Prospective associations of technostress at work, burnout symptoms, hair cortisol, and chronic low-grade inflammation.

BACKGROUND: Working conditions in the age of digitalization harbor risks for chronic stress and burnout. However, real-world investigations into biological effects of technostress, that is stress in the context of digital technology use, are sparse. This study prospectively assessed associations between technostress, general work stress, burnout symptoms, hair cortisol, and chronic low-grade inflammation. METHODS: Hospital employees (N = 238, 182 females, Mage = 28.5 years) participated in a prospective cohort study with two follow-ups six months apart (T2, T3). Participants answered standardized questionnaires on general job strain (job demand-control ratio), technostressors (work interruptions, multitasking, information overload), burnout symptoms (exhaustion, mental distance), and relevant confounders. Moreover, they provided capillary blood samples for C-reactive protein (CRP) and hair strands for hair cortisol concentration (HCC) analysis. Structural equation modelling was performed. RESULTS: The factorial structure of survey measures was confirmed. Burnout symptoms (MT2 = 2.17, MT3 = 2.33) and HCC (MT2 = 4.79, MT3 = 9.56; pg/mg) increased over time, CRP did not (MT2 = 1.15, MT3 = 1.21; mg/L). Adjusted path models showed that technostress was negatively associated with HCC (ß = -0.16, p =.003), but not with burnout and CRP. General work stress in contrast, was not significantly associated with burnout, HCC or CRP. Furthermore, there were reciprocal effects of CRP on HCC (ß = 0.28, p =.001) and of HCC on CRP (ß = -0.10, p ≤.001). Associations were robust in additional analyses including further confounders. CONCLUSION: This is the first study on prospective effects of technostress on employees' endocrine and inflammatory systems. Results suggest differential effects of technostress on the hypothalamic-pituitary-adrenocortical axis activity. Given its key role for long-term health, the findings have important implications for occupational health and safety in digitalized work environments.

Evaluation of stress, burnout and hair cortisol levels in health workers at a University Hospital during COVID-19 pandemic.

In the critical context of COVID-19 pandemic, healthcare workers are on the front line, participating directly in the care, diagnosis, and treatment of patients with COVID-19. This exposes them to a higher risk of developing chronic stress, psychological distress, and any other mental health symptoms. OBJECTIVE: to evaluate stress and burnout in a health workers population and, in addition, to measure hair cortisol concentration as a current biomarker of stress. MATERIALS AND METHODS: 234 health workers from Hospital de Clínicas "José de San Martín", Buenos Aires University, were included in this study. In this population hair samples were obtained from the posterior vertex as close to the scalp as possible and the individuals completed the following surveys: perceived stress, social support, burnout scale, life event scale, and sociodemographic data. Hair cortisol was measured by an automated chemiluminescent method. The studied population was divided into three groups considering those individuals below the healthy reference sample range (< 40 pg/mg hair), within the healthy reference range (40-128 pg/mg hair) and above the reference range (> 128 pg/mg hair). This study used a transversal and observational design. RESULTS: Our results show that 40% of the studied population presented hair cortisol values outside of the healthy reference range. In the whole studied population, a direct correlation was found between hair cortisol concentration and perceived stress as well as between hair cortisol concentration and the emotional exhaustion component of burnout (r = 0.142, p = 0.030; r = 0.143, p = 0.029, respectively). 12% of the studied population showed Burnout (52% doctors and residents, 19% nurses, 19% administrative personnel). Higher values in hair cortisol levels were found in the group with burnout versus individuals without burnout (p = 0.034). Finally, a mediation analysis was performed, finding that depersonalization is a mediating variable in the relationship between self-perceived stress and hair cortisol level (F = 4.86, p = 0.0086; indirect effect IC: 0.0987-1.8840). CONCLUSION: This is the first study in which a stress biomarker such as hair cortisol is evaluated in this population and in this context. Healthcare workers are subjected to increased levels of stress and burnout. High depersonalization, emotional exhaustion, and decreased personal sense of accomplishment characterize this population. It is the responsibility of the health authorities to implement strategies to manage this psychological emergency.

Evaluation of Anxiety, Depression, and Biological Markers in Health Professionals with Burnout.

INTRODUCTION: Medical profession is a stress factor for the development of burnout, symptoms of anxiety and depression as a result of 24-hour work, delayed work-life balance gratification and challenges associated with patient care. AIM: This study aimed to verify the rates of burnout, anxiety, and depression presented by health professionals working 24-hour shifts under emergency conditions. Saliva cortisol and glycated hemoglobin were also studied as stress-related biomarkers. MATERIALS AND METHODS: Ninety-five medical professionals - physicians, biologists, chemists, and laboratory technicians were compared to a control group working outside medicine. Burnout was measured by the Maslach Burnout Inventory. Anxiety and depression were measured by the State-Trait Anxiety Inventory and the Zung Depression Scale. Salivary cortisol and glycated hemoglobin were analyzed by the immunoassay methods. RESULTS: The level of burnout in the subscale of emotional exhaustion was high in 95.6% of medical professionals. In the subscale of personal accomplishment, 100% had high scores. Regarding the State-Trait Anxiety Inventory, 22.2% and 68.9% of the medical specialists showed a positive score (≥40) for S-anxiety and T-anxiety scale, respectively. 11.1% indicated greater anxiety (score ≥ 55) for T-anxiety. In relation to the depression scale, 31.1% had mildly depressive states and 8.9% had moderately depressive states. Participants with a high level of emotional exhaustion presented higher results for saliva cortisol and glycated hemoglobin compared to the control group. A significant positive correlation existed between the two dimensions - emotional exhaustion and depression (r=0.683, p<0.01). CONCLUSIONS: Our study may be relevant for further research in order to decrease the negative aspects of professional stress.

MRS Shows Regionally Increased Glutamate Levels among Patients with Exhaustion Syndrome Due to Occupational Stress.

Despite the rapid increase of reports of exhaustion syndrome (ES) due to daily occupational stress, the mechanisms underlying ES are unknown. We used voxel-based 1H-MR spectroscopy to examine the potential role of glutamate in this condition. The levels of glutamate were found to be elevated among ES patients (n = 30, 16 females) compared with controls (n = 31, 15 females). Notably, this increase was detected only in the anterior cingulate and mesial prefrontal cortex (ACC/mPFC), and the glutamate levels were linearly correlated with the degree of perceived stress. Furthermore, there was a sex by group interaction, as the glutamate elevation was present only in female patients. Female but not male ES patients also showed an increase in N-acetyl aspartate (NAA) levels in the amygdala. No group differences were detected in glutamine concentration (also measured). These data show the key role of glutamate in stress-related neuronal signaling and the specific roles of the amygdala and ACC/mPFC. The data extend previous reports about the neurochemical basis of stress and identify a potential neural marker and mediator of ES due to occupational stress. The observation of specific sex differences provides a tentative explanation to the well-known female predominance in stress-related psychopathology.

Rx risk or resistance? Psychotropic medication use in relation to physiological and psychosocial functioning of psychiatric hospital workers.

To avoid methodological biases, psychoneuroendocrine studies have generally excluded psychotropic medication users. In workplace stress research, this has limited our ability to understand how psychotropic medication use affects many stress-related measures of interest. In this exploratory study, the effects of psychotropic medication use on stress physiology, occupational stress, and mental health were measured in a sample of healthy adult psychiatric hospital workers (N = 203, 70 % women). Diurnal cortisol was assessed on two non-consecutive work-days at five time-points (e.g., awakening, thirty minutes after awakening, 2 P M, 4 P M and bedtime). Cortisol reactivity was assessed by exposing participants to the Trier Social Stress Test. An allostatic load index was constructed using 19 neuroendocrine, immune, cardiovascular, and metabolic biomarkers. Occupational stress (e.g., job strain, effort-reward imbalance) and psychiatric symptoms (e.g., depression, burnout) were assessed with well-validated self-reports. Results showed that psychotropic medication use had no significant effects on diurnal cortisol profiles; however, psychotropic users had significantly decreased cortisol reactivity to the Trier Social Stress Test and higher allostatic load. Psychotropic users also had decreased effort-reward imbalance, but not job strain. Depressive symptoms did not differ between psychotropic medications users and non-users; however, burnout symptoms were higher among psychotropic medication users than non-users. Taken together, our findings do not warrant the systematic exclusion of psychotropic medication users from psychoneuroendocrine studies if insights into individual differences are sought among workers and other populations exposed to elevated stress.

Growth factors and neurotrophins in patients with stress-related exhaustion disorder.

Growth factors, such as vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), and neurotrophic factors, including brain-derived neurotophic factor (BDNF), have attracted attention in studies of the biological effects of long-term stress exposure due to their neuroprotective roles. This study investigated whether circulating levels of EGF, VEGF and BDNF were altered in individuals with stress-related exhaustion disorder. Forty patients diagnosed with exhaustion disorder and 40 healthy subjects (50% women) provided fasting blood samples for analysis of EGF, VEGF, and BDNF in plasma. We found significantly lower levels of EGF, VEGF, and BDNF in patients with ED compared to healthy controls. This pattern was seen in both male and female patients. Given the important roles of BDNF and VEGF for brain plasticity and neurogenesis, decreased levels after long-term stress exposure could indicate increased risk of neuronal damage and cognitive impairments in this patient group.

Effort-reward imbalance at work is associated with hair cortisol concentrations: Prospective evidence from the Dresden Burnout Study.

Chronic stress experienced at work is considered a major health challenge for modern societies. In fact there is ample evidence that deleterious work environments, based on high efforts in relation to few rewards, substantially augment the risk for a number of highly prevalent diseases (e.g. ischemic heart disease, stroke). One potential pathway mediating these associations involves the stress-related activation of the hypothalamus-pituitary-adrenocortical (HPA) axis with proceeding alterations in the secretion of its main effector hormone cortisol. In this study we assessed a prospective, two-year effect of effort-reward imbalance (ERI) on cortisol secretion, based on a sub sample (N = 150; mean ±â€¯SD age: 42.4 ±â€¯11.1; 84.0% female) of the ongoing Dresden Burnout Study (DBS). The provided ERI measures were collected as part of the online baseline and first follow up assessment. Further, cortisol secretion patterns over prolonged periods of time were evaluated in three consecutive years of laboratory baseline and follow up visits. Our findings suggest prospective associations between ERI and cortisol, indicating a blunted cortisol secretion in response to long-term work stress (p < 0.001). Given the regulatory properties of cortisol on various central and peripheral target tissues (e.g. cardiovascular system, liver, adipose tissue), a long-term decrease of cortisol availability can be hypothesized to cause multiple health-challenging consequences. Based on our findings, providing work environments where high efforts are always linked with high rewards have to be considered an important issue for employees health.

Mediating effects of hair cortisol on the mutual association of job burnout and insomnia: A retrospective exploratory study.

BACKGROUNDS: The present study was designed to clarify the mutual association of job burnout and insomnia and to detect the mediating effects of hair cortisol on that association. METHODS: In all, 68 female employees were recruited for the study from one secondary and one tertiary hospital between October 2018 and November 2018 in Beijing. Participants completed a questionnaire for the collection of demographic data and standardized measures for burnout and insomnia. Hair sample collection and anthropometric measurements were performed at the same time. RESULTS: Median hair cortisol concentration (HCC) was 5.89 ng/g hair (interquartile range = 2.20-10.74). And ages are between 22 and 51 years old (32.50 ±â€¯6.13), among which 22 were below 30 years, 20 were between 30 and 35 years, and 26 were over 35 years. A majority of Pearson's coefficients were significant, with the exception of that for the correlation between personal accomplishment and HCC or depersonalization. Significant mutual correlations were shown between burnout dimensions and insomnia directly. HCC acted as a mediator in the pathway from emotional exhaustion, depersonalization to insomnia; and no significant mediating effect of HCC in the pathway from insomnia to burnout was found. CONCLUSIONS: Job burnout may directly or indirectly (through chronically elevated cortisol) increase insomnia risk, whereas insomnia probably promotes burnout. Prospective studies involving different body systems and a larger sample size should be performed to further identify the mechanisms underlying the associations between burnout and insomnia among the working population.

Examining reactivity patterns in burnout and other indicators of chronic stress.

INTRODUCTION: Burnout symptomatology is associated with various negative health consequences; however, the mechanisms underlying these associations remain unclear. One potential pathway involves alterations in the acute stress response. The aims of the present study were to examine burnout-associated alterations in stress-reactivity patterns, during a standardized social stressor compared to a control condition, as well as to examine whether effects associated with greater burnout symptomatology were distinct from other, conceptually overlapping indicators of chronic stress (i.e. depressive symptomatology and elevated hair cortisol concentration [HCC]). MATERIALS AND METHODS: In a randomized two-factor design a total of 70 employed males with varying burnout symptoms but without evidence of physical or psychiatric disease were exposed to the Trier Social Stress Test for Groups (TSST-G) or a non-stressful control condition. Acute stress reactivity was assessed using self-report stress measures and non-invasive biomarkers. Associations among acute stress reactivity, burnout and depressive symptoms (assessed with self-report measures), as well as HCC were analysed using repeated measure ANCOVAs and moderation analysis. RESULTS: Burnout symptomatology was associated with elevated stress perception independent of the experimental condition. In addition, depressive symptomatology was associated with enhanced anticipatory appraisal, whereas HCC was not related to any subjective stress measure. On a physiological level, burnout and depressive symptomatology, as well as HCC were associated with a pattern of blunted cardiovascular reactivity, however the timing of this effect varied. CONCLUSION: Our results indicate burnout-associated modulations in stress reactivity, which diverge, at least partly, from other indicators of chronic stress.

Job-related burnout is associated with brain neurotransmitter levels in Chinese medical workers: a cross-sectional study.

Objective The aim of the present study was to investigate the relationship between job burnout and neurotransmitter levels in medical staff. Methods A total of 80 medical staff were enrolled in the study and assessed for occupational burnout using the Maslach Burnout Inventory - General Survey (MBI-GS). The levels of neurotransmitters in the cerebral cortex were analysed using an SP03 encephalofluctuograph. Results The levels of the neurotransmitters γ-aminobutyric acid, 5-hydroxytryptamine (5-HT), norepinephrine (NE), glutamate, acetylcholine (Achl) and dopamine (DA) were significantly lower in men than in women. Medical staff with lower levels of exhaustion had significantly higher neurotransmitter levels than staff with moderate levels of exhaustion. However, there was no significant interaction between sex and exhaustion on neurotransmitter levels. Canonical correlation showed that exhaustion was positively associated with 5-HT and DA, but negatively associated with NE and Achl, regardless of age and sex. Conclusion Neurotransmitter levels in the cerebral cortex were associated with job-related burnout in medical staff. The findings suggest that long-term job-related burnout may lead to behavioural and psychiatric disorders.

Association between burnout and cortisol secretion, perceived stress, and psychopathology in palliative care unit health professionals.

ABSTRACTObjective:A high incidence of burnout has been reported in health professionals working in palliative care units. Our present study aims to determine whether there are differences in the secretion of salivary cortisol between palliative care unit health professionals with and without burnout, and to elucidate whether there is a relationship between burnout syndrome and perceived stress and psychopathological status in this population. METHOD: A total of 69 health professionals who met the inclusion criteria participated in our study, including physicians, nurses, and nursing assistants. Some 58 were women (M = 29.65 years, SD = 8.64) and 11 men (M = 35.67 years, SD = 11.90). The level of daily cortisol was registered in six measurements taken over the course of a workday. Burnout syndrome was evaluated with the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), the level of perceived stress was measured using the Perceived Stress Scale, and psychopathological status was gauged using the SCL-90-R Symptoms Inventory. RESULTS: There were statistically significant differences in secretion of cortisol in professionals with high scores on a single subscale of the MBI-HSS [F(3.5) = 2.48, p < 0.03]. This effect was observed 15-30 minutes after waking up (p < 0.01) and at bedtime (p < 0.06). Moreover, the professionals with burnout showed higher scores on the psychopathology and stress subscales than professionals without it. SIGNIFICANCE OF RESULTS: A higher score in any dimension of the burnout syndrome in palliative care unit health professionals seems to be related to several physiological and psychological parameters. These findings may be relevant for further development of our understanding of the relationship between levels of burnout and cortisol secretion in the health workers in these units.

Hair cortisol as a biological marker for burnout symptomatology.

Burnout is a syndrome with negative impact on cognitive performance and mood as a consequence of long-term stress at work. It is further associated with increased risk for mental and physical diseases. One potential pathway to mediate chronic work-stress and adverse health conditions in burnout is through alterations in long-term glucocorticoid secretion. Here, we present cross-sectional data on hair cortisol/cortisone (hairF/hairE) concentrations and burnout from a population-based sample of the Dresden Burnout Study (DBS; N=314 hair samples). Burnout symptoms (emotional exhaustion, cynical attitudes toward work, and reduced efficacy) were assessed with the Maslach Burnout Inventory-General Survey (MBI-GS). To control for potential confounds, depressivity was as well assessed using the Patient Health Questionnaire (PHQ-9) screening instrument for major depression. The present findings indicate specific hypercortisolism in participants who suffer from burnout. No significant associations were found between depressivity and hairF/hairE.

Salivary cortisol and nitrite concentrations in school teachers: A longitudinal pilot study.

OBJECTIVE: Occupational/mental stressors, which may be evaluated with measurements of salivary cortisol concentrations, affect the endothelial function and has implications on cardiovascular health. Nitric oxide (NO) is known to have an important role in cardiac function and may also be assessed in the saliva, but its participation in physiological responses to hypothalamic-pituitary-adrenal (HPA) axis stimulation is still not completely understood. The aim of the present study was to test the hypothesis that salivary NO (as nitrite) and cortisol concentrations in school teachers vary throughout the academic year. METHODS: Saliva samples were collected from 13 teachers distributed across five secondary schools. The samples were collected at 6:30 a.m., 11:30 a.m., and 5:30 p.m. in the months of March, July, and December. Salivary cortisol levels were measured by enzyme immunoassay (EIA), and salivary NO concentration was determined by the quantification of nitrite. The area under the curve in relation to ground (AUC) was calculated to assess the cortisol and nitrite concentrations throughout the day. RESULTS: No significant changes were observed in cortisol or nitrite concentrations across the three periods of the school year, while cortisol and nitrite levels showed a low positive and significant correlation (r=0.3455, p=0.0336). CONCLUSION: The results suggest that changes in salivary cortisol levels are accompanied by changes in salivary nitrite levels. This is the first time that such association has been demonstrated. These results encourage further studies aimed to confirm the importance of salivary NO measurement in relation to occupational stress and cardiovascular health.

Supplementation with Robuvit® in subjects with burnout associated to high oxidative stress.

BACKGROUND: This supplement registry study evaluated the effect of supplementation with Robuvit® on the burnout syndrome (BOS) of patients with significant fatigue and high oxidative stress. Robuvit® (French oak wood extract) is a standardized supplement, effective in treating chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD) and convalescence. METHODS: A group of 108 subjects with BOS, consisting of a subgroup of 42 young surgeons in training and a subgroup of 66 managers, were studied. Subjects followed a standard management (SM); one half of the subjects received 300 mg/day of Robuvit® for 4 weeks in addition to SM. RESULTS: Robuvit® was (P<0.05) more effective compared to SM in improving parameters evaluated with the aid of Maslach Burnout Inventory: dealing with patients problems, improving the relationship with patients, decreasing emotional drainage and intolerance (P<0.05). The feeling of a positive influence improved. The decrease in strain from interactions at work, the decrease in the lack of care feeling, the improved levels in interest were all positively affected with Robuvit (P<0.05) in comparison with SM. The need for giving up decreased, the level of satisfaction improved and the regrets for being in the profession decreased. BOS symptoms were positively affected by the supplement (P<0.05). Oxidative stress (388;24 Carr Units decreased to 344;22 with Robuvit®; P<0.05), SM had no influence on oxidative stress. Robuvit® was also more effective in professionals with burnout syndrome than the SM only in in decreasing emotional drainage, fatigue and intolerance (P<0.05). Robuvit® significantly improved the feeling of having a positive influence (P<0.05). Also, Robuvit® significantly decreased the strain resulting from interactions at work and improved the care for colleagues/customers (P<0.05). Interest and enthusiasm were significantly increased in subjects taking Robuvit® in comparison with controls with standard management alone (P<0.05). The mean score of the desire to give up was decreased with Robuvit® in comparison with SM (P<0.05) and job satisfaction was significantly improved (P<0.05). The feeling of regrets of being in the profession was significantly reduced with the supplement in comparison to SM (P<0.05). Robuvit® reduced oxidative stress (P<0.05) from 397;33 to 323;29 Carr Units in comparison with a low decrease with SM (from 396;19 vs. 378;27) at 4 weeks. CONCLUSIONS: In conclusion, in this registry study on BOS, Robuvit® by controlling fatigue (the primary symptom) and oxidative stress, relieves the most important 'symptoms' associated with BOS. The effects are comparable in young surgeons not accustomed to stress, as well as in professionals in management positions who are used to control stress.

Getting better, but not well: A 1.5 year follow-up of cognitive performance and cortisol levels in clinical and non-Clinical burnout.

The purpose was to reexamine cognitive performance and cortisol levels of initial clinical burnout patients, non-clinical burnout individuals, and healthy controls. After 1.5-years of the initial measurement, clinical burnout patients showed a reduction of burnout symptoms and general physical and psychological complaints, but these were still elevated compared with controls. Nonetheless, they continued to report cognitive problems and still showed a minor impaired cognitive test performance. However, they no longer reported larger subjective costs associated with cognitive test performance and their cortisol awakening response (CAR) returned to a normal level. Compared with controls, non-clinical burnout individuals still reported the same, elevated, level of burnout symptoms, general physical and psychological complaints, and cognitive problems. Their cognitive test performance and associated subjective costs remained normal. However, they seemed to continue to display a lowered CAR. To conclude, after 1.5-years, clinical burnout patients got better, but not 'well', and non-clinical burnout individuals remained not 'well'.

Workload and cortisol levels in helicopter combat pilots during simulated flights / Carga mental y niveles de cortisol en pilotos de helicóptero de combate en vuelos simulados / Carga de trabalho e níveis de cortisol em pilotos de helicópteros de combate durante voos simulados

Objective. Examine and compare the cortisol levels before and after a simulated flight related to workload in experienced helicopter combat pilots, searching for physiological levels of anxiety. Method. 15 volunteer Spanish Army helicopter combat pilots (36.83 ± 8.04 years) were studied before and after a simulated flight (eight new tasks). Salivary cortisol was measured by DRG salivary cortisol ELISA, and we studied workload using the NASA-TLX. Results. The differences in the mean values of cortisol level before (5.33 ± 1.55) and after the task at the flight simulator (4.47 ± 0.73) are statistically significant (t14 = 3.301; p = .005) with a high effect size (d = 0.75). Similar significant differences were also found (t14 = 3.301; p = .005) between the workload before (19.76 ± 10.54), and after the task (24.82 ± 10.42; medium effect size d = −0.48). No significant relationships were found between the cortisol levels and the workload. Conclusions. Cortisol levels in saliva and workload are the usual in stress situations, and change inversely: workload increases at the end of the task, whereas the cortisol levels decrease after the simulated flight. The somatic anxiety decreases as the task is done. In contrast, when the pilots are faced with new and demanding tasks, even if they fly this type of helicopter in different conditions, the workload increases toward the end of the task. From an applied point of view, these findings should impact the tactical, physical and mental training of such pilots (AU)

Objetivo. Examinar y comparar los niveles de cortisol antes y después de un vuelo simulado en relación con la carga de trabajo de pilotos de helicópteros con experiencia de combate, en busca de niveles fisiológicos de la ansiedad. Método. Se estudió a 15 pilotos de helicópteros voluntarios del Ejército Español (36.83 ± 8.04 años) antes y después de un vuelo simulado compuesto por 8 tareas nuevas. El cortisol salival se midió por DRG Cortisol ELISA y la carga de trabajo con el NASA-TLX. Resultados. Las diferencias entre los valores medios de nivel de cortisol antes (5.33 ± 1.55) y después de la tarea en el simulador de vuelo (4.47 ± 0.73) son estadísticamente significativas (t14 = 3.301; p = 0.005; elevado tamaño de efecto, d = 0.75), así como (t14 = 3.301; p = 0.005) entre la carga de trabajo antes (19.76 ± 10.54) y después de la tarea (24.82 ± 10.42; tamaño de efecto medio, d = −0.48). No hubo relaciones significativas entre los niveles de cortisol y la carga de trabajo. Conclusiones. Los niveles de cortisol en saliva y la carga de trabajo son habituales en situaciones de estrés, y cambian inversamente: la carga de trabajo aumenta al final de la tarea, mientras que los niveles de cortisol —y de ansiedad somática— disminuyen después del vuelo simulado. En cambio, frente a tareas nuevas y exigentes, la carga de trabajo aumenta al final. Estos hallazgos deberían afectar la planificación del entrenamiento táctico, físico y mental de estos pilotos (AU)

Objetivo. Examinar e comparar os níveis de cortisol antes e depois de voo simulado em relação a carga de trabalho de experientes pilotos de helicóptero de combate, procurando por níveis fisiológicos de ansiedade. Métodos. 15 voluntários pilotos de helicópteros de combate do exército espanhol (36.83 ± 8.04 años) foram estudados antes e depois de um voo simulado (8 novas tarefas). Cortisol salivar foi mensurado por DRG Cortisol salivar ELISA, e foi estudado a carga de trabalho usando o NASA-TLX. Resultados. As diferenças nos valores médios dos níveis de cortisol antes (5.33 ± 1.55) e depois da tarefa no simulador de voo (4.47 ± 0.73) foram estatisticamente significantes (t14 = 3.301; p = .005) com o tamanho do efeito (d = 0.75). Diferenças significantes similares também foram encontradas (t14 = 3.301; p = .005) entre a carga de trabalho antes (19.76 ± 10.54), e depois da tarefa (24.82 ± 10.42); tamanho do efeito médio (d = −0.48). Nenhuma relação significativa foi encontrada entre os níveis de cortisol e a carga de trabalho. Conclusão. Níveis de cortisol na saliva e carga de trabalho são comuns em situações de estresse, e mudam inversamente: a carga de trabalho aumenta ao final da tarefa, enquanto o nível de cortisol diminui depois do voo simulado. A ansiedade somática diminui quando a tarefa acaba. Em contraste, quando os pilotos enfrentam uma nova e exigente tarefa, mesmo que eles voem no mesmo tipo de helicóptero em diferentes situações, a carga de trabalho aumenta em direção ao final da tarefa. Para um ponto de vista aplicável, os achados devem impactar o treinamento tático, físico e mental destes pilotos (AU)

Programa de entrenamiento en coherencia cardiaca para la reducción del estrés en personal sanitario con cervicalgia crónica: un estudio piloto / Training program in cardiac coherence for stress reduction in healthcare personnel with chronic neck pain: a pilot study

La presente nota clínica tiene por objetivo divulgar los resultados de un trabajo piloto para valorar las potencialidades de un entrenamiento en coherencia cardiaca (CC) para la reducción del estrés en personal sanitario con cervicalgia crónica. Para ello, 8 enfermeras participaron en un programa de entrenamiento en CC y se evaluadas pre/post en los siguientes factores: dolor (EVA), inteligencia emocional (TMMS-24), sintomatología ansioso-depresiva (escalas Hamilton y Goldberg) y estrés laboral (NSS). Tras el entrenamiento se observó una disminución significativa en las puntuaciones de dolor y su sintomatología asociada (contracturas, dolor por movilidad y parestesias), así como en la sintomatología depresiva. Asimismo, se observaron mayores puntuaciones en inteligencia emocional (escala de percepción) (AU)

This case report aims to disseminate the results of a pilot study exploring the potentialities of training program in cardiac coherence (CC) for reducing stress in nurses with chronic neck pain. For this purpose, 8 nurses participated in a training program in CC and were evaluated pre/post on the following factors: pain (VAS), emotional intelligence (TMMS-24), anxious depressive symptoms (Hamilton & Goldberg scales) and job related stress (NSS). After the training, a significant decrease in pain scores and associated symptoms (spasms, pain due to mobility and paresthesias) as well as depressive symptoms was observed. Also, higher scores were observed in emotional intelligence (perception scale) (AU)

A small randomized pilot study of a workplace mindfulness-based intervention for surgical intensive care unit personnel: effects on salivary α-amylase levels.

OBJECTIVE: To determine whether a workplace stress-reduction intervention decreases reactivity to stress among personnel exposed to a highly stressful occupational environment. METHODS: Personnel from a surgical intensive care unit were randomized to a stress-reduction intervention or a waitlist control group. The 8-week group mindfulness-based intervention included mindfulness, gentle yoga, and music. Psychological and biological markers of stress were measured 1 week before and 1 week after the intervention. RESULTS: Levels of salivary α-amylase, an index of sympathetic activation, were significantly decreased between the first and second assessments in the intervention group with no changes in the control group. There was a positive correlation between salivary α-amylase levels and burnout scores. CONCLUSIONS: These data suggest that this type of intervention could decrease not only reactivity to stress but also the risk of burnout.