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Entrainment of breathing rate to movement frequency during work at two intensities.

Ten males and six females exercised on an electrically braked cycle ergometer. Three conditions were tested: preferred pedal frequency with no cues; preferred frequency established by listening to a metronome and preferred frequency maintained by watching a digital display. Each condition was performed at a low workload and a high workload, and this set of tests was repeated once. During each test, computer sampling of pedal and breath information occurred, and the relationship of breath signal occurrences to pedal signals was plotted by a post stimulus histogram program. Fourier analysis of psh data (Time Series Spectrum Estimation) decomposed each histogram into it's frequency components. The magnitude of the frequency at the fundamental of the pedal period (F1), and it's first harmonic (F2), were assessed using F ratios. For retest results, preferred condition, 100% of subjects were entrained for both low and high workloads. With the metronome, 87% were entrained at the low workload and 94% at the high workload. For both workloads, 94% were entrained when watching a digital printout of pedal frequency. For preferred pedal rate, at the two workloads tested, the results of this study strongly support the existence of entrainment, and provide evidence for neurogenic input to ventilatory control during steady state work.

Adult↗

Circadian rhythms of autonomic parameters during mental and physical activity.

The structure of circadian rhythms of autonomic parameters was monitored during working week in subjects occupied by physical and mental work. Differences in the rhythm structure depended on the work type and schedule, as well as on the subject age. Hard physical work was associated with biphasic changes in the autonomic nervous system functioning with dominating sympathetic and parasympathetic components in the beginning and at the end of the working week, respectively. Intensive physical work caused rhythm synchronization: the acrophases were shifted to 14.00 and the amplitude of daily oscillations was high. Mental activity with individual working schedule resulted in chronic desynchronization most pronounced in subjects over 30.

Adult↗

[Relationship between subjectively perceived working conditions and alcohol consumption: results of the TACOS study].

The purpose of this investigation was to examine the relationship between subjectively perceived working conditions and alcohol consumption based on a stress coping model. The investigation is part of the study 'Transitions in Alcohol Consumption and Smoking' (TACOS), a representative general population survey in a Northern German region. The current evaluation includes 2,471 working individuals, aged 18-64 years. Data with regard to alcohol consumption were collected via the 'Munich Composite International Diagnostic Interview' (M-CIDI). The three scales of the 'Normative and Subjective Assessment of working analysis' (NUSA) Contents of work, Physical work conditions and Intensity of work gathered differentiated information on subjectively perceived working conditions. The ANOVA results show that alcohol consumption does not account for variance in the scales of subjective working conditions. Further correlation and regression analyses do not reveal a relationship between the scales of NUSA and the quantity of drinking.A substantial relationship between subjectively perceived working conditions and moderate alcohol consumption, alcohol abuse or alcohol dependence could not be established. The reported results appear to indicate complex and multifactorial associations between subjectively perceived working conditions and alcohol consumption. Implications for alcohol prevention in worksite environments are discussed.

Adaptation, Psychological↗

Effects of active recovery under a decreasing work load following intense muscular exercise on intramuscular energy metabolism.

The effect of active recovery at a decreasing % of MVC following intense muscular exercise on intramuscular pH was investigated in vivo using 31P-MRS. Seven healthy men participated, and their right wrist flexor muscle group was examined. The subjects were asked to flex their right wrist at 60 % of the maximum voluntary contraction (MVC) every 2 s until the intracellular pH in the wrist flexor muscle decreased to 6.4. After the exercise period, the subjects underwent active or passive recovery for 10 min. For the active recovery (AR), the subject was asked to continue exercising at a decreasing % of MVC, decreasing from 25 to 5 % MVC every two min during AR. 31P-MR-spectra were obtained throughout the experiments, and from the spectra the intracellular pH (pHi) was calculated as an indicator of intracellular events. AR data were compared to data collected during passive recovery (PR). During AR, the pHi increased immediately after the exercise period; whereas in that of PR, it did not recover within 5 minutes after exercise. The results suggested that mild exercise was an effective manoeuver to promote recovery from intramuscular metabolic acidosis.

Adult↗

The meaning of caring to nurses: an investigation into the nature of caring work in an intensive care unit.

BACKGROUND: The purpose of the study was to generate knowledge, which informs the discipline of nursing as caring represents an essential human need. Despite the wealth of research discussing caring in nursing, little is related to the highly technological intensive care unit environment. AIMS OF THE STUDY: To explore the meaning of caring to intensive care unit nurses. To determine if the meaning of caring to these nurses has potential for altering nursing practice and to gain an insight into how caring experiences were evident to them. DESIGN AND METHOD: The design of the study was descriptive and qualitative. Semi-structured interviews were conducted to collect data on the experiences of twelve nurses who were selected by purposive sampling. Data analysis involved using Colaizzi's reductive procedure. RESULTS: Findings suggest that the nurses in the study participated in delivering holistic and humane care of the patient and their relatives. The essential structure of caring was identified as a process of competent physical and technical action imbued with affective skills. CONCLUSIONS: This study revealed caring to be synonymous with nursing. The descriptive accounts of the nurses' experiences of caring in this study attempt to illuminate the nature of intensive care unit nursing. It legitimates, from the perspectives of these particular participants, the importance of caring. The participants described caring as a process involving feelings together with professional knowledge, competence, skill and nursing action. This involved the holistic care of the patient and relatives in meeting their individual needs. RELEVANCE TO CLINICAL PRACTICE: This study demonstrated that the lived experience of caring reflects the humanistic nature of nursing. It confirms that to care is human and the capacity to care is affirmed and actualised in caring for the critically ill patient and their relatives.

Affect↗

The effect of work activity in pregnancy on the risk of severe preeclampsia.

The aim of this study was to evaluate the impact of type of employment and level of physical activity at work on the risk of severe preeclampsia. For this purpose, we carried out a case control study of 160 nulliparous pregnant women with severe preeclampsia and 320 normotensive nulliparous controls who received prenatal care from members of one medical staff. The type of employment and the level of physical activity sustained at work were ascertained at birth through an interview based on a standard questionnaire. The degree of physical activity at work was assessed by a 4-level activity score based on type of work, physical intensity, posture at work, and weekly working hours. In logistic regression analysis, after adjustment for potential confounders (maternal age, time of stopping work, prepregnancy body mass index, social status of the partner, history of previous abortion, and prepregnancy smoking status), clerical workers had a significantly lower risk of severe preeclampsia than women who were unemployed at the beginning of pregnancy (OR 0.53, 95% CI 0.30, 0.96). In multivariate analysis, there was a significant linear trend relating the degree of physical activity at work, to the risk of preeclampsia (likelihood chi-square = 9.38, 3 df, p = 0.002). We then restricted the analysis to women who had ever worked in pregnancy (n = 339) also adjusting for confounders, and found that clerical workers were still at significantly lower risk of severe preeclampsia than women not formally employed (OR 0.2, 95% CI 0.08, 0.49). In addition, moderate/high physical activity at work was associated with a 2-fold increase in the risk of severe preeclampsia compared to mild activity (OR 2.08, 95% CI 1.11, 3.88). We conclude that moderate to high physical activity at work seems to increase the risk of severe preeclampsia.

Adult↗

Assessment of skeletal muscle fatigue of road maintenance workers based on heart rate monitoring and myotonometry.

OBJECTIVE: This research work is dedicated to occupational health problems caused by ergonomic risks. The research object was road building industry, where workers have to work very intensively, have long work hours, are working in forced/constrained work postures and overstrain during the work specific parts of their bodies. The aim of this study was to evaluate the work heaviness degree and to estimate the muscle fatigue of workers after one week work cycle. The study group consisted of 10 road construction and maintenance workers and 10 pavers aged between 20 and 60 years. METHODS: Physical load were analyzed by measuring heart rate (HR), work postures (OWAS) and perceived exertion (RPE). Assessments of the muscles strain and functional state (tone) were carried out using myotonometric (MYO) measurements. The reliability of the statistical processing of heart rate monitoring and myotonometry data was determined using correlating analysis. RESULTS: This study showed that that road construction and repairing works should be considered as a hard work according to average metabolic energy consumption 8.1 +/- 1.5 kcal/min; paving, in its turn, was a moderately hard work according to 7.2 +/- 1.1 kcal/min. Several muscle tone levels were identified allowing subdivision of workers into three conditional categories basing on muscle tone and fatigue: I--absolute muscle relaxation and ability to relax; II--a state of equilibrium, when muscles are able to adapt to the work load and are partly able to relax; and III--muscle fatigue and increased tone. It was also found out that the increase of muscle tone and fatigue mainly depend on workers physical preparedness and length of service, and less on their age. CONCLUSION: We have concluded that a complex ergonomic analysis consisting of heart rate monitoring, assessment of compulsive working postures and myotonometry is appropriate to assess the work heaviness degree and can provide prognosis of occupational pathology or work-related musculoskeletal disorders for the workers under different workload conditions. These results can also be used when deciding on necessary rest time and its periodicity.

Journal Article↗

Evaluation of patients with clinically suspected melanoma recurrence: current practice patterns of plastic surgeons.

The optimal extent-of-disease evaluation for patients with clinically suspected melanoma recurrence is not known. The available modalities are numerous and many are expensive. We documented the extent of work-up carried out by plastic surgeons when their patients with melanoma develop clinical recurrence. A custom-designed questionnaire was mailed to a random sample (n=3,032) of the 4,320 members of the American Society of Plastic and Reconstructive Surgeons (ASPRS). Subjects were asked which specific laboratory tests and imaging studies they would order for a patient with initial T2N0M0 disease treated with curative intent who later presented with either regional nodal metastases or pulmonary metastases. We measured the variability in practice patterns among surgeons and estimated the effects of physician age, U.S. census region, health maintenance organization (HMO) penetration rates, and type of recurrence (regional versus systemic) on work-up intensity. Of the 1,142 questionnaires completed (38%), 395 (35%) were evaluable. Non-evaluability was usually due to lack of melanoma patient follow-up in surgeons' practices. Lesion biopsy, chest X-ray, complete blood count, liver function tests, and computed tomography were frequently used, but there was no consensus for most modalities. More tests, particularly computed tomography, were utilized for evaluating systemic recurrence than for regional recurrence (p<0.05). The intensity of work-up differed significantly (p<0.05) by surgeon age for three diagnostic tests but not by U.S. census region or HMO penetration rate. This is the first empirical data on this subject from a large sample of an international society of highly credentialed experts. The lack of consensus for most tests in current practice is presumably due to multiple factors, including the lack of evidence supporting any particular strategy.

Adult↗