Subjective Feelings Of Fatigue Research Articles

P1479: A BASELINE AUDIT OF THE USE A VALIDATED PSYCHOMETRIC TOOL (ASCQ-ME) TO ASSESS THE UNMET PSYCHOLOGICAL NEEDS OF A 2021 COHORT OF PATIENTS LIVING WITH SICKLE CELL

Background: Adults living with inherited red cell disorders face myriad social and emotional challenges. While the literature highlights higher incidence rates of depression and anxiety in those with sickle cell disease (SCD) compared to the general population, granular data on the specific emotional experience of these people is missing, resulting in boundaries to accessing mental health care. New disease modifying drugs can now preferentially increase haemoglobin with relatively small impact on crisis frequency or reduce crisis frequency with minimum impact on haemoglobin. Current management of patients still focuses on pain crisis and crisis prevention. At the time of this study, in the UK, hydroxycarbamide and exchange transfusion were the only available disease modifying therapies. Aims: This study aimed to quantify psycho-social functioning and more accurately identify multifactorial level of need in patients living with SCD. Methods: The present study used a validated, detailed, psychometric test, the Adult Sickle Cell Questionnaire Measure (ASCQ-Me), to identify need in a population of adults living with SCD in Cambridge. Self-report ASCQ-Me data was collected from patients (N=59) first on how SCD has affected 5 domains of psych-social impact (emotional, pain, sleep, social, stiffness), and second about the frequency and severity of sickle crisis. Demographic data was recorded based on sickle genotype, age, sex, disease modification, whether patients had fatigue, and whether patients requested counselling at the time of annual review. Results: Patients who reported fatigue had significantly lower scores across all 5 domains of psychological impact than patients that did not report fatigue. However, there was no difference in Hb or HbF levels. When patients were split by disease modification (hydroxycarbamide, exchange transfusion, or no modification) there seemed to be a trend towards worsening psychological impact in all 5 domains for patients in the exchange group, with better outcomes from patients on hydroxycarbamide. There was no significant difference in psychological impact scores when patients were split by sex or sickle genotype. In particular, there was a trend towards higher frequency, but reduced intensity of pain crisis in patients with SC disease, but this did not reach significance. Patients who stated that they would like to be referred for psychological counselling also showed significantly worse scores across all 5 domains of psychological impact. Image:Summary/Conclusion: There is an unmet need in providing psychological support for patients with complex diseases like sickle cell. Our finding that the subjective feeling of fatigue is associated with a multidimensional lower performance in the ASCQ-Me, in addition to disease modifying therapy, psychological support will remain very important and should not be attributed to anaemia alone.

Ergonomic Task Analysis for Prioritization of Work-Related Musculoskeletal Disorders among Mango-Harvesting Farmers

This paper proposes a mixed ergonomic tool analysis algorithm to prioritize work-related musculoskeletal problems. This study is a cross-sectional study assessing the prevalence of work-related musculoskeletal disorders (WMSDs) with associated risk factors among 14 male mango-harvesting farmers (all right-handed) with the mean age of 52.28 ± 7.75 years. Four tasks following mango-harvesting processes were analyzed: (1) mango harvesting, (2) mango transporting, (3) mango size sorting, and (4) mango weighing and transporting to the truck. The perceived physical exertion while working on a mango-harvesting farm was based on the Borg CR-10 with a modified Standardized Nordic Questionnaire. Physical risk level due to awkward posture was evaluated by the Rapid Upper Limb Assessment (RULA), and risk due to whole-body posture in association with the level of WMSDs risk was evaluated by the Rapid Entire Body Assessment (REBA) score sheets. The subjective feelings of fatigue and posture analysis were normalized and combined using the theorem of power superposition to establish the fatigue effective index (FEI) for determining priorities to solve ergonomics-based task problems. This study indicated clearly that WMSDs are highly prevalent in mango-harvesting farmers, whereas the highest prevalence of WMSDs was reported in the right shoulder, right upper arm and lower back. The result provided the FEI of mango-harvesting farmers, ranked as follows: (1) size-sorting task, (2) weight-lifting task, (3) harvesting task, and (4) transporting task. The authors concluded that mango size sorting should be the first task to be improved to resolve the muscle fatigue problems among male mango-harvesting farmers.

Preoperative carbohydrate loading with individualized supplemental insulin in diabetic patients undergoing gastrointestinal surgery: A randomized trial

BackgroundPreoperative carbohydrate drink is used to improve patients’ comfort and recovery, but evidence remains limited in diabetic patients. Herein we investigated the effects of preoperative carbohydrate loading with individualized supplemental insulin regimen in diabetic patients undergoing gastrointestinal surgery. MethodsA total of 63 adult patients with type 2 diabetes mellitus undergoing major gastrointestinal surgery were randomized to receive either carbohydrate loading with individualized supplemental insulin (Carbohydrate group) or routine management (Control group). The primary outcome was time to first flatus after surgery. Among secondary outcomes, subjective feelings of thirsty, hunger and fatigue were assessed with the Visual Analogue Scale (scores range from 0 to 100, where 0 indicate no discomfort and 100 the most severe discomfort) before and after surgery. Adverse events were monitored until 24 h after surgery. ResultsAll patients were included in the intention-to-treat analysis. Time to first flatus did not differ between groups (median 41 h [IQR 18–69] in the Control group vs. 43 h [27–54] in the Carbohydrate group; hazard ratio 1.24 [95% CI 0.74–2.07]; P = 0.411). The VAS score of preoperative subject feeling of thirsty (median difference −33 [95% CI -50 to −15], P < 0.001), hunger (−25 [-40 to −10], P < 0.001), and fatigue (−5 [-30 to 0], P = 0.004), as well as postoperative subject feeling of thirsty (−50 [-60 to −30], P < 0.001), hunger (−20 [-40 to 0], P = 0.003), and fatigue (0 [-20 to 0], P = 0.020) were all significantly lower in the Carbohydrate group than in the Control group. Intraoperative hypotension (40.6% [13/32] vs. 16.1% [5/31], P = 0.031) and postoperative nausea and vomiting within 24 h (31.3% [10/32] vs. 9.7% [3/31], P = 0.034) occurred less in patients given carbohydrate drink. ConclusionIn diabetic patients undergoing gastrointestinal surgery, preoperative carbohydrate loading with individualized supplemental insulin did not promote gastrointestinal recovery but improved perioperative well-being.

Faktori povezani sa subjektivnim osećajem umora tri meseca nakon preležane KOVID-19 infekcije

Introduction: The subjective feeling of fatigue is one of the most common post-COVID-19 manifestations. It is characterized by intolerance to physical and cognitive effort that the individual previously tolerated well, accompanied by weakness and other symptoms. Aim: The aim of this study was to examine the frequency of the subjective feeling of fatigue, three months after recovery from the infection, amongst patients who had been infected with COVID-19, as well as to analyze correlated factors. Methods: This cross-sectional study included 110 patients who had previously contracted COVID-19, and who came for a regular follow-up examination at the Health Center Kosovska Mitrovica, 3 months after recovery from acute infection. A specially designed questionnaire was used, which consisted of the segment with sociodemographic data, the segment with the data on the patient's health status and the course of their COVID-19 infection, as well as the segment of the questionnaire related to self-assessment of the patient's health status after the COVID-19 infection. Results: In our sample, out of 110 respondents, as many as 52 felt fatigue. Factors that were statistically significantly associated with the subjective feeling of fatigue, three months after treatment, were the age of the subject and the presence of chronic disease (p &lt; 0.05). The presence of fever and pneumonia during infection were statistically significantly associated with the presence of the subjective feeling of fatigue, three months after treatment (p &lt; 0.05). Hospitalized patients and those who were hospitalized for a longer period of time were also more likely to feel fatigue three months after recovering from the infection (p &lt; 0.05). Conclusion: The subjective feeling of fatigue, as one of post-COVID manifestations, as well as the consequent inability of the patient to resume work-related and personal tasks and responsibilities, can be a serious individual and public health problem, which is why it is necessary to appropriately recognize and treat it.

Sex differences in the impact of state and trait fatigue on gait variability.

123 healthy adults (77 female, 46 male), aged 18-36years, completed the Mental and Physical State and Trait Energy and Fatigue Scale. Using a median split for each fatigue variable, participants were placed into "low" or "high" fatigue categories. Gait variability was defined as the asymmetry of lateral step variability (ALSV) and coefficient of variation (CV) of gait speed, stride length and double limb (DL) support during overground walking. Males with low state PF had greater ALSV than females with low state PF (p=0.05, η2p=0.07) and males with high state PF (p=0.007, η2p=0.15). Females with high trait MF had greater CV of gait speed than females with low trait mental fatigue (p=0.02, η2p=0.08). Males with low trait MF had greater CV of gait speed (p=0.01, η2p=0.10) and stride length (p=0.002, η2p=0.17) than females with low trait MF. CV of DL support did not vary based on fatigue level or sex (p≥0.11). There are sex-specific differences in the impact of state PF on asymmetry of lateral step variability and trait MF on the variability of gait speed and stride length.

Iron Dysregulation and Frailty Syndrome.

Patients with diagnosed frailty syndrome (FS) represent a special group of patients with chronic disease. In the classic definition, frailty syndrome includes such parameters as reduced muscle strength, subjective feeling of fatigue, unintentional weight loss, slow gait, and low physical activity. Frailty syndrome leads to an increased incidence of adverse events, such as falls, hospitalizations, and the need to place patients in care and health institutions associated with the loss of independence; frailty syndrome is also associated with an increased incidence of death. In European countries, the frequency of frailty syndrome in the geriatric population is estimated to be 17% with a range from 5.8% to 27%, and its incidence increases with age. A much higher percentage of frailty syndrome patients is also observed among hospitalized patients. The incidence of frailty syndrome is influenced by many socio-economic factors, but also medical factors. Materials and Methods: A total of 120 patients, >65 years of age, participated in the study. During the study, anthropometric measurements, surveys, laboratory determinations of basic biochemical parameters, and iron status were investigated; 5 mL of peripheral blood in EDTA was also collected for further laboratory tests of hepcidin and soluable transferrin receptor (sTfR) using ELISA. Then, the statistical analysis was performed based on survey and clinical data. Results: Among the patients >65 years of age, the incidence of frailty syndrome was 27.5%. It was found that its occurrence was associated with socio-economic factors, malnutrition, multiple morbidities, reduced muscle strength and gait speed, and polypharmacotherapy. The relationship between reduced iron concentration and the occurrence of frailty syndrome was confirmed. Conclusions: According to the analysis, it was found that a decrease in iron concentration was associated with frailty syndrome.

Physical Activity and Music to Counteract Mental Fatigue

Mental fatigue impairs both cognitive and physical performance. Bioactive substances (e.g., caffeine) have been used to counteract mental fatigue but could have side effects. The present study aimed to test two non-bioactive strategies to counteract mental fatigue: physical activity and listening to music. The participants first performed an arm-pointing task, then carried out a 32-min cognitively demanding task to induce mental fatigue (TLDB task), followed by another arm-pointing task at the end of the experiment. Between the end of the cognitively demanding task and the last arm-pointing task, 20 min went during which participants performed either 15 min of physical activity, of listening to music or of discussion (control). The subjective feeling of mental fatigue was assessed before each arm-pointing task and after the cognitively demanding task. For “physical activity” and “listening to music” groups, EEG was recorded at rest after each evaluation of subjective feeling of mental fatigue and during the cognitively demanding task. An increase in alpha power during the cognitively demanding task evidenced the presence of mental fatigue, without recovery during the following 20-min period. In the control condition, the arm-pointing task performance was deteriorated 20-min after the cognitively demanding task, while it remained stable after both physical activity and listening to music. Furthermore, recovery on the subjective feeling of mental fatigue was similar for both groups. The present results suggested that practicing physical activity and listening to music could be efficient strategies to counteract the negative effects of mental fatigue on motor performances.

The efficiency of a mixed exercise program on quality of life and fatigue levels in patients with breast cancer.

Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.

Objective assessment of nap as a method to improve cognitive performance using a bio-mathematical model

Introduction: Strategic naps are considered as efficacious means of maintaining performance and reducing the individual’s sleep debt. It can reduce subjective feelings of fatigue and improve performance and alertness. However, literature is scant on assessment of naps and associated cognitive performance in the Indian military aviation scenario. This study is an attempt to assess the nap duration and its objective assessment on gain in performance, if any. Material and Methods: In this cross-sectional observational study, sleep data were collected from 23 aviation personnel in a military flying base using actigraphy device. The actigraphic data were then fed into a software called fatigue avoidance scheduling tool. The nap duration and its effect on cognitive parameters were analyzed. Results: About 65.2% of the participant were found to be Day-Time Habitual Nappers. Of the 50 Naps logged by these participants, 11 (22%) naps were less than 30 min, 14 (28%) were between 30 and 60 min, 15 (30%) were between 60 and 120 min, and only 10 (20%) were above 120 min. Post-nap gain in the effectiveness and other cognitive parameters was found to be different in different cognitive domains. Conclusion: Naps more than 30 min had the optimal efficiency. The nap-induced gain in the task effectiveness and cognitive performance was confirmed. While the performance enhancement was significant for the naps more than 30 min, naps more than 60 min did not have any added advantages.

Influence Of A Multi-ingredient Pre-workout Supplement On Energy Expenditure, Oxygen Uptake, And Subjective Feelings Of Fatigue During Low-intensity Aerobic Exercise

Influence Of A Multi-ingredient Pre-workout Supplement On Energy Expenditure, Oxygen Uptake, And Subjective Feelings Of Fatigue During Low-intensity Aerobic Exercise

Effects of mechanical bed massage on subjective feeling of fatigue and performance after exercise-induced back fatigue in athletes: a randomized controlled trial

article: Effects of mechanical bed massage on subjective feeling of fatigue and performance after exercise-induced back fatigue in athletes: a randomized controlled trial - Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 May;180(5):151-7 - Minerva Medica - Journals

Is Motivation Associated with Mental Fatigue during Padel Trainings? A Pilot Study

Motivation seems to enhance athletes’ mental efforts, but this has not been tested yet in padel. The objective was to test the effects of motivation on mental fatigue during padel trainings. Thirty-six elite youth players participated (twenty-two males, Mage = 17.40, SDage = 2.16, and fourteen females, Mage = 17.90, SDage = 3.21). We designed four padel training matches, introducing a constraint in two of them in a counterbalanced order. The constraint was: Couples that win more sets in these two matches obtain a free lesson with a professional padel player. Motivation was quantified by a questionnaire before the matches. Moreover, subjective feelings of mental load and fatigue were measured with questionnaires, and objective measures of fatigue were quantified through heart-rate variability and reaction time. Results suggest that the constraint significantly increases motivation (p &lt; 0.001). Furthermore, in these matches, players reported significantly higher feelings and objective measures of fatigue (p &lt; 0.001 for HRV and VAS; p = 0.04 for reaction time). An increase in the resources used by the neural facilitation system, mediated by higher values of motivation, seems a relevant candidate to explain this phenomenon.

Investigation of the Optimum Display Luminance of an LCD Screen under Different Ambient Illuminances in the Evening

Ambient illuminance and screen luminance have a significant influence on the visual fatigue and visual performance associated with the use of computers. The current study was conducted to investigate optimal screen luminance under different ambient illuminances and fit a curve of the optimum luminance of LCD screens under evening illumination. Thirty-three participants were assigned to rate screen brightness, visual comfort with screen luminance, satisfaction with ambient illuminance and visual fatigue under six screen luminance levels (3.87, 21.47, 42.74, 64.12, 84.77 and 106.7 cd/m2) combined with five ambient illuminance levels (0, 25, 50, 75 and 100 lx) in the evening. The results showed that optimum LCD screen luminance increased with increasing ambient illuminance. Moreover, ambient illuminance and screen luminance levels should be in the range of 13.08–62.16 lx and 20.63–75.15 cd/m2, respectively, to obtain the optimal subjective feelings of visual fatigue and visual comfort during the evening.

Comparison of Chief Surgeons' and Assistants' Feelings of Fatigue Between Laparoendoscopic Single-site and Conventional Laparoscopic Adrenalectomy.

Our objective was to compare the surgical staff's feelings of fatigue between laparoendoscopic single-site adrenalectomy (LESS-A) and conventional laparoscopic adrenalectomy (CLA) before and after surgery. Data were collected for surgical procedures performed between June 2011 and September 2017 (57 LESS-A and 37 CLA). Each procedure in both groups was performed by the same chief surgeon. The subjective fatigue feelings of the key members of the surgical team (chief surgeon, scopist, assistant surgeon) were assessed using the "Jikaku-sho shirabe" questionnaire, which contained questions about work-related feelings of fatigue. It consisted of 25 subjective items for 5 factors drawn from factor analysis (drowsiness, instability, uneasiness, local pain or dullness, and eyestrain). For each item, the participants were requested to estimate the intensity of their feelings using a five-point rating scale before and after surgery. There was no significant difference in operative time (p = 0.231) between the LESS-A and CLA procedure groups. For the chief surgeon, local pain or dullness (p = 0.603) and eyestrain (p = 0.086) were similar between the LESS-A and CLA procedures. The scopists and assistant surgeons in the LESS-A group did not suffer local pain or dullness (p = 0.793 and p = 0.240, respectively). They did, however, suffer more eyestrain than those in the CLA group (p = 0.001 and p = 0.001, respectively). Although LESS-A is generally considered to be a technically difficult procedure, the results of this study demonstrate that the feelings of physical fatigue are roughly equivalent between LESS-A and CLA procedures.

Effect of Football on Fatigue of Patients with Breast Cancer Treated with Nano-Chemotherapy

Cancer-related fatigue is one of the most common and uncontrollable subjective and persistent fatigue feelings in patients after breast cancer surgery, which seriously affects the rehabilitation effect and quality of life of patients. The purpose of this study was to investigate the effect of football intervention on cancer-related fatigue and quality of life in patients with breast cancer after nano-chemotherapy. The objective of this study is to explore the exercise program that can make patients actively carry out rehabilitation exercise and achieve good rehabilitation effect, so as to provide a theoretical and empirical basis for the study of cancer fatigue and quality of life of patients after breast cancer surgery. In this study, a quasi-experimental study method was used to conveniently select 60 breast cancer outpatients with tumor-related fatigue symptoms in a tertiary hospital in Liaoning Province. According to the convenience group, they were divided into a control group and an intervention group, 30 cases in each group. The control group received routine hospital nursing, while the intervention group received football intervention for 6 months on the basis of routine hospital nursing. The intervention measures include explaining the related knowledge of cancer-related fatigue, helping patients develop football projects, guiding patients to record football sports diaries, checking patients’ football sports diary records at the beginning of each chemotherapy cycle, and discussing football sports feelings with patients. After six months of intervention, the researchers assessed cancer-related fatigue symptoms and quality of life. Football can improve the fatigue, physiological, psychological, and psychological states of breast cancer patients after nano-chemotherapy; reduce fatigue, anxiety, and depression; improve sleep; and ultimately improve the quality of life.

Effects of Dehydration on Archery Performance, Subjective Feelings and Heart Rate during a Competition Simulation.

This study aimed to investigate the effect of dehydration on archery performance, subjective feelings and heart rate response. Ten national level archers performed two archery competition simulations, once under euhydration (EUH) and once in a dehydrated state (DEH), induced by 24-h reduced fluid intake. Hydration status was verified prior to each trial by urine specific gravity (USG ≥ 1.025). Archery score was measured according to official archery regulations. Subjective feelings of thirst, fatigue and concentration were recorded on a visual analogue scale. Heart rate was continuously monitored during the trials. Archery performance was similar between trials (p = 0.155). During DEH trial (USG 1.032 ± 0.005), the athletes felt thirstier (p < 0.001), more fatigued (p = 0.041) and less able to concentrate (p = 0.016) compared with the EUH trial (USG 1.015 ± 0.004). Heart rate during DEH at baseline (85 ± 5 b∙min−1) was higher (p = 0.021) compared with EUH (78 ± 6 b∙min−1) and remained significantly higher during the latter stages of the DEH compared to EUH trial. In conclusion, archery performance over 72 arrows was not affected by dehydration, despite the induced psychological and physiological strain, revealed from decreased feeling of concentration, increased sensation of fatigue and increased heart rate during the DEH trial.

Optimal imaging of multi-channel EEG features based on a novel clustering technique for driver fatigue detection

Fatigue may cause a decrease in mental and physical performance capacity, which is a serious safety risk for the drivers in the transportation system. Recently, various studies have demonstrated the deviations of electroencephalogram (EEG) indicators from normal vigilant state during fatigue in time and frequency domains. However, when considering spatial information, these feature descriptors are not satisfying the demand for reliable detection due to the well-known challenge of signal mixing. In this paper, we propose a novel approach based on clustering on brain networks (CBNs) to alleviate the problem to improve the performance of driver fatigue detection. The clustering algorithm was employed to extract the spatial nodes with distinct connectivity attributes throughout the EEG-based brain networks. Then, the temporal features of wavelet entropy from the extracted nodes were transformed to spatio-temporal images so that the image edge detection method (pulse-coupled neural networks) to distinguish different stages of fatigue can be used. The experimental results demonstrated the temporal features from the extracted nodes reduced signal mixing and showed clearer deviations. The detected fatigue based on the imaging method was to an extent consistent with self-reported subjective feelings and most of the critical fatigue was detected before the subjective feelings of fatigue. For all the subjects, 21 of 29 accidents happened after detected fatigue in the simulated driving task. Therefore, the proposed method owns potential value for early warning and avoidance of traffic accidents caused by driver fatigue.

New Conditioning Evaluation Method Using Heart Autonomic Function In Competitive Archery Athletes

PURPOSE: Archery is mainly an outdoor sport that involves shooting arrows from a standing position at a target 70 meters away. It is a relatively static sport that requires less physical activity than most other sports, but extremely fine control over movements. In the present study we investigated a new method of evaluating the condition of athletes in target sports, such as archery, for improving performance from the perspective of autonomic function, i.e., heart rate and heart rate variability (HRV) and respiratory sinus arrhythmia (RSA). METHODS: The participants were members of the Japanese women’s national archery team (athlete A: age, 30 years, height, 180.0 cm, weight, 69.0 kg; athlete B: age, 18 years, height, 157.5 cm, weight, 50.0 kg). HRV was measured 1) at rest in the supine position for 5-min, 2) at rest in the supine position for 3-min, after having five deep breaths, then, 3) in the standing position for 3-min and finished the measurement with five deep breaths. The ECG data were derived from the chest II leads using the Biopac MP36 data acquisition system (Santa Barbara, CA, USA) and input at a sampling frequency of 1 kHz, and heart rate and HRV were measured from the R-R interval. RESULTS: The HRV results for athletes A and B are shown in Table 1. In the present study, athletes A and B were both asked about their subjective feelings of fatigue and their archery performance (scores) at the time of the HRV measurements. Athlete A reported subjective feelings of fatigue at the time of the measurement. Athlete B had no subjective feelings of fatigue, but the inability to achieve high scores. CONCLUSION: The results suggest that even when there are no subjective feelings of fatigue, but the heart rate is high, LF/HF is high, HF is low, or RSA is low, in that case, cardiac sympathetic nervous function will be predominant, and poorer performance may be expected.

Inconsistencies between mental fatigue measures under compensatory control theories

Abstract Mental fatigue has traditionally been defined as a condition of reduced cognitive efficiency and performance, accompanied by a subjective feeling of fatigue. Even though we could expect to find associations between the three defining characteristic of mental fatigue (performance impairment, physiological deactivation and subjective fatigue), research has shown that the emergence of inconsistencies between measures is more frequent than one might expect: people proved capable of maintaining adequate performance levels even after having declared themselves fatigued. This could be explained under the compensatory control mechanism models, which state that humans are able to provide additional resources under demanding conditions, but only at the expense of psychophysiological cost and subjective fatigue. We tested this explanation by manipulating task complexity and time performing a simulated air-traffic control task. We collected psychophysiological, performance and subjective data. A decrease in pupil size was seen in the low-aircraft-density condition, while pupil size remained constant in the high-aircraft-density condition. Participants’ task performance was optimal in both conditions, though they showed an increase in subjective feelings of fatigue, especially in the high-complexity task condition. Thus, complexity seemed to trigger compensatory mechanisms, which reallocated extra resources that physiologically activated participants in order to deal with a higher complexity task, whereas subjective fatigue could be acting as a signal to the organism of impending resource depletion. Our findings support compensatory control theories and offer an explanation of inconsistencies between fatigue measures. Further research on compensatory mechanisms is needed to enable better management of fatigue effects to prevent work-related accidents.

Effects of a Preoperative Carbohydrate-Rich Drink Before Ambulatory Surgery: A Randomized Controlled, Double-Blinded Study.

BackgroundThe guidelines recommend oral carbohydrates up to 2 hr before elective surgery. The objective of this study was to explore the safety and feasibility of preoperative carbohydrate drink in patients undergoing ambulatory surgery.Material/MethodsPatients undergoing ambulatory surgery under general anesthesia were enrolled. They were fasted from midnight and randomly assigned to a study group (200 mL of a carbohydrate beverage) or the control group (pure water) and received the assigned drink 2 hr before surgery. Bedside ultrasonography was performed to monitor gastric emptying at T0 (before liquid intake), T1 (5 min after intake), T2 (1 hr after intake), and T3 (2 hr after intake). Subjective feelings of thirst, hunger, anxiety, and fatigue were assessed 1 hr after liquid intake using the visual analogue scale (VAS).ResultsIn both groups, gastric antrum cross-sectional area, gastric content volume, and weight-corrected gastric content volume increased at T1 and returned to baseline at T3. These parameters were significantly higher in the study group at T2 (6.28±1.38 vs. 4.98±0.78, 67.22±29.49 vs. 49.04±15.4, 1.10±0.51 vs. 0.85±0.37, P<0.05). Thirst and hunger VAS scores were reduced in both groups. The study group suffered significantly less hunger (28.44±10.41 vs. 36.03±14.42, P<0.05). Blood electrolytes (sodium, potassium, calcium) and glucose concentration levels were similar in both groups at T2. No gastric regurgitation or pulmonary aspiration was recorded.ConclusionsAdministration of 200 mL of oral carbohydrate beverage 2 hr before ambulatory surgery is safe, effective, and can be used for preoperative management of fasting patients.