Direct intervention on distinct RAR characteristics may yield secondary gains on several self-reported sleep-related outcomes, particularly those related to daytime functioning. Trial Registration ACTRN12618001255279

Post-COVID-19 Syndrome: Retinal Microcirculation as a Potential Marker for Chronic Fatigue.

Post-COVID-19 syndrome (PCS) is characterized by persisting sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PCS can affect patients with all COVID-19 disease severities. As previous studies have revealed impaired blood flow as a provoking factor triggering PCS, it was the aim of the present study to investigate the potential association between self-reported chronic fatigue and retinal microcirculation in patients with PCS, potentially indicating an objective biomarker. A prospective study was performed, including 201 subjects: 173 patients with PCS and 28 controls. Retinal microcirculation was visualized by OCT angiography (OCT-A) and quantified using the Erlangen-Angio-Tool as macula and peripapillary vessel density (VD). Chronic fatigue (CF) was assessed according to the variables of Bell's score, age and gender. VDs in the superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were analyzed, considering the repetitions (12 times). Seropositivity for autoantibodies targeting G protein-coupled receptors (GPCR-AAbs) was determined by an established cardiomyocyte bioassay. Taking account of the repetitions, a mixed model was performed to detect possible differences in the least square means between the different groups included in the analysis. An age effect in relation to VD was observed between patients and controls (p &lt; 0.0001). Gender analysis showed that women with PCS showed lower VD levels in the SVP compared to male patients (p = 0.0015). The PCS patients showed significantly lower VDs in the ICP as compared to the controls (p = 0.0001 (CI: 0.32; 1)). Moreover, considering PCS patients, the mixed model revealed a significant difference between those with chronic fatigue (CF) and those without CF with respect to VDs in the SVP (p = 0.0033 (CI: -4.5; -0.92)). The model included variables of age, gender and Bell's score, representing a subjective marker for CF. Consequently, retinal microcirculation might serve as an objective biomarker in subjectively reported chronic fatigue in patients with PCS.

Executive and social functioning in pediatric posterior fossa tumor survivors and healthy controls.

Executive and social functioning difficulty is well established in pediatric brain tumor survivors. Few studies have compared posterior fossa (PF) tumor survivors in comparison to their peers. The relationship between attention, processing speed, working memory, fatigue, and executive and social functioning was investigated to better understand the factors that impact executive and social functioning in PF tumor populations. Sixteen medulloblastomas, 9 low-grade astrocytomas (LGAs), and 17 healthy controls recruited from 4 sites completed measures of working memory and processing speed, and self-reported fatigue. One parent completed questionnaires on executive and social functioning. There were no significant differences among all 3 groups on parent-reported executive and social functioning; of note, parents of LGA survivors expressed greater concerns regarding behavioral and cognitive regulation than did parents of medulloblastoma survivors and healthy controls. Parent-reported attention was related to parent-reported emotion, behavior, and cognitive regulation. Worse self-reported fatigue was associated with greater emotional dysregulation for the 2 PF tumor groups. Parents of PF tumor survivors described their children as performing similarly to their peers in most facets of executive and social functioning. While LGA survivors are traditionally thought to have more favorable outcomes, our finding of parent-reported executive functioning concerns to be worse for this group highlights the importance of long-term follow-up for all PF tumor survivors. Additionally, significant effects of attention on aspects of executive functioning in PF tumor survivors may inform current clinical practice and the future development of more effective interventions.

Intermuscular adipose tissue in patients with systemic lupus erythematosus

ObjectivePatients with SLE frequently have debilitating fatigue and reduced physical activity. Intermuscular adipose tissue (IMAT) accumulation is associated with reduced physical exercise capacity. We hypothesised that IMAT is increased in...

Effects of energy balance on cognitive performance, risk-taking, ambulatory vigilance and mood during simulated military sustained operations (SUSOPS)

Sustained operations (SUSOPS) require military personnel to conduct combat and training operations while experiencing physical and cognitive stress and limited sleep. These operations are often conducted in a state of negative energy balance and are associated with degraded cognitive performance and mood. Whether maintaining energy balance can mitigate these declines is unclear. This randomized crossover study assessed the effects of energy balance on cognitive performance, risk-taking propensity, ambulatory vigilance, and mood during a simulated 72-h SUSOPS. MethodsTen male Soldiers (mean ± SE; 22.4 ± 1.7 y; body weight 87.3 ± 1.1 kg) completed two, 72-h simulated SUSOPS in random order, separated by 7 days of recovery. Each SUSOPS elicited ∼4500 kcal/d total energy expenditure and restricted sleep to 4 h/night. During SUSOPS, participants consumed either an energy-balanced or restricted diet that induced a 43 ± 3% energy deficit. A cognitive test battery was administered each morning and evening to assess: vigilance, working memory, grammatical reasoning, risk-taking propensity, and mood. Real-time ambulatory vigilance was assessed each morning, evening, and night via a wrist-worn monitoring device. ResultsParticipants exhibited heightened risk-taking propensity (p = 0.047) with lower self-reported self-control (p = 0.021) and fatigue (p = 0.013) during energy deficit compared to during energy balance. Vigilance accuracy (p < 0.001) and working memory (p = 0.040) performance decreased, and vigilance lapses increased (p < 0.001) during SUSOPS, but did not differ by diet. Percentage of correct responses to ambulatory vigilance stimuli varied during SUSOPS (p = 0.019) independent of diet, with generally poorer performance during the morning and night. Total mood disturbance (p = 0.001), fatigue (p < 0.001), tension (p = 0.003), and confusion (p = 0.036) increased whereas vigor decreased (p < 0.001) during SUSOPS, independent of diet. ConclusionProlonged physical activity combined with sleep restriction is associated with impaired vigilance, memory, and mood state. Under such conditions, maintaining energy balance prevents increased risk-taking and improves self-control, but does not improve other aspects of cognitive function or mood. Given the small sample in the present study, replication in a larger cohort is warranted.

Effects of total sleep deprivation on execution lapses during vigilance tasks

ABSTRACT Total sleep deprivation (TSD) results in reduced efficiency of cognitive resources. Moreover, when the available cognitive resources are less than required, individuals exhibit lapses in responsiveness. Accordingly, this study explored the effects of TSD on executive function and the characteristics of execution lapses. Functional near-infrared spectroscopy was used to monitor the prefrontal cortex’s functional connections in resting and tasking states for various sleep deprivation durations. Data from participants’ attentional performance test and self-reported fatigue were collected over 30 hours of wakefulness. Task performance was compared based on time of day, time on task, and reaction time. The results show that participants’ arousal level significantly decreased post 14 hours (P < .05), while sleepiness increased. The prefrontal cortex connection and attentional performance dropped at the Window of Circadian Low (3:00 ~ 6:00). The number of execution lapses was higher during the initiation, inhibition, and fatigue phases and rose markedly post 14 hours of wakefulness. We conclude that maintaining better inhibition control requires a reasonable extension of the reaction time. Moreover, subjective perception is significantly correlated with task performance and right prefrontal connection strength. This study presents the scientific evidence for measures to address consistently long working hours and disrupted circadian rhythms.

Virtual cardiac fitness training in pediatric heart transplant patients: A pilot study.

Cardiac fitness training in pediatric heart transplant recipients can improve functional capacity. Widespread implementation has been limited mostly due to logistical constraints, specifically related to travel. The aim of this study was to implement and assess a virtual cardiac fitness program for pediatric heart transplant patients. Participants were between the age of 10 and 20 years old. All subjects completed an initial 6MWT, strength/flexibility assessment, and QOL assessment with the PROMIS measurement. Participants then underwent a 16-week intervention with exercise sessions twice weekly for 30 min with a trained exercise physiologist over a virtual platform. At the end of the intervention period, participants repeated a 6MWT, strength/flexibility assessment, and PROMIS measurement. Throughout the study, patients wore a FitBit accelerometer to monitor daily activity levels. Thirteen individuals were enrolled. Mean age was 15.4 years (SD =3.4) with a mean post-transplant period of 9.7 years (SD = 4.3). Session attendance was 83%. Post-intervention measurements showed improvements in 6MWT (median, +21 m, p=.02), push-up repetitions (median, +5 rep, p=.0005), wall-sit duration (median, +10 s, p=.001), plank duration (median, +9 s, p=.03), sit-up repetitions (median, +7 rep, p=.002), and sit and reach distance (median, +5 cm, p=.04). PROMIS measurement showed significant improvements in self-reported fatigue (Δz-score, -7.7, p=.008) and sleep impairment (Δz-score, -5.9, p=.002). Average daily step count increased 1464 steps per day per patient (p=.008). We have demonstrated the successful implementation of a virtual cardiac fitness with excellent adherence and improvement in physical fitness and QOL metrics.

212 FATIGUE EXPERIENCED BY ADULTS WITH LONG-COVID WAS NOT ASSOCIATED WITH AN EMG-DERIVED MUSCLE FATIGUE INDEX

Abstract Background One of the most prominent challenges of the COVID-19 pandemic is the emergence of the post-COVID-19 syndrome or ‘long-COVID’ following the acute phase of the viral infection. With a plethora of debilitating symptoms across many physiological systems, the pathophysiology of long-COVID remains elusive and subject of intense research efforts. Adults with long COVID are often affected by prolonged fatigue, which could be linked to neuromuscular function impairment. We hypothesised that there might be a correlation between subjective fatigue and an Electromyograph(EMG)-derived muscle fatigue index in adults with long-COVID. Methods As part of a neuro-cardiovascular instability assessment protocol, participants were asked to squeeze the thigh muscles as hard as possible for ten seconds during both supine resting and after active and passive standing (head-up tilt) tests. Surface EMG was used to capture on each leg the physiological activity of the vastus lateralis and rectus femoris during the squeezes, from which the muscle fatigue index was computed based on both the mean and median frequencies of each 10-second maximum prompted muscle contraction. Using two-sided Spearman correlation coefficients, we examined the associations between the muscle fatigue indices and self-reported fatigue measured by the Chalder Fatigue Scale (CFQ). Results 108 participants were included, 77 female and 31 male, with a mean age of 46 (range 25-78) years, 22% of whom were hospitalised in the acute phase of SARS-CoV-2 infection. Strong intercorrelations were found between the muscle fatigue indices derived from the mean and median frequencies of thigh muscle contractions. However, no significant correlations were detected between the muscle fatigue indices and CFQ scores. Conclusion Self-reported fatigue as measured by the CFQ was not associated with an EMG-derived muscle fatigue index in this long-COVID cohort.

The Economic and Humanistic Burden of Pediatric-Onset Multiple Sclerosis.

Background: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. Pediatric-onset MS (POMS), defined as onset of MS before 18 years of age, is estimated to account for 2% to 5% of the MS population worldwide. Objectives: To conduct a literature review focused on the healthcare resource utilization and cost as well as quality-of-life (QOL) outcomes among patients with POMS. Methods: We conducted a systematic literature review of English-language studies published after September 2010 in MEDLINE and Embase to describe the global economic healthcare resource utilization and costs and humanistic (QOL) burden in patients with POMS. Results: We found 11 studies that reported on healthcare resource utilization, cost, or insurance coverage and 36 studies that reported on QOL outcomes in patients with POMS. Patients with POMS had higher rates of primary care visits (1.41 [1.29-1.54]), hospital visits (10.74 [8.95-12.90]), and admissions (rate ratio, 4.27 [2.92-6.25];OR, 15.2 [12.0-19.1]) compared with healthy controls. Mean per-patient costs in the United States were $5907 across all settings per year of follow-up between 2002 and 2012; mean costs per hospital stay were $38 543 (in 2015 USD) between 2004 and 2013. Three studies reported psychosocial scores between 71.59 and 79.7, and 8 studies reported physical health scores between 74.62 to 82.75 using the Pediatric Quality of Life Measurement Model (PedsQLTM). Twelve studies used the PedsQL™ Multidimensional Fatigue Scale. Mean scores on the self-reported general fatigue scale ranged from 63.15 to 78.5. Quality-of-life scores were lower than those of healthy controls. Discussion: Our review presents a uniquely broad and recent overview of the global economic and humanistic burden of patients with POMS. Additional research on healthcare resource utilization and cost would provide a more robust understanding of the economic burden in this population. Conclusions: Healthcare resource utilization and costs are high in this population, and patients report reduced QOL and significant fatigue compared with healthy children and adolescents.

The effect of shift work on burnout and occupational fatigue among clinical faculty members during the COVID-19 pandemic.

Shift work of clinical faculty members in the COVID-19 pandemic may cause burnout and occupational fatigue and as a result, may reduce the quality of student education and disrupt the treatment of patients, so this study was conducted to evaluate this case. The statistical population of this cross-sectional research included all clinical faculty members of Ahvaz Jundishapur University of Medical Sciences in southwestern Iran, who experienced a shift work system (night shift from 8 p.m. to 8 a.m.) during the COVID-19 pandemic, and finally, 71 of them participated in it. The sampling method was also available. Two inventories were used to collect data, namely the Maslach Burnout Inventory [MBI-HSS (MP)] and the Swedish Occupational Fatigue Inventory (SOFI-20). The self-reported burnout of faculty members was high (mean ± SD = 98.18 ± 17.18), which was graded into the range of emotional exhaustion (38.01 ± 10.2), range of personal accomplishment, (33.75 ± 6.75), and the range of depersonalization (26.42 ± 3.5), respectively. Perceived occupational fatigue of faculty members was also high (M ± SD = 82.25 ± 34.79), which included the dimensions of lack of motivation (18.69 ± 8.65), drowsiness (17.43 ± 8.7), lack of energy (16.33 ± 7.67), physical discomfort (15.65 ± 8.62), and physical stress (13.51 ± 6.9), respectively. In terms of demographic characteristics, occupational fatigue was significantly more common among women. The self-reported burnout and occupational fatigue of clinical faculty members due to shift work were reported to be high in this study. Although our knowledge of burnout has advanced in recent years, many gaps in our knowledge still remain. In order for clinical faculty members to properly fulfill their mission to treat patients, educate students, and promote public health, it is necessary to provide all the necessary conditions for their effective activity. Some interventions, such as improving organizational strategies and providing technical solutions, incentives, and occupational facilities, can help reduce or eliminate these problems.

Depression and fatigue in active IBD from a microbiome perspective—a Bayesian approach to faecal metagenomics

BackgroundExtraintestinal symptoms are common in inflammatory bowel diseases (IBD) and include depression and fatigue. These are highly prevalent especially in active disease, potentially due to inflammation-mediated changes in the microbiota-gut-brain axis. The aim of this study was to investigate the associations between structural and functional microbiota characteristics and severity of fatigue and depressive symptoms in patients with active IBD.MethodsWe included clinical data of 62 prospectively enrolled patients with IBD in an active disease state. Patients supplied stool samples and completed the questionnaires regarding depression and fatigue symptoms. Based on taxonomic and functional metagenomic profiles of faecal gut microbiota, we used Bayesian statistics to investigate the associative networks and triangle motifs between bacterial genera, functional modules and symptom severity of self-reported fatigue and depression.ResultsAssociations with moderate to strong evidence were found for 3 genera (Odoribacter, Anaerotruncus and Alistipes) and 3 functional modules (pectin, glycosaminoglycan and central carbohydrate metabolism) with regard to depression and for 4 genera (Intestinimonas, Anaerotruncus, Eubacterium and Clostridiales g.i.s) and 2 functional modules implicating amino acid and central carbohydrate metabolism with regard to fatigue.ConclusionsThis study provides the first evidence of association triplets between microbiota composition, function and extraintestinal symptoms in active IBD. Depression and fatigue were associated with lower abundances of short-chain fatty acid producers and distinct pathways implicating glycan, carbohydrate and amino acid metabolism. Our results suggest that microbiota-directed therapeutic approaches may reduce fatigue and depression in IBD and should be investigated in future research.

Self-reported work-related accumulative fatigue of nurses: A cross-sectional study in public hospitals in China.

ObjectivesWork-related fatigue is a serious safety risk to nurses and their patients. This study aimed to assess self-reported work-related accumulative fatigue of nurses and its associated factors.MethodsA questionnaire survey of 2,918 clinical nurses conveniently sampled from 48 public hospitals across six provinces in China was conducted. The “Self-diagnosis Checklist for Assessment of Workers' Accumulated Fatigue” was adopted to assess the level of work-related accumulative fatigue of the study participants. Chi-square tests and ordinal regression analyses were performed to determine the sociodemographic characteristics associated with work-related accumulative fatigue.ResultsAbout one third of respondents reported low work-related accumulative fatigue, compared with 23.1% reporting high and 24.6% reporting very high levels of work-related accumulative fatigue. Higher levels of work-related accumulative fatigue were associated with female gender (AOR = 0.614 for male relative to female, p = 0.005), age between 30 and 40 years (AOR = 1.346 relative to >40 years, p = 0.034), 5–10 years of work experience (AOR = 1.277 relative to >10 years, p = 0.034), and bachelor or above degree qualifications (AOR = 0.806 for associate degree relative to bachelor or above degree, p = 0.007). Those who worked in rural county hospitals (AOR = 0.816 for metropolitan relative to rural county hospitals, p = 0.006) and resided in central China (AOR = 1.276 relative to western China, p = 0.004) had higher odds of reporting higher levels of work-related accumulative fatigue.ConclusionHigh levels of work-related accumulative fatigue are evident in nurses of public hospitals in China. The problem is more serious in the female nurses in their mid-career and those who worked in the central region and rural setting.

Smooth-pursuit performance during Eye-typing from Memory indicates Mental Fatigue.

Mental fatigue is known to occur as a result of activities related to e.g. transportation, health-care, military operations and numerous other cognitive demanding tasks. Gaze tracking has wide-ranging applications, with the technology becoming more compact and processing power reducing. Though numerous techniques have been applied to measure mental fatigue using gaze tracking, smooth-pursuit movement, a natural eye movement generated when following a moving object with gaze, has not been explored with relation to mental fatigue. In this paper, we report the results from a smooth-pursuit movement based eye-typing experiment with varying task difficulty to generate cognitive load, performed in the morning and afternoon by 36 participants. We have investigated the effects of time-on-task and time of day on mental fatigue using self-reported questionnaires and smooth-pursuit performance, extracted from the gaze data. The self-reported mental fatigue increased due to time-on-task, but the time of day did not have an effect. The results illustrate that smooth-pursuit movement performance declined with time-on-task, with increased error in the gaze position and an inability to match the speed of the moving object. The findings exhibit the feasibility of mental fatigue detection using smoothpursuit movements during an eye-interactive task of eye-typing.