The psychological and physiological health effects of fatigue

Connecting the dots: the role of fatigue in female infertility

Fatigue, an increasingly acknowledged symptom in various chronic diseases, has garnered heightened attention, during the medical era of bio-psycho-social model. Its persistence not only significantly compromises an individual's quality of life but also correlates with chronic organ damage. Surprisingly, the intricate relationship between fatigue and female reproductive health, specifically infertility, remains largely unexplored. Our exploration into the existing body of evidence establishes a compelling link between fatigue with uterine and ovarian diseases, as well as conditions associated with infertility, such as rheumatism. This observation suggests a potentially pivotal role of fatigue in influencing overall female fertility. Furthermore, we propose a hypothetical mechanism elucidating the impact of fatigue on infertility from multiple perspectives, postulating that neuroendocrine, neurotransmitter, inflammatory immune, and mitochondrial dysfunction resulting from fatigue and its co-factors may further contribute to endocrine disorders, menstrual irregularities, and sexual dysfunction, ultimately leading to infertility. In addition to providing this comprehensive theoretical framework, we summarize anti-fatigue strategies and accentuate current knowledge gaps. By doing so, our aim is to offer novel insights, stimulate further research, and advance our understanding of the crucial interplay between fatigue and female reproductive health.

Feasibility of application-based psychomotor vigilance testing to assess fatigue in doctors working night shifts and correlation with smartwatch assessed shift intensity

OBJECTIVES

To assess: (1) the feasibility of novel data collection methods (wearable technology and an application-based psychomotor vigilance test (PVT)), (2) the impact of night shift working on fatigue, both objective and perceived, for doctors working night shifts in acute hospital specialties and (3) the effects of shift intensity and naps obtained on participant fatigue.

METHODS

We adopted an innovative, multimodal approach to data collection allowing assessment of objective and perceived measures of fatigue, in addition to markers of shift intensity. This comprised 5 min PVT for objective quantification of fatigue (via the validated, smartphone-based NASA PVT+ application), wearable electronic devices (Fitbit Versa2) for assessment of shift intensity (step counts and active minutes) and questionnaires to elicit perceptions of fatigue and shift intensity.

RESULTS

Data was collected from 25 participants for a total of 145 night shifts. Objective fatigue (assessed by PVT performance) was significantly increased post night shift, with a PVT mean reaction time 257 ms pre shift versus 283 ms post shift (p<0.0001). However, differences in PVT pre and post shift were not affected by night shift intensity, nor breaks or naps taken on shift. Differences in psychomotor performance between doctors working in different specialties were also observed.

CONCLUSIONS

The data collection methods used were found to be feasible with good participant engagement. Findings support existing evidence that night shift working in healthcare workers is associated with fatigue, with psychomotor impairment observed post shift. Lower shift intensity and napping did not appear to mitigate this effect.

Impact of pruritus on patient fatigue: a cross-sectional study

Through an analysis of 114 015 adult patients in the NIH All of Us research programme – an initiative structured to incorporate populations that have been historically under-represented in biomedical research – we concluded that diagnoses of chronic pruritus and pruritus-related conditions were significantly associated with increased fatigue compared with age-, sex- and race/ethnicity propensity-matched controls without pruritus.

Assessing unsafe behaviors and their relationship with work-related factors among EMS staff in Iran: a cross-sectional study

BACKGROUND

Emergency Medical Services (EMS) staff often encounter various safety incidents. Work-related factors can lead to unsafe behaviors and safety incidents. This study assessed unsafe behaviors and their relationship with work-related factors among EMS staff.

METHODS

This descriptive-correlational study used census sampling method to select 284 EMS staff in Ardabil Province, northwest of Iran, from April to June 2023. The data collection tools were demographic and occupational information form, Mearns Unsafe Behavior Scale, Cohen Perceived Stress Scale, Michielsen Fatigue Scale, and Patterson Teamwork Scale. The data were analyzed using the SPSSv-16, descriptive statistics, Pearson correlation, and multiple linear regression.

RESULTS

The mean of unsafe behavior, fatigue, perceived stress, non-conflict of teamwork, and conflict of teamwork were 15.80 (± 4.77), 20.57 (± 6.20), 16.10 (± 6.13), 117.89 (± 17.24), and 40.60 (± 9.59), respectively. Multiple linear regression analysis showed that "partner trust and shared mental models (PTSMM)," "physical fatigue," "age," "type of shift," "employment status," and "overtime hours per month" were predictors of general unsafe behavior (P < 0.001) and "mild task conflict (MTC)," "employment status," "partner trust and shared mental models (PTSMM)" were predictors of unsafe behavior under incentives EMS staff (P < 0.001).

CONCLUSION

The present study showed that some work-related factors were predictors of unsafe behaviors. The negative consequences of unsafe behaviors should be considered, and long-term planning should be done to reduce them. Developing specific guidelines for addressing unsafe behaviors, implementing measures to reduce fatigue, managing overtime hours in the workplace, and Establishing a system where novice staff work with experienced staff during their first year can be beneficial in reducing these behaviors among EMS staff.

Evaluation of sweat-based biomarkers using wearable biosensors for monitoring stress and fatigue: a systematic review

Objectives. This systematic review aims to report the evaluation of wearable biosensors for the real-time measurement of stress and fatigue using sweat biomarkers. Methods. A thorough search of the literature was carried out in databases such as PubMed, Web of Science and IEEE. A three-step approach for selecting research articles was developed and implemented. Results. Based on a systematic search, a total of 17 articles were included in this review. Lactate, cortisol, glucose and electrolytes were identified as sweat biomarkers. Sweat-based biomarkers are frequently monitored in real time using potentiometric and amperometric biosensors. Wearable biosensors such as an epidermal patch or a sweatband have been widely validated in scientific literature. Conclusions. Sweat is an important biofluid for monitoring general health, including stress and fatigue. It is becoming increasingly common to use biosensors that can measure a wide range of sweat biomarkers to detect fatigue during high-intensity work. Even though wearable biosensors have been validated for monitoring various sweat biomarkers, such biomarkers can only be used to assess stress and fatigue indirectly. In general, this study may serve as a driving force for academics and practitioners to broaden the use of wearable biosensors for the real-time assessment of stress and fatigue.

The validation of Chinese version of workplace PERMA-profiler and the association between workplace well-being and fatigue

BACKGROUND

Well-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman's five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue.

METHODS

The Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach's alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity.

RESULTS

The analyses included 312 Chinese workers. Cronbach's alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension.

CONCLUSION

The Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

Distress and well-being in dentists: performance of a screening tool for assessment

OBJECTIVES

Dentists' well-being is being challenged today by many factors. However, effective screening tools to assess their distress and well-being are yet to be validated. The present study aims to evaluate the ability of the Well-Being Index (WBI) to identify distress and stratify dentists' well-being and their likelihood for adverse professional consequences.

METHOD AND MATERIALS

A convenience sample of dentists completed a web-based 9-item WBI survey along with other instruments that measured quality of life (QOL), fatigue, burnout, and questions about suicidal ideation, recent dental error, and intent to leave their current job.

RESULTS

A total of 597 dentists completed the survey. The overall mean WBI score was 2.3. The mean WBI score was significantly greater in dentists with low QOL than among dentists without low QOL (4.1 vs 1.6, p < 0.001). Dentists with extreme fatigue, burnout, and suicidal ideation had significantly higher mean WBI score than those without distress (all p < 0.001). WBI score stratified the dentists' likelihood of reporting a recent dental error and intent to leave their current job.

CONCLUSION

The WBI may be a useful screening tool to assess well-being among dentists and identify those in distress and at risk for adverse professional consequences.

Association between COVID-19 and outstanding academic performance at a Spanish university

BACKGROUND

SARS-CoV-2 is the causative agent of COVID-19 identified in December 2019, an acute infectious respiratory disease that can cause persistent neurological and musculoskeletal symptoms such as headache, fatigue, myalgias difficulty concentrating, among others including acute cerebrovascular disease with a prevalence of 1-35%. The aim of this study is to evaluate the impact of COVID-19 in undergraduate students on their academic performance as an indicator of their intellectual ability and performance in a university that maintained 100% face-to-face teaching during the 2020-2021 academic year.

METHODS

A total of 7,039 undergraduate students were analyzed in a prospective cohort study at the University of Navarra. A questionnaire including sociodemographic and behavioral questions was sent. PCRs were performed throughout the academic year for the diagnosis of SARS-CoV-2 infection and students' academic results were provided by the academic center, adjusted descriptive and multivariate models were performed to assess the association.

RESULTS

A total of 658 (9.3%) participants were diagnosed with COVID-19, almost 4.0% of them achieved outstanding academic results, while uninfected students did so in 7.3%. SARS-CoV-2 infection was associated with a significant decrease in having outstanding academic results (OR = 0.57; 95% CI: 0.38-0.86).

CONCLUSION

Having COVID-19 disease, decreased academic performance in undergraduate students. Therefore, it is necessary to prevent infection even in the youngest sections of the population.

Erythrocyte morphology and fatigue levels in podologists

Aesthetic and clinical care of the feet includes reducing nail thickness and removing calluses which are perfomed by high-speed nail drill machines. These micromotors diffuse skin material, nail dust, and pathogenic fungi into the air, some of which are then inhaled and causes an occupational risk to workers. This study examines occupational risks of inhaling organic dust in the working environment of Podologists (PDL) through their erythrocyte morphologies. Chalder Fatigue Scale was used to determine fatigue symptoms of the participants related to occupational exposures. 25 PDL and 26 control subjects were compared. Peripheral smear technique was used to identify erythrocyte morphologies. The results demonstrated that physical, mental, total fatigue levels, and erythrocyte anomaly amounts of the individuals in the PDL group were higher (p < .05). Findings also revealed that fatigue effectively formed Hypochromic, Stomatocytes, Dacrocytes, Elliptocytes, Spherocytes, and Ovalocytes. This study aims to increase awareness of podologists' occupational risks..

Sleep and Fatigue as Mediators of Racial Discrimination and Internalizing Symptoms in Black Adolescent-Caregiver Dyads

While the association of racial discrimination and internalizing symptoms in Black individuals is well established, we still have a limited understanding of mechanisms and contextual factors influencing this association, such as sleep and the family context. The present study examined sleep and fatigue as mediators underlying the relationship between racial discrimination and internalizing symptoms within Black adolescent-caregiver dyads. Using data from a larger survey study of risk and resilience in Black adolescents (Mage= 14.36, 49.5% female) and their caregivers (Mage= 39.25, 75.9% female), we used the Actor-Partner Interdependence Model extended Mediation (APIMeM) to test associations of racial discrimination, sleep factors, and internalizing symptoms among 179 dyads. Significant actor effects revealed that sleep disturbance and fatigue independently mediated the association of racial discrimination and internalizing symptoms among adolescents and caregivers. Additionally, partner effects were found, such that adolescents' experiences of discrimination were indirectly associated with their caregivers' internalizing symptoms via caregiver fatigue. No direct or indirect effects of caregiver experiences of discrimination on adolescent outcomes were found. The findings highlight the important role sleep and fatigue play in the link between racial discrimination and internalizing symptoms among Black adolescents and adults; and the role that the family context may play in this association. Mental health and sleep interventions for Black individuals should address the impact of racial discrimination on internalizing symptoms, with an emphasis on family-focused interventions.

Causal association between self-reported fatigue and coronary artery disease: a bidirectional two-sample Mendelian randomization analysis

Background

Observational studies have reported the association between fatigue and coronary artery disease (CAD), but the causal association between fatigue and CAD is unclear.

Method

We conducted a bidirectional Mendelian randomization (MR) study using publicly available genome-wide association studies (GWAS) data. The inverse-variance weighted (IVW) method was used as the primary analysis. We performed three complementary methods, including weighted median, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO) to evaluate the sensitivity and horizontal pleiotropy of the results.

Result

Self-reported fatigue had a causal effect on coronary artery atherosclerosis (CAA) (OR 1.047, 95%CI 1.033-1.062), myocardial infarction (MI) (OR 1.027 95%CI 1.014-1.039) and coronary heart disease (CHD) (OR 1.037, 95%CI 1.021-1.053). We did not find a significant reverse causality between self-reported fatigue and CAD. Given the heterogeneity revealed by MR-Egger regression, we employed the IVW random effect model. For the examination of fatigue on CHD and the reverse analysis of CAA, and MI on fatigue, the MR-PRESSO test found horizontal pleiotropy. No significant outliers were found.

Conclusion

The MR analysis reveals a causal relationship between self-reported fatigue and CAD. The results should be interpreted with caution due to horizontal pleiotropy.

The Prevalence and Correlated Factors of Occupational Stress, Cumulative Fatigue, and Musculoskeletal Disorders among Information Technology Workers: A Cross-Sectional Study in Chongqing, China

Occupational stress, cumulative fatigue, and work-related musculoskeletal disorders (WMSDs) are major concerns in the field of occupational health. Previous studies on occupational health focused on key industries, such as medical care, while there were few related studies on Information Technology (IT) industry. Our study explored the factors influencing occupational stress, cumulative fatigue, and musculoskeletal disorders in the IT industry. We collected 1363 IT workers' valid questionnaires, of which 73.1% of participants were technicians in Chongqing, 2021. The core occupational stress scale (COSS), self-diagnosis checklist for the assessment of workers' accumulated fatigue and Chinese musculoskeletal disorders questionnaire were used to measure the occupational stress, cumulative fatigue, and musculoskeletal disorders of the respondents. Logistic regressions were used to explore the correlated factors affecting these indicators. The results showed that the prevalence of occupational stress, cumulative fatigue, and musculoskeletal disorders was 50.4%, 47%, and 72.3%, respectively. Working in the current position for 3-10 years was a common increased risk for all three indicators. Insomnia was associated with an increased risk of cumulative fatigue (Odds Ratio, OR = 2.156, p < 0.001) and musculoskeletal disorders (OR = 1.878, p < 0.001). Cumulative fatigue was also associated with an increased risk of having WMSDs (OR = 3.207, p < 0.001). According to our findings, occupational factors, such as long working years, overtime work, and personal lifestyle, are highly related to the occurrence of occupational stress, cumulative fatigue, and musculoskeletal disorders for IT industry workers. More attention should be paid to women and those with long working hours in the IT industry.

Physical and psychological job demands and fatigue experience among offshore workers

Offshore operations are generally challenging and hazardous, and the workers are exposed to conditions that may lead to fatigue. A cross-sectional study evaluated physical and psychological job demands and their associations with fatigue among offshore workers. The offshore workers (n = 251) completed a questionnaire including demographic/job details, Multidimensional Fatigue Inventory (MFI‒20), and Job Content Questionnaire (JCQ). Data were analysed using linear regression modelling. Results indicated that the physical (particularly performing repetitive motions and applying pressure with hands and wrists) and psychological (e.g., intense task concentration and fast working) job demands were relatively high. The total mean (SD) fatigue score (MFI‒20) was 56.3 (13.9). Individual factors (Body Mass Index ‒ BMI), physical job demands (awkward working postures, frequent moving/lifting heavy objects and doing lots of physical efforts) and psychological job demands (task interruptions by other people and doing an excessive amount of work) were the main variables associated with different dimensions of fatigue in the multivariate models. While physical fatigue was only associated with the physical job demands, both physical and psychological job demands were significantly associated with mental fatigue in the multivariate context. The findings have possible implications for job design and implementation of intervention programmes to promote health and performance of the employees.

Healthy Nutrition, Physical Activity, and Sleep Hygiene to Promote Cardiometabolic Health of Airline Pilots: A Narrative Review

Background

Airline pilots experience unique occupational demands that may contribute to adverse physical and psychological health outcomes. Epidemiological reports have shown a substantial prevalence of cardiometabolic health risk factors including excessive body weight, elevated blood pressure, poor lifestyle behaviors, and psychological fatigue. Achieving health guidelines for lifestyle behavior nutrition, physical activity, and sleep are protective factors against the development of noncommunicable diseases and may mitigate the unfavorable occupational demands of airline pilots. This narrative review examines occupational characteristics for sleep, nutrition, and physical activity and outlines evidence-based strategies to inform health behavior interventions to mitigate cardiometabolic health risk factors among airline pilots.

Methods

Literature sources published between 1990 and 2022 were identified through electronic searches in PubMed, MEDLINE (via OvidSP), PsychINFO, Web of Science, and Google Scholar databases, and a review of official reports and documents from regulatory authorities pertaining to aviation medicine and public health was conducted. The literature search strategy comprised key search terms relating to airline pilots, health behaviors, and cardiometabolic health. The inclusion criteria for literature sources were peer-reviewed human studies, meta-analyses, systematic reviews, and reports or documents published by regulatory bodies.

Results

The results of the review show occupational factors influencing nutrition, sleep, and physical activity behaviors and delineate evident occupational disruptions to these lifestyle behaviors. Evidence from clinical trials demonstrates the efficacy of nutrition, sleep, and physical activity interventions for enhancing the cardiometabolic health of airline pilots.

Conclusion

This narrative review suggests that implementing evidence-based interventions focused on nutrition, physical activity, and sleep could help mitigate cardiometabolic health risk factors among airline pilots, who are particularly susceptible to adverse health outcomes due to unique occupational demands.

Impact of fatigue on anaesthesia providers: a scoping review

BACKGROUND

Recently, fatigue has received more attention as a workplace hazard. This scoping review focuses on fatigue in anaesthesia providers. We explore the prevalence of fatigue in anaesthesia providers, and we examine how fatigue impacts their performance.

METHODS

A literature search was independently conducted from December 2019 through March 2020. The following four databases were consulted: MEDLINE, CINAHL, EMBASE, and PubPsych. Only studies discussing fatigue in anaesthesia providers were eligible.

RESULTS

The initial database search identified a total of 118 studies, of which 30 studies were included in the review. Eight articles concerned the prevalence of fatigue in anaesthesia providers, whereas 22 explored the impact of fatigue on the performance of anaesthesia providers. Up to 60.8% of anaesthesia providers suffered from severe excessive daytime sleepiness, and fatigue was denoted as a common workplace problem in up to 73.1% of anaesthesia providers. Fatigue had a negative influence on medication errors and vigilance, and it decreased the performance of anaesthesia providers during laboratory psychomotor testing. There was a decrease in non-technical skills (notably communication and teamwork) and worsening mood when fatigued.

CONCLUSIONS

Based on this scoping review, fatigue is a prevalent a phenomenon that anaesthesia providers cannot ignore. A combination of deterioration in non technical skills, increased medication errors, loss of sustained attention, and psychomotor decline can lead to poorer performance and cause patient harm. Concrete strategies to mitigate fatigue should be developed.

The Relationship Between Mindfulness, Fatigue, and Perceived Symptoms Among Frontline Nurses Who Performed Nucleic Acid Sample Collection During the COVID-19 in China: A Cross-Sectional Study

Objective

Given the immense stress faced by medical staff during the COVID-19 pandemic, this study aimed to evaluate the relationship between mindful attention awareness, fatigue, and perceived symptoms among frontline nurses who performed nucleic acid sample collection during the COVID-19 pandemic, to reduce their fatigue and help them cope with perceived uncomfortable symptoms.

Methods

A convenience sampling method was used to survey nurses who travelled to Hainan for nucleic acid sampling in August 2022 using an online (WeChat) questionnaire. A total of 514 frontline nurses who performed nucleic acid tests completed the questionnaire. The questionnaire covered basic demographic information, Mindful Attention Awareness Scale (MAAS) ratings, and Fatigue Severity Scale (FSS) ratings. Spearman correlation analysis was used to separate the relationship between MASS and FSS, and univariate and multivariate factor analyses were used to explore the relevant influences contributing to the occurrence of fatigue.

Results

A total of 514 individuals completed the survey,93.97% (n=483) were female, mean age was 31.15 ± 5.7, MASS score was 69.01 ± 13.53, and 296 (57.59%) nurses experienced symptoms of fatigue during the auxiliary period. Spearman correlation analysis showed that FSS was associated with MASS. Multifactorial analysis showed that sex, age, marital status, fertility status, years of work, adaptation to dietary habits, hidrorrhea, and MAAS scores affected the presence of fatigue symptoms among the medical staff in Hainan (P<0.05).

Conclusion

The psychological status of frontline nurses undergoing nucleic acid testing during the pandemic was poor, and the appearance of fatigue symptoms could be effectively reduced by increasing levels of positive thinking among medical staff to help them cope with public health emergencies.

What matters most? Network analysis of mental health, recovery experiences, sleep, and fatigue among career firefighters

Firefighters exhibit a higher prevalence of mental health issues than other occupations because they often directly or indirectly experience potentially traumatic events. Previous research has suggested that recovery experiences, sleep, and fatigue may be protective or risk factors for firefighters' mental health. This study conducted regularised partial correlation network analysis to investigate and visualise the complex relationships between these variables. We collected data through an online survey, and 3144 career firefighters from a large east-coast city in China, were included in the analyses. The results of the network analysis showed that: (1) only relaxation and mastery experiences directly correlated with one dimension of the mental health scale, namely, life/social functioning; (2) sleep quality had stronger correlations with mental health issues than sleep quantity; and (3) mental health issues were central nodes of the network. These results indicated that firefighters' mental health was close to other variables in the network and acted as a bridge linking other variables. Therefore, more attention should be paid to the mental health of firefighters to prevent comorbidities. The study's results also indicated that recovery experiences and sleep may be protective factors for firefighters' mental health.

Discrimination and Health Among First-Generation Hispanic/Latinx Immigrants: the Roles of Sleep and Fatigue

INTRODUCTION

A growing literature documents the associations between discrimination and health. Emerging evidence suggests that among Hispanic/Latinx immigrants, discrimination leads to the deterioration of health outcomes over time. While sleep has been proposed as an important mediator of the relationship between discrimination and health, few studies have explicitly investigated this pathway, particularly among Hispanic/Latinx populations.

OBJECTIVE

To investigate the relationships between racial/ethnic discrimination, sleep, and physical and mental health among Hispanic/Latinx immigrants in the USA. Data and Methods Using data from a parent study of first-generation Hispanic/Latinx immigrants in the southeastern USA, we conducted sequential mediation analyses using the bootstrapping method to investigate whether self-reported sleep duration, sleep quality, and fatigue mediate the relationship(s) between self-reported discrimination, as measured by the discrimination subscale of the Riverside Acculturative Stress Inventory, and self-reported physical and mental health.

RESULTS

Nocturnal awakenings, fatigue, and sleep quality were statistically significant sequential mediators of the relationship between discrimination and physical health (b = -.001, SE = .001, CI [-.0027, -.0001]); fatigue alone also mediated this relationship (b = -.01, SE = .01, CI [-.0279, -.0003]). Nocturnal awakenings, fatigue, and sleep quality were also significant sequential mediators of the relationship between discrimination and mental health (b = -.001, SE = .001, CI [-.0031, -.0001]).

CONCLUSION

Sleep and fatigue play an important role in linking discrimination and health among first-generation Hispanic/Latinx immigrants. The development and implementation of interventions that focus on reducing fatigue among this population could mitigate the effects of unfair treatment on health outcomes.

Efficacy and safety of fermented Prunus mume vinegar on fatigue improvement in adults with unexplained fatigue: A randomized controlled trial

Background

The accumulation of fatigue leads to reduced physical, emotional, psychological, and social functions.

Objectives

Fermented Prunus mume vinegar (PV) improves fatigue in animals; however, studies in humans have not been conducted. We aimed to examine the effects and safety of consuming fermented PV for 8 weeks on fatigue indices in adults with unexplained fatigue while considering the placebo effect.

Methods

A randomized, double-blind, placebo-controlled trial was conducted in adults of >19 years, who were diagnosed with unexplained fatigue for at least 1 month. Eighty participants were randomly assigned to receive daily 70 mL of fermented PV (2.56 mg/g, chlorogenic acid, and 15.3 mg/g, citric acid) or a placebo for 8 weeks. At baseline and 4 and 8 weeks after treatment, the participants were visited for blood tests (liver enzyme, glucose, creatinine, lactate, malondialdehyde [MDA], and creatine kinase [CK]) and questionnaires (Fatigue Severity Scale [FSS], fatigue visual analog scale [VAS], Beck Depression Inventory [BDI], the Korean version of the Brief Encounter Psychosocial Instrument [BEPSI-K], EQ-5D-3L, and EQ-VAS]).

Results

Fermented PV supplementation for 8 weeks did not remarkably improve the fatigue indices when compared to placebo. Additionally, differences in fatigue VAS, BDI, BEPSI-K, EQ-5D-3L, EQ-VAS, lactate, CK, and MDA concentrations between the groups were not observed. However, FSS had positively correlated with fatigue VAS, BDI, and BEPSI-K, whereas it was negatively correlated with EQ-5D-3L and EQ-VAS at the baseline and 8 weeks. None of the participants reported adverse events.

Conclusion

The efficacy of fermented PV did not exceed the efficacy of placebo in adults with unexplained fatigue.

Clinical trial registration

[ClinicalTrials.gov], identifier [NCT04319692].

Approaches to managing work-related fatigue to meet the needs of American workers and employers

On September 13-14, 2019, the National Institute for Occupational Safety and Health (NIOSH) hosted a national forum entitled "Working hours, sleep and fatigue: Meeting the needs of American workers and employers." The purpose of this inaugural meeting was to discuss current evidence about the broad-based risks and effective countermeasures related to working hours, sleep, and fatigue, with further considerations to tailor solutions for specific industries and worker populations. We aimed to identify the knowledge gaps and needs in this area and future directions for research. We also sought to identify similarities across industries with the goal of sharing lessons learned and successful mitigation strategies across sectors. Participants included an international representation of academics, scientists, government representatives, policymakers, industry leaders, occupational health and safety professionals, and labor representatives. A total of eight manuscripts were developed following stakeholder comments and forum discussions. Six focused on sector-specific approaches (i.e., Agriculture, Forestry & Fishing; Healthcare & Social Assistance; Mining; Oil and Gas Extraction; Public Safety; Transportation, Warehousing & Utilities) to identify unique factors for fatigue-risk and effective countermeasures. Two additional manuscripts addressed topic areas that cut across all industries (disproportionate risks, and economic evaluation). Findings from the Forum highlight that the identification of common risk factors across sectors allows for transfer of information, such as evidence for effective mitigation strategies, from sectors where fatigue risk has been more widely studied to those sectors where it has been less so. Further considerations should be made to improve knowledge translation activities by incorporating different languages and modes of dissemination such that information is accessible for all workers. Additionally, while economic evaluation can be an important decision-making tool for organizational- and policy-level activities, multi-disciplinary approaches combining epidemiology and economics are needed to provide a more balanced approach to economic evaluation with considerations for societal impacts. Although fatigue risk management must be tailored to fit industries, organizations, and individuals, knowledge gained in this forum can be leveraged, modified, and adapted to address these variabilities. Our hope is to continue sharing lessons learned to encourage future innovative, multi-disciplinary, cross-industry collaborations that will meet the needs of workers and employers to mitigate the risks and losses related to workplace fatigue.

A rapid, non-invasive method for fatigue detection based on voice information

Fatigue results from a series of physiological and psychological changes due to continuous energy consumption. It can affect the physiological states of operators, thereby reducing their labor capacity. Fatigue can also reduce efficiency and, in serious cases, cause severe accidents. In addition, it can trigger pathological-related changes. By establishing appropriate methods to closely monitor the fatigue status of personnel and relieve the fatigue on time, operation-related injuries can be reduced. Existing fatigue detection methods mostly include subjective methods, such as fatigue scales, or those involving the use of professional instruments, which are more demanding for operators and cannot detect fatigue levels in real time. Speech contains information that can be used as acoustic biomarkers to monitor physiological and psychological statuses. In this study, we constructed a fatigue model based on the method of sleep deprivation by collecting various physiological indexes, such as P300 and glucocorticoid level in saliva, as well as fatigue questionnaires filled by 15 participants under different fatigue procedures and graded the fatigue levels accordingly. We then extracted the speech features at different instances and constructed a model to match the speech features and the degree of fatigue using a machine learning algorithm. Thus, we established a method to rapidly judge the degree of fatigue based on speech. The accuracy of the judgment based on unitary voice could reach 94%, whereas that based on long speech could reach 81%. Our fatigue detection method based on acoustic information can easily and rapidly determine the fatigue levels of the participants. This method can operate in real time and is non-invasive and efficient. Moreover, it can be combined with the advantages of information technology and big data to expand its applicability.

Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial

BACKGROUND

There is no approved pharmaceutical intervention for Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS). Fatigue in these patients can last for decades. Long COVID may continue to ME/CFS, and currently, it is estimated that up to 20 million Americans have significant symptoms after COVID, and the most common symptom is fatigue. Anhydrous Enol-Oxaloacetate, (AEO) a nutritional supplement, has been anecdotally reported to relieve physical and mental fatigue and is dimished in ME/CFS patients. Here, we examine the use of higher dosage AEO as a medical food to relieve pathological fatigue.

METHODS

ME/CFS and Long-COVID patients were enrolled in an open label dose escalating "Proof of Concept" non-randomized controlled clinical trial with 500 mg AEO capsules. Control was provided by a historical ME/CFS fatigue trial and supporting meta-analysis study, which showed average improvement with oral placebo using the Chalder Scale of 5.9% improvement from baseline. At baseline, 73.7% of the ME/CFS patients were women, average age was 47 and length of ME/CFS from diagnosis was 8.9 years. The Long-COVID patients were a random group that responded to social media advertising (Face Book) with symptoms for at least 6 months. ME/CFS patients were given separate doses of 500 mg BID (N = 23), 1,000 mg BID (N = 29) and 1000 mg TID (N = 24) AEO for six weeks. Long COVID patients were given 500 mg AEO BID (N = 22) and 1000 mg AEO (N = 21), again over a six-week period. The main outcome measure was to compare baseline scoring with results at 6 weeks with the Chalder Fatigue Score (Likert Scoring) versus historical placebo. The hypothesis being tested was formulated prior to data collection.

RESULTS

76 ME/CFS patients (73.7% women, median age of 47) showed an average reduction in fatigue at 6 weeks as measured by the "Chalder Fatigue Questionnaire" of 22.5% to 27.9% from baseline (P < 0.005) (Likert scoring). Both physical and mental fatigue were significantly improved over baseline and historical placebo. Fatigue amelioration in ME/CFS patients increased in a dose dependent manner from 21.7% for 500 mg BID to 27.6% for 1000 mg Oxaloacetate BID to 33.3% for 1000 mg TID. Long COVID patients' fatigue was significantly reduced by up to 46.8% in 6-weeks.

CONCLUSIONS

Significant reductions in physical and metal fatigue for ME/CFS and Long-COVID patients were seen after 6 weeks of treatment. As there has been little progress in providing fatigue relief for the millions of ME/CFS and Long COVID patients, anhydrous enol oxaloacetate may bridge this important medical need. Further study of oxaloacetate supplementation for the treatment of ME/CFS and Long COVID is warranted. Trial Registration https://clinicaltrials.gov/ct2/show/NCT04592354 Registered October 19, 2020. 1,000 mg BID Normalized Fatigue Data for Baseline, 2-weeks and 6-weeks evaluated by 3 Validated Fatigue Scoring Questionnaires.

The impact of chronic pain on creative ideation: An examination of the underlying attention-related psychophysiological mechanisms

Background

Attentional deficits in patients with chronic pain are common and well studied. Yet, few studies have examined the effects of chronic pain on more complex cognitive abilities that rely on well‐functioning attentional systems. With the current study, we aimed to investigate whether the impact of chronic pain on attention affects creative ideation as measured with an adaptation of the alternate uses task (AUT).

Methods

Performance in the AUT was compared between 33 patients suffering from chronic pain and 33 healthy matched controls. While solving the task, EEG was recorded to measure the degree of internally directed attention assessed by means of task‐related power (TRP) changes.

Results

The results revealed that patients with chronic pain generated less creative ideas than healthy controls. This lack of performance was accompanied by lower event‐related synchronization (ERS), especially in right parietal sites. Furthermore, these ERS differences explained one‐third of the inter‐group variance in AUT performance.

Conclusions

These results suggest that performance decrements in creative ideation in patients with chronic pain may be at least partly attributable to attentional impairments associated with chronic pain.

Significance

Chronic pain negatively affects attention and more complex cognitive abilities. However, the underlying psychophysiological mechanisms and the role of attention as a source of these impairments in more complex abilities are poorly understood. By analyzing task‐related power changes in the EEG, the role of internal attention in creative ideation could be determined, revealing the functional relationship between chronic pain, attention, and a more complex cognitive ability.

Wearable biosensors for human fatigue diagnosis: A review

Fatigue causes deleterious effects to physical and mental health of human being and may cause loss of lives. Therefore, the adverse effects of fatigue on individuals and the society are massive. With the ever-increasing frequency of overtraining among modern military and sports personnel, timely, portable and accurate fatigue diagnosis is essential to avoid fatigue-induced accidents. However, traditional detection methods require complex sample preparation and blood sampling processes, which cannot meet the timeliness and portability of fatigue diagnosis. With the development of flexible materials and biosensing technology, wearable biosensors have attracted increased attention to the researchers. Wearable biosensors collect biomarkers from noninvasive biofluids, such as sweat, saliva, and tears, followed by biosensing with the help of biosensing modules continuously and quantitatively. The detection signal can then be transmitted through wireless communication modules that constitute a method for real-time understanding of abnormality. Recent developments of wearable biosensors are focused on miniaturized wearable electrochemistry and optical biosensors for metabolites detection, of which, few have exhibited satisfactory results in medical diagnosis. However, detection performance limits the wide-range applicability of wearable fatigue diagnosis. In this article, the application of wearable biosensors in fatigue diagnosis has been discussed. In fact, exploration of the composition of different biofluids and their potential toward fatigue diagnosis have been discussed here for the very first time. Moreover, discussions regarding the current bottlenecks in wearable fatigue biosensors and the latest advancements in biochemical reaction and data communication modules have been incorporated herein. Finally, the main challenges and opportunities were discussed for wearable fatigue diagnosis in the future.

Research on the influencing factors of fatigue and professional identity among CDC workers in China: an online cross-sectional study

OBJECTIVE

This study aimed to investigate the status quo and the influencing factors of fatigue and professional identity among the Centers for Disease Control and Prevention (CDC) workers in China during the pandemic.

DESIGN

A cross-sectional design.

SETTING

CDC workers employed by the Liaoning CDC system were enrolled (administrative staffs were excluded).

PARTICIPANTS

1020 CDC workers.

PRIMARY OUTCOME MEASURES

Fatigue scores and professional identity scores.

SECONDARY OUTCOME MEASURES

Postcompetency scores, respect scores, occupational stress scores, resilience scores and self-efficacy scores.

RESULTS

The average scores of fatigue and professional identity were 8.23, 38.88, respectively. Factors including perceived public respect (β=-0.129, p<0.01), resilience (β=-0.104, p<0.05) and self-efficacy (β=-0.22, p<0.01) were negatively associated with fatigue. Educational background (bachelor vs junior college or below) (β=0.105, p<0.01), (master or above vs junior college or below) (β=0.092, p<0.05), workplace (county vs district) (β=0.067, p<0.05), (city vs district) (β=0.085, p<0.05), fighting the COVID-19 on the front line (β=0.059, p<0.05) and occupational stress (β=0.166, p<0.01) were positively correlated with fatigue. Educational background (bachelor vs junior college or below) (β=-0.097, p<0.01), (master or above vs junior college or below) (β=-0.114, p<0.01), workplace (city vs district) (β=-0.114, p<0.01), fighting the COVID-19 on the front line (β=-0.047, p<0.05) and occupational stress (β=-0.105, p<0.01) were negatively associated with professional identity. Factors including postcompetency (β=0.362, p<0.01), perceived public respect (general vs low) (β=0.219, p<0.01), (high vs low) (β=0.288, p<0.01), resilience (β=0.097, p<0.05) and self-efficacy (β=0.113, p<0.01) were positively connected with professional identity.

CONCLUSION

The fatigue among the CDC workers was at a higher level. The level of professional identity was high, and administrators should take measures to alleviate fatigue and maintain professional identity. In addition, methods aiming to attenuate occupational stress, and improve resilience and self-efficacy should be immediately put into action.

Central and Peripheral Fatigue in Physical Exercise Explained: A Narrative Review

The study of the origin and implications of fatigue in exercise has been widely investigated, but not completely understood given the complex multifactorial mechanisms involved. Then, it is essential to understand the fatigue mechanism to help trainers and physicians to prescribe an adequate training load. The present narrative review aims to analyze the multifactorial factors of fatigue in physical exercise. To reach this aim, a consensus and critical review were performed using both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Central and peripheral fatigue are two unison constructs part of the Integrative Governor theory, in which both psychological and physiological drives and requirements are underpinned by homeostatic principles. The relative activity of each one is regulated by dynamic negative feedback activity, as the fundamental general operational controller. Fatigue is conditioned by factors such as gender, affecting men and women differently. Sleep deprivation or psychological disturbances caused, for example, by stress, can affect neural activation patterns, realigning them and slowing down simple mental operations in the context of fatigue. Then, fatigue can have different origins not only related with physiological factors. Therefore, all these prisms must be considered for future approaches from sport and clinical perspectives.

Media Consumption, Stress and Wellbeing of Video Game and eSports Players in Germany: The eSports Study 2020

The popularity of video gaming and eSports is increasing rapidly. However, most research focuses on the economical features and psychological consequences of gaming and only little is known about the health behavior of the players. Therefore, this study is a follow-up of the eSports Study 2019 and further investigates the health and health behavior of video game and eSports players in Germany. This cross-sectional study, conducted between April and September 2019, includes 1038 players (91.2% male; 23.0 ± 5.4 years; body mass index: 24.8 ± 5.0 kg/m²) who provided data regarding their health status, physical activity, sleep, media consumption, stress and wellbeing via a web-based survey. Descriptive statistics were performed on all questions. Linear regressions were used to examine the relation between media consumption, wellbeing and stress. Almost all respondents classified their health status as “good” or better (92.5%). The average sedentary and physical activity time was 7.2 ± 3.5 h/day and 8.8 ± 10.7 h/week, respectively. Respondents slept for 7.5 ± 1.3 h/night on weekdays and for 8.5 ± 1.5 h/night on weekends, but many were “sometimes” or more frequently overtired (53.1%). Daily duration of playing video games (230.4 ± 159.3 min/day) and watching livestreams and videos with (102.6 ± 101.7 min/day) and without gaming content (72.9 ± 88.5 min/day) were much higher than watching regular television (18.9 ± 49.1 min/day) or reading analog media (32.1 ± 53.5 min/day). In terms of stress and wellbeing, most players reported low stress levels (13.8 ± 5.7) and reached a moderate average score of 60.1 ± 16.4 out of 100 points in the WHO-5 Well-Being Index. Linear regressions revealed no relevant significant associations. The results indicate good subjective health and health behavior of the target group. However, the high amounts of screen-based media-consumption, as well as the moderate stress and wellbeing levels show potential for improvement. In addition, the target group consumed high amounts of digital media in reference to gaming, while traditional media consumption was distinctly low. Consequently, media campaigns that address health promotion in this target group should use the platforms of digital media instead.

Multi-Parameter Physiological State Monitoring in Target Detection Under Real-World Settings

Mental state changes induced by stimuli under experimental settings or by daily events in real life affect task performance and are entwined with physical and mental health. In this study, we developed a physiological state indicator with five parameters that reflect the subject's real-time physiological states based on online EEG signal processing. These five parameters are attention, fatigue, stress, and the brain activity shifts of the left and right hemispheres. We designed a target detection experiment modified by a cognitive attention network test for validating the effectiveness of the proposed indicator, as such conditions would better approximate a real chaotic environment. Results demonstrated that attention levels while performing the target detection task were significantly higher than during rest periods, but also exhibited a decay over time. In contrast, the fatigue level increased gradually and plateaued by the third rest period. Similar to attention levels, the stress level decreased as the experiment proceeded. These parameters are therefore shown to be highly correlated to different stages of the experiment, suggesting their usage as primary factors in passive brain-computer interfaces (BCI). In addition, the left and right brain activity indexes reveal the EEG neural modulations of the corresponding hemispheres, which set a feasible reference of activation for an active BCI control system, such as one executing motor imagery tasks. The proposed indicator is applicable to potential passive and active BCI applications for monitoring the subject's physiological state change in real-time, along with providing a means of evaluating the associated signal quality to enhance the BCI performance.

The Recovery Umbrella in the World of Elite Sport: Do Not Forget the Coaching and Performance Staff

In the field of sports science, the recovery umbrella is a trending topic, and even more so in the world of elite sports. This is evidenced by the significant increase in scientific publications during the last 10 years as teams look to find a competitive edge. Recovery is recognized to be an integral component to assist athlete preparation in the restoration of physical and psychological function, and subsequently, performance in elite team sports athletes. However, the importance of recovery in team staff members (sports coaches and performance staff) in elite sports appears to be a forgotten element. Given the unrelenting intense nature of daily tasks and responsibilities of team staff members, the elite sports environment can predispose coaches to increased susceptibility to psycho-socio physiological fatigue burden, and negatively affect health, wellbeing, and performance. Therefore, the aim of this opinion was to (1) develop an educational recovery resource for team staff members, (2) identify organizational task-specific fatigue indicators and barriers to recovery and self-care in team staff members, and (3) present recovery implementation strategies to assist team staff members in meeting their organizational functions. It is essential that we do not forget the coaching and performance staff in the recovery process.

The Intricate Web of Fatigue in Women

The modern woman has taken her rightful place in society as a worker, a caregiver, a mother, and a world citizen. However, along with the privileges of these roles comes the great cost of stress and resultant exhaustion and fatigue. Psychosocial, physical, cultural, and disease-related realms of stress act as strands of a web that serve to bind and hinder women with chronic stress. New areas of research, such as exercise intervention, improved social programs (e.g., childcare), and supplementation are constantly evaluated for effectiveness alongside traditional remedies such as exercise. This review will highlight some of the key issues regarding stress in women and explore reports of new treatment modalities in light of the specific requirements of the modern woman.

Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic. Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA). Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire. Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.

Daytime fatigue as a predictor for subsequent retirement among older New Zealand workers

OBJECTIVES

There is limited information on the role of fatigue on retirement, either independently or in association with poor sleep. The aim of this study was to examine the prospective association between daytime fatigue, measured as feeling tired or feeling worn out, independently and in relation to dissatisfaction with sleep, and subsequent retirement among 960 older workers in New Zealand.

METHODS

Data from 2 consecutive surveys (2008 and 2010) of the New Zealand Health, Work, and Retirement Longitudinal Study were used. Poisson regression was used to investigate whether feeling tired and feeling worn out in 2008, along with dissatisfaction with sleep, were associated with self-reported retirement either due to health reasons or other reasons by 2010.

RESULTS

The risk for retirement due to health reasons during a 2-year follow-up was 1.80-fold (95% confidence interval [CI] 1.16-2.45) among those who felt tired and 1.99-fold (95% CI 1.34-2.64) among those who felt worn out when compared to those not tired or not feeling worn out after adjusting for several sociodemographic, work characteristics and self-rated health. The risk for retirement due to health reasons was even higher when participant experienced both tiredness and feeling worn out. Dissatisfaction with sleep did not predict retirement due to health or other reasons.

CONCLUSIONS

Our results highlight that workers at risk of subsequent retirement due to health reasons may be identified with rather simple questions on tiredness and feeling worn out even among generally healthy older workers.

The Cross-Sectional Relations of COVID-19 Fear and Stress to Psychological Distress among Frontline Healthcare Workers in Selangor, Malaysia

Previous pandemics have demonstrated short and long-term impacts on healthcare workers’ mental health, causing knock-on effects on patient care and professional functioning. Indeed, the present COVID-19 pandemic has created unprecedented disruption in social interactions and working conditions. Malaysia has been under the Recovery Movement Control Order since June 2020; however, with the upsurge of cases, healthcare workers face pressure not only from working in resource-deprived settings but also from the increasing patient load. The primary objective of the present study was to examine the cross-sectional relationship of COVID-19 fear and stress to psychological distress (operationalized as anxiety and depression) in healthcare workers. The present sample included 286 frontline healthcare workers from three hospitals in Selangor, Malaysia. Self-administered questionnaires containing sociodemographic and occupational items, the Malay versions of the Coronavirus Stress Measure scale, the Fear of Coronavirus-19 scale, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 were distributed via online platforms. Hierarchical multiple regression findings suggest that age, shift work, and COVID-19 stress consistently predicted anxiety and depression among frontline healthcare workers after adjusting for sociodemographic and occupational variables. The present findings suggest that frontline healthcare workers are not only inoculated against COVID-19 itself but also against the psychological sequelae of the pandemic.

Occupational Fatigue: Relationship With Personality Traits and Decent Work

Psychology of working theory (PWT) and psychology of working framework (PWF) offered a psychological view of decent work. The present study examined the associations among personality traits, decent work and Occupational Fatigue Exhaustion Recovery Scale (OFER). Two hundred and thirty four participants filled out the Big Five Questionnaire, the Italian version of the Decent Work Scale, and the Italian version of the OFER Scale. Hierarchical regressions showed that decent work explained incremental variance beyond personality traits with respect to OFER both considering total score and its three dimensions (chronic fatigue, acute fatigue, persistent fatigue). The present study underlined the value of decent work in relation to occupational fatigue beyond the contributions of personality, in particular in relation to the dimensions of Adequate compensation and Free time and rest for less occupational fatigue (both as total and as dimensions).

Time in Nature Associated with Decreased Fatigue in UK Truck Drivers

Heavy goods vehicle (HGV) driving is recognised as a highly hazardous occupation due to the long periods of sedentary behaviour, low levels of physical activity and unhealthy food options when working. These risk factors combine with shift work and concomitant irregular sleep patterns to increase the prevalence of fatigue. Fatigue is closely linked with stress and, subsequently, poor physiological and psychological health. In parallel, a wealth of evidence has demonstrated the health and wellbeing benefits of spending time in nature. Here, we sought to examine whether spending time in nature was associated with lower levels of fatigue, anxiety and depression in HGV drivers. 89 long-distance drivers (98.9% male, mean ± SD age: 51.0 ± 9 years, body mass index: 29.8 ± 4.7 kg/m²) participating in a wider health promotion programme reported time spent in nature (during and before the Covid-19 pandemic) and symptoms of occupational fatigue, depression and anxiety. After controlling for covariates, truck drivers who visited nature at least once a week exhibited 16% less chronic fatigue prior to the pandemic, and 23% less chronic fatigue and 20% less acute fatigue during the pandemic. No significant differences were observed for either anxiety or depression. As fatigue has a range of physical and mental health sequelae, we propose that increased exposure to natural settings may make a valuable contribution to interventions to promote the health and wellbeing of this underserved group.

Fatigue and the Need for Recovery among Latino/a Immigrant Cattle Feedyard Workers

Cattle feedyards are animal feeding operations where beef cattle are finished to market weight on grain. Cattle feeding can be dirty, demanding, and dangerous work. This study sought to assess the predictors of fatigue and the need for recovery among Latino/a immigrant cattle feedyard workers in the United States. A path model was examined to explore direct and indirect relations among physical fatigue, mental fatigue, need for recovery, job characteristics, and health and sociodemographic covariates. Lower self-reported health, experiencing physical pain, not handling animals, and decreased decision latitude were directly related to increased physical fatigue. Shorter tenure working on cattle feedyards, lower educational level, experiencing physical pain, and increased job demands were directly related to heightened mental fatigue. Being female, experiencing physical pain, an elevated average of hours worked per day, increased job demands, and less decision latitude were directly related to an increased need for recovery and indirectly related to both physical and mental fatigue. Physical and mental fatigue have specific correlates, but job characteristics, including job demands and decision latitude, can directly and indirectly impact workers' levels of physical and mental fatigue and their need for recovery. Both preventive measures and restructuring work operations may reduce the risk for fatigue and the need for recovery. Implications for cattle feedyard workers, supervisors, and employers are discussed. Finding ways to balance productivity and the well-being of workers should be a high priority for cattle feedyards across the country.

Effort-Reward Imbalance, Resilience and Perceived Organizational Support: A Moderated Mediation Model of Fatigue in Chinese Nurses

PURPOSE

Fatigue undermines nurses' well-being and work performance worldwide. Work stress is a critical factor that causes nurses' fatigue, but the solutions are not well known. This study aimed to identify the moderated mediation model of fatigue involving effort-reward imbalance (ERI), resilience and perceived organizational support (POS) in Chinese nurses.

METHODS

In a cross-sectional investigation conducted in Liaoning Province of China, 996 nurses completed the self-administered measurements of fatigue, ERI, resilience and POS. Moderated mediation was tested using the PROCESS procedure. The "pick-a-point" method was adopted to assess conditional effect on fatigue.

RESULTS

The indirect effect of ERI on fatigue through resilience was significant (a×b = 0.119, BCa 95% CI: 0.094 to 0.146), indicating a partial mediation of resilience. POS moderated the association of resilience with fatigue (β = -0.056, p = 0.006). The higher the level of POS was, the stronger the resilience-fatigue association became. Thus, the mediating role of resilience in the ERI-fatigue association was gradually increased with the increase of POS level (low POS: 0.073; moderate POS: 0.095; high POS: 0.116).

CONCLUSION

Resilience could partially mediate the ERI-fatigue association. POS could act as a moderator that enhanced the association of resilience with fatigue. A moderated mediation model of fatigue was demonstrated in Chinese nurses. Managers should establish a balanced social reciprocity, and improve nurses' resilience and POS in order to decrease nurses' fatigue.