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Motor neuron excitability: the Hoffmann reflex following exercise of low and high intensity.

The current exercise literature lacks physiological evidence for a stress reduction induced by high intensity aerobic work. The purpose of this study was to investigate the effectiveness of high intensity aerobic work on stress reduction and to evaluate the currently tenable hypotheses in view of the data on the response to high intensity work. The subjects participated in a control trial and two 20-min treadmill exercise trials at low and high (40% and 75% VO2max) intensity. The H- and M-wave responses to artificial stimulation of the tibial nerve (Angel and Hofmann, 1963) were used to assess spinal cord activation level which constituted the major dependent variable in the study. Low intensity exercise showed a 12.8% reduction in the H max/M max ratio (P less than 0.05) while high intensity exercise reduced the H max/M max ratio by 21.5% (P less than 0.0002). The two exercise treatment levels were also significantly different from each other (P less than 0.02). These data provide objective evidence for the efficacy of high intensity exercise in stress reduction as measured by the Hoffmann reflex and provide indirect evidence for a possible thermal hypothesis for exercise-induced stress reduction.

Action Potentials↗

[Survey of work schedules of Swiss intensive care units and assessment of their possible impact on nurses].

Work schedules impact significantly on the health and well-being of health care professionals. The prevailing schedules can place the care providers 'at risk both psychologically and physically as well as in their social and private sphere. The added burden of daily activities in intensive care units (ICUs) intensifies these effects. The present quantitative study was designed to determine the range of work schedules currently in practice in intensive care units in Switzerland and to assess their possible health impact on nurses. Furthermore, it assessed how the organizational context differs between intensive care units with better and worse work schedules. A questionnaire was developed, pilot tested, and distributed to 84 ICUs in Switzerland. All 84 professionals responsible for designing the work schedules of nurses on ICUs were requested to fill out the questionnaire. The collected data were analyzed using descriptive statistical methods. To assess the health impact of the work schedules, a method was developed which considers the most important health relevant dimensions of the work schedules for a global estimate. Finally, the most extreme groups regarding the health impact of the working schedules were compared regarding their organizational context using non-parametric and parametric tests. The findings show that the working schedules in ICUs could be considerably improved, particularly regarding duration and density of working hours as well as regarding supportive structures of the hospitals.

Humans↗

[Evaluation of the intensity of stress at work and burnout syndrome in the managers].

BACKGROUND: Burn out syndrome is connected with the intensity of stress at work. It is a common problem among people who work in management departments. This significantly decreased the effectiveness of work and the quality of psychosocial functioning. The purpose of the study was to establish the dependence between occupational stress and burnout syndrome in the group of managers. MATERIAL AND METHODS: The studied group consisted of 73 managers, aged 27-55 years. The Perceived Job Stress Questionnaire and Maslach Burnout Inventory (MBI) were used in this study. RESULTS: The data obtained revealed significant intensity of stress filling at work in evaluated group. The most stressful factors occur: psychical balance of work, lack of rewards, social contacts and uncertainty at work. The highest risk of burnout syndrome is associated with symptoms of emotional exhaustion and depersonalization. CONCLUSIONS: Higher intensity of occupational stress is connected with the greater intensification of burnout syndrome in investigated group of managers.

Adaptation, Psychological↗

[Motivation and psychological suitability for work in a pediatric intensive care unit].

During interviews with physicians and nurses on the general pediatric intensive care unit (ICU) of the University of Heidelberg Children's Hospital personnel reported on various aspects of their work. One complex of questions dealt with the motivation to work in intensive medicine. Physicians and nurses showed different patterns of motivation. Physicians could be clearly divided into those who found intensive medicine fascinating and those who tended to fear it. Nurses' motivation is multifaceted and differentiated. The information gained from the interviews questions the sense of obligating physicians without interest or aptitude to rotate to an ICU during their specialty training in pediatrics. This policy is associated with corresponding risks for patients. The work of often superiorly qualified nurses becomes more difficult.

Aptitude↗

[The representations of nursing auxiliaries and technicians about team work at an intensive-care unit].

This study aims to explain and analyze the representations of nursing auxiliaries and technicians about team work at an intensive-care unit. The qualitative approach was used and the Theory of Social Representations was adopted as a theoretical-methodological reference framework. The empirical material was obtained from interviews with four technicians and twelve nursing auxiliaries working at the intensive care units of Medical, Surgical and Pediatric Clinics. The information obtained was analyzed by means of the content analysis technique, following the thematic analysis mode. Results indicated conflicting interaction among nursing workers, highlighting the need to implement more efficient staff management models that focus on conflict management actions among different nursing teams.

Intensive Care Units↗

Comparison of exercise variables measured during intensity of simulated training to variables at maximal effort in standardbreds.

The heart rate changes during routine training in a group of 8 actively racing Standardbreds were used to simulate the training work on a treadmill (ST) and indices of exercise compared to maximal effort (MAX) on the treadmill. The following parameters were recorded during treadmill work: heart rate, velocity, O2 consumption, respiratory and stride frequency, and stride length. Blood lactate concentrations were measured before and after each work test. Heart rate during simulated training was mean +/- s.d. 87.8 +/- 5.5% heart rate in MAX, one of the 8 horses working < 80% of maximal HR and 2 of the 8 horses working above 90% maximal heart rate. Mean +/- s.d. oxygen consumption during the ST was 75.1% +/- 8.4% MAX, but correlated poorly against percentage heart rate for individual horses (r2 = 0.02). At similar velocities for the ST and MAX, only respiratory frequency differed significantly (P > 0.05), being higher during the ST. Most horses worked at intensities based on heart rate consistent with proposed guidelines of 80-90% of maximal heart rate. However, in 3 of the 8 horses work intensity of insufficient or excessive amounts may have occurred.

Animals↗

Oxygen deficit and repayment in submaximal exercise.

Oxygen deficit and repayment ratios were investigated at various work loads, intensities and durations. An active baseline was used (walking at 60 m/min) from which deficit and repayment values were calculated. Oxygen uptake (VO2) and core temperatures were measured in 30 males at baseline and during treadmill running (140 m/min) for randomly assigned durations (0.5 ...20 min). Measurements were also made during a 30-min recovery period at baseline work. Results indicated: 1) No difference in O2-repayment between steady-state work and work prior to steady state (P greater than 0.10). 2) O2-repayment was independent of work duration (P greater than 0.10). 3) When workload and intensity were controlled, O2-deficit was not significant factor in O2-repayment (P greater than 0.10). 4) Work intensity (work VO2/VO2 max) was the most significant factor in O2-repayment accounting for 69% of the variance (r equals 0.83, P less than 0.001). Small increments in core temperature and ventilation were not significant factors in O2-repayment. When a working baseline is used, the magnitude of O2-repayment after exercise is independent of the work duration or the attainment of steady state. The extent of O2-repayment after exercise is mainly dependent upon the physiological intensity of the work and the absolute workload (R=0.89, P less than 0.001).

Aerobiosis↗

Hormonal, electrolyte, and renal responses to exercise are intensity dependent.

Previous work indicates that the magnitude and direction of renal responses to exercise depend on the exercise intensity. To examine mechanisms responsible for these findings, renal and hormonal responses were studied in eight healthy male subjects (29.6 +/- 1.9 yr) before and immediately after four 20-min bouts of submaximal exercise (cycle ergometry) at work loads representing 25, 40, 60, and 80% of maximal oxygen consumption. Urine flow, osmotic clearance, glomerular filtration rate, and sodium excretion (UNa+V) all tended to rise at the 25% work load but were markedly reduced at the higher work intensities. Changes in urine flow paralleled changes in glomerular filtration rate (r = 0.91). Plasma vasopressin (ADH), aldosterone, and plasma renin activity tended to increase progressively with increases in work load, with the increases for all hormones reaching statistical significance when the level of exercise reached greater than or equal to 60% of maximal oxygen consumption. However, atrial natriuretic peptide was elevated (P less than 0.05) at all work loads from greater than 1.6-fold of control levels at the 25% work load to greater than 7-fold at the 80% work load. The increase in urine flow (6 of 8 subjects) and UNa+V (7 of 8 subjects) may be due to the increase in atrial natriuretic peptide and/or a 10% suppression (P less than 0.05) of ADH at the 25% work load.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Oxygen uptake to work rate relation throughout peak exercise in normal subjects: relevance for rate adaptive pacemaker programming.

The oxygen uptake to work rate (VO2/WR) relationship observed throughout peak exercise testing is already being applied for rate adaptive pacemaker programming. However, the detailed curve design of VO2/WR with respect to the anaerobic threshold (AT) has not yet been investigated. It was the purpose of this study to determine the VO2/WR slope below and above the AT in a healthy control group. Seventy-eight healthy control subjects (45.9 +/- 17.4 years; 34 women: 49.9 +/- 18.6 years 44 men: 43.6 +/- 16.6 years) were exercised on a treadmill with "breath-by-breath" gas exchange monitoring using the symptom limited "ramping incremental treadmill exercise" (RITE) protocol. The slope of the VO2/WR relationship from rest to peak exercise (r-p), rest to AT (slope A), and AT to peak exercise (slope B) in mL oxygen uptake per watt of external treadmill work was determined by linear regression analysis. [table: see text] The oxygen uptake to work rate relationship throughout peak exercise in the entire study group generated a significant slope change at the AT (31%, P < 0.0001) with a decreasing slope during higher work load intensities. Female subjects demonstrated a greater percentage of slope change at AT (43%), as compared to men (22%, P < 0.01). When using the oxygen uptake to work rate relationship for the programming of the pacemaker's rate response to exercise, the significant slope change at the AT should be considered to more appropriately pace during higher work intensities supported by anaerobic metabolism. Female pacemaker patients should be programmed to generate a steeper VO2/WR slope below AT with a greater slope change at AT, as compared to men. Abnormally high oxygen uptake to work rate ratios above the AT may be possibly used as an indicator of overpacing.

Adult↗

The intensive care unit: social work intervention with the families of critically ill patients.

Hospital intensive care units can be a significant practice area for social workers. Nowhere are families in more obvious crises than when faced with the life-threatening illness of a significant other who may be unresponsive and dependent on a frightening array of highly technical equipment. Using the crisis model for their intervention, social workers can significantly lessen the trauma experienced by these families. Additionally, they can develop other supportive hospital resources such as family groups and volunteer services to help meet their needs.

Adaptation, Psychological↗

[Circadian periodicity of blood coagulation system indices and the hormonal activity of the adrenals in healthy persons (under conditions of rest and of stressed work)].

13 patients with the heart ischemic disease (HID) were examined in conditions of a relative rest (hospital) and 20 patients - during an intensive day work. Within the 24-hr rhythm of gemocoagulation parameters, 3 phases were distinguished (conventionally): I a tendency to hypercoagulation at 0-3-6 a.m.; II the most safe period at 9 a.m.; III an increased ability of coagulation at 12-3-6-9 p.m. During the intensive day work, hypercoagulative shifts become more obvious and the anticoagulating system becomes activated at the I and the III phases. Within the 24: hr rhythm of the plasma fibrinolytic activity, 2 phases were distinguished (conventionally): I low activity at 0-3-6-9-12 a.m.; II sufficient activity at 3-6-9 p.m. During the intensive day work fibrinolytic activity increases, and the character of 24-hr rhythm preserves. Within the 24-hr rhythm of the adrenal hormonal activity, 3 phases were distinguished (conventionally): I a reduced activity at 0-3-6 a.m.; II high activity at 9 a.m.; III high enough activity at 12-3-6-9 p.m. In conditions of intensive day work the 24-hr rhythm of the adrenal hormonal activity does not change.

17-Hydroxycorticosteroids↗

The influence of occupational physical activity on the menstrual cycle and fecundability.

We examined the influence of the level of occupational physical activity per working hour (intensity score) and per working day (fatigue score) on menstrual function and fecundability in a population of 260 nonmedical female workers who were employed at 39 Dutch hospitals and were planning a pregnancy. We studied the influence of the intensity and fatigue scores as such and in combination with unfavorable working hours (before 8:00 am or after 6:00 pm) and high working speed (working at high speed for more than 50% of the time). The data did not reveal a clear relation between the occupational physical activity levels (representing an estimated energy requirement of up to 3 times the basal metabolic rate) and menstrual function, but the presence of a small effect could have been missed. The fecundability of women with a high fatigue score, particularly in association with unfavorable working hours, was lower than that of women with a low fatigue score (fecundability odds ratio = 0.37; 95% confidence interval = 0.18-0.77). Moderate levels of physical activity, as found in cleaners, kitchen staff, and clerical workers at hospitals, appear to affect the female reproductive system. Fecundability, as measured by the time to pregnancy, seems to be a more sensitive parameter for these biological changes than menstrual function.

Adolescent↗