Work-related behavior and experience patterns of music educators - a basis for intervention.

OBJECTIVES: Music educators are subjected to many physical and psychological stresses encountered in the workplace. These stresses could be counteracted by certain work-related behavior and experience patterns as personal resources to reduce the negative consequences of stress. The aim of the study was to determine the existing work-related behavioral and experiential patterns and the characteristics of the Work-Related Behavior and Experience Patterns (Arbeitsbezogenes Verhaltens- und Erlebensmuster - AVEM) questionnaire dimensions in the professional group of music educators according to age group. MATERIAL AND METHODS: A total of 205 music educators (66.3% female) from various music schools in Germany participated in the online survey. The subjects were divided into 3 age groups (AG): AG I: ≤35 years, AG II: 36-45 years, AG III: ≥46 years. In addition to sociodemographic and occupational data, the standardized AVEM questionnaire was used according to Schaarschmidt and Fischer. The age and occupation-related data were evaluated in a correlation analysis with the expression of AVEM dimensions. RESULTS: A total of 71.4% of the music educators were ≥46 years old group. Another 12.8% belonged to AG II, and 15.8% belonged to AG III. The sex distribution in the 3 age groups was comparable (p = 0.261). The expression of all AVEM dimensions was within the reference range. The most pronounced dimension, with a stanine value of M±SD 5.2±2.15, was the willingness to spend. There was also no significant difference in the assignment to the 4 patterns in the 3 age groups (p = 0.669). Age showed a negative correlation with the experience of social support (ρ = -0.354). CONCLUSIONS: The age-independent and high intervention-requiring expressions of the AVEM risk patterns A and B led to the recommendation of workplace prevention and health promotion measures. Therefore, it seems reasonable to promote appropriate stress management measures and resilience during studies. Int J Occup Med Environ Health. 2024;37(2):176-93.

Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science.

This updated guideline replaces the "Guideline for the application of heart rate and heart rate variability in occupational medicine and occupational health science" first published in 2014. Based on the older version of the guideline, the authors have reviewed and evaluated the findings on the use of heart rate (HR) and heart rate variability (HRV) that have been published in the meantime and incorporated them into a new version of this guideline.This guideline was developed for application in clinical practice and research purposes in the fields of occupational medicine and occupational science to complement evaluation procedures with respect to exposure and risk assessment at the workplace by the use of objective physiological workload indicators. In addition, HRV is also suitable for assessing the state of health and for monitoring the progress of illnesses and preventive medical measures. It gives an overview of factors influencing the regulation of the HR and HRV at rest and during work. It further illustrates methods for measuring and analyzing these parameters under standardized laboratory and real workload conditions, areas of application as well as the quality control procedures to be followed during the recording and evaluation of HR and HRV.

The Predominance of the Health-Promoting Patterns of Work Behavior and Experience in General Practice Teams-Results of the IMPROVEjob Study.

This study aims to identify the distribution of the "Work-related behavior and experience patterns" (Arbeitsbezogenes Verhaltens-und Erlebnismuster, AVEM) in general practitioners and their teams by using baseline data of the IMPROVEjob study. Members of 60 general practices with 84 physicians in a leadership position, 28 employed physicians, and 254 practice assistants participated in a survey in 2019 and 2020. In this analysis, we focused on AVEM variables. Age, practice years, work experience, and working time were used as control variables in the Spearman Rho correlations and analysis of variance. The majority of the participants (72.1%) revealed a health-promoting pattern (G or S). Three of eleven AVEM dimensions were above the norm for the professional group "employed physicians". The AVEM dimensions "striving for perfection" (p < 0.001), "experience of success at work" (p < 0.001), "satisfaction with life" (p = 0.003), and "experience of social support" (p = 0.019) differed significantly between the groups' practice owners and practice assistants, with the practice owners achieving the higher values, except for experience of social support. Practice affiliation had no effect on almost all AVEM dimensions. We found a high prevalence of AVEM health-promoting patterns in our sample. Nearly half of the participants in all professional groups showed an unambitious pattern (S). Adapted interventions for the represented AVEM patterns are possible and should be utilized for maintaining mental health among general practice teams.

[Against the mental stress-Resilient work in surgery]. / Wider psychische Belastungen ­ resilientes Arbeiten in der Chirurgie.

BACKGROUND: Surgery represents a challenging medical discipline. AIM: This article focuses on psychological stress in surgery and explains resilience as a protective factor against the consequences of psychological stress, based on selected literature references and own relevant clinical experiences. In this context, the sense of coherence, social support and self-efficacy expectation are discussed in more detail as resilience factors. METHOD: Narrative review. RESULTS (CORNER POINTS): Surgery is classified as a challenging medical subspecialty with a high reputation but associated with diverse and varied physical and psychological stress factors. Stress factors differ individually in terms of requirements (can be overdemanding or underdemanding but also stimulating, relevant to learning and meaningful, thus positively or negatively stressful) and resources (potentially beneficial working conditions, experience, or behavior, e.g., social support, scope for action). Fluctuations within surgical specialties and a high dropout rate during residency training are well known and the causes include high psychological stress. In the case of persistent and at the same time insufficient compensation of work stress caused by a lack of or insufficient resources, these can be associated with mental illnesses. Nonetheless, many physicians spend their entire lives working in hospital or private surgical settings and remain healthy, a strong sense of resilience to mental illness may be fundamental to this. Resilience can be present as a personal characteristic or it can be learnt through a process or adapted through positive or negative influences, thus strengthening the personal characteristics. Overall, data on surgeon resilience or interventional studies in resilience research in the surgical setting are limited and provide another research gap. Resilience training (directed at a sense of coherence, social support, strengthening knowledge of coping skills, positive emotions, optimism, hope, self-efficacy expectations, control beliefs or robustness), also clearly indicated in the "robust" medical specialty of surgery, is always individual and should not be generalized. If the surgeon cannot retrieve sufficient resources due to the stressful situation, stress management with its methods is helpful to reduce the psychological stress and to be able to maintain the performance and health of this person. CONCLUSION: The consolidation of resilience as a notable aspect of employee management. In collegial interactions, resilience must be based on workplace-based approaches to strengthen coping mechanisms in the face of work stress. Workplace-related stress should also be perceived, addressed and counteracted within the organization, certainly also as an elementary management task.

Relaxation and strain among emergency medical service personnel and emergency control center dispatchers during the first two waves of the SARS-CoV-2 pandemic.

BACKGROUND: Workloads of emergency medical service personnel (EMP) and emergency control center dispatchers (CCDs) were manifold. The SARS-CoV-2 pandemic presented new challenges for the prehospital emergency medical service. The purpose of this study was to compare the status of stress/strain and recovery of Recovery-Stress Questionnaire among EMP and CCDs in Germany during the first 2 waves of the SARS-CoV-2 pandemic both between occupational groups and over time. MATERIAL AND METHODS: A total of 2426 emergency medical service personnel and control center dispatchers were questioned with the Recovery-Stress Questionnaire based on Kallus. The results from the first 2 waves of the pandemic (June-August 2020 and January-February 2021) were compared. RESULTS: During the first and second wave of SARS-CoV-2 pandemic, the subjectively perceived stress of emergency medical service personnel and control center dispatchers increased, but recovery decreased. The CCDs showed more unfavorable values compared to EMP. CONCLUSIONS: Health promotion interventions are necessary to counteract possible career changes or mental or other diseases due to insufficient management. Med Pr Work Health Saf. 2023;74(5):353-62.

Well-being of veterinarians in rural and urban areas.

Introduction: The field of veterinary medicine is characterized by a variety of challenging working conditions. The alarmingly low mental well-being of veterinarians has been examined from various perspectives. However, the influence of work location on the well-being of veterinary professionals has scarcely been investigated. The aim of the study was therefore to analyze the well-being of German veterinarians and to determine whether there is a correlation between well-being and work location. Methods: As part of a cross-sectional study, 999 veterinary professionals answered questions regarding their work location (self-designed questions) and well-being (WHO-Five Well-being Index, WHO-5). A differentiation was made according to work location: urban cities (population > 100,000), medium/small cities (population < 100,000 inhabitants), and rural areas. Results: Overall, the surveyed veterinarians had low well-being (ranging from 56.8% in rural areas to 61.3% in medium/small towns). The results of the general linear model indicated a significant difference in the WHO total score among veterinarians from different work locations (p < 0.001). However, when sex, age, type of employment, and field of specialization were included in the analysis, no significant between-subject effects were found. Conclusion: According to the results, work location does not seem to have a significant influence on the well-being of veterinarians and therefore may be of lower priority in the development and implementation of interventions. However, further investigation of work-related predictors of the mental health of veterinarians is recommended, as the results indicate a low well-being among these professionals.

Current incidence of professional burnout among Ukrainian oncologists in Kharkiv.

OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and the military conflicts in Ukraine suggest that workrelated stressors increased during these crises increases work-related stress reactions. Burnout as a long-term consequence of insufficiently compensated for workloads. The regional prevalence of burnout is particularly high among oncologists. The aim of this study was to assess the current risk of burnout within this group of physicians and to examine gender differences through gender-based analysis. MATERIAL AND METHODS: Thirtyseven oncologists (17 men and 20 women aged 46.5±13.6 years [range 26-74 years]) in Kharkiv, Ukraine, participated. The Maslach Burnout Inventory - General Survey (MBI-GS) questionnaire was used to determine the extent of occupational. RESULTS: Gender, age, and work experience had no effect on the following results. Women demonstrated higher scores in emotional exhaustion and personal accomplishment of the MBI than men. In contrast, men offered higher cynicism scores. The MBI total score was also higher for the male oncologists. Only 1 person of the total sample had risk of burnout. CONCLUSIONS: The results showed a high prevalence of burnout symptoms among Ukrainian oncologists without gender differences. From occupational health perspective behavioral and behavior-preventive measures are needed for clinics and oncologists to counteract the burnout symptoms, e.g. exhaustion or cyniscism. Further studies are needed here to examine the effectiveness of these measures. Int J Occup Med Environ Health. 2023;36(6):717-3.

Autonomic dysregulation in long-term patients suffering from Post-COVID-19 Syndrome assessed by heart rate variability.

Post-COVID-19 Syndrome (PCS) is a condition with multiple symptoms partly related to dysregulation of the autonomic nerve system. Assessment of heart rate variability (HRV) using 24 h Holter-ECG may serve as a surrogate to characterize cardiac autonomic activity. A prospective study including 103 PCS patients (time after infection = 252 days, age = 49.0 ± 11.3 years, 45.7% women) was performed and patients underwent detailed clinical screening, cardiopulmonary exercise testing, and 24 h Holter monitoring. Data of PCS patients was compared to 103 CAD patients and a healthy control group (n = 90). After correction for age and sex, frequency-related variables differed in PCS patients compared to controls including LF/HFpower, LF/HFnu, and LF/HF ratio (24 h; p ≤ 0.001). By contrast, these variables were largely comparable between PCS and CAD patients, while sympathetic activation was highest in PCS patients during the 24 h period. Overall, PCS patients showed disturbed diurnal adjustment of HRV, with impaired parasympathetic activity at night. Patients hospitalized during acute infection showed an even more pronounced overactivation of sympathetic activity compared to patients who underwent ambulant care. Our data demonstrate persistent HRV alterations in PCS patients with long-term symptom duration, suggesting a sustained impairment of sympathovagal balance. Moreover, sympathetic overstimulation and diminished parasympathetic response in long-term PCS patients are comparable to findings in CAD patients. Whether HRV variables have a prognostic value in PCS and/or might serve as biomarkers indicating a successful interventional approach warrants further longitudinal studies.

Effect of Work-Related Behavior and Experience Patterns on Sleep Quality in Emergency Medical Service Personnel.

OBJECTIVE: The aim of this study was to examine the influence of work-related behavior and experience patterns on sleep quality in emergency medical service personnel. METHODS: From the total sample of 508 emergency medical service workers who took part in the Germany-wide online survey, 368 respondents completed the questionnaires on sleep characteristics (Pittsburgh Sleep Quality Index [PSQI]) and work-related behavior and experience pattern. Three hundred sixty-seven of the 368 participants also finished the Regensburg Insomnia Scale. RESULTS: Based on their work-related behavior and experience pattern results, individuals were categorized into one of the four following patterns: two risk patterns (A, B) and two healthy behavior and experience patterns (G, S). Participants that were classified into risk-pattern A and B (33.85%) scored significantly higher in both PSQI and Regensburg Insomnia Scale overall score and all PSQI components implicating a poorer sleep quality. A total of 78.5% of the individuals with pattern A and B were considered bad sleepers whereas only 43.4% of individuals with pattern G and S were scored as bad sleepers. CONCLUSIONS: Work-related behavior and experience patterns showed a strong association to sleep characteristics and may therefore be used to identify appropriate preventative measures.

[Stress experience by information and communication technologies among nurses in outpatient care - A qualitative interview study]. / Belastungserleben durch Informations- und Kommunikationstechnologien bei Pflegefachpersonen in der ambulanten Pflege.

Stress experience by information and communication technologies among nurses in outpatient care - A qualitative interview study Abstract: Background: "Work 4.0" is also becoming increasingly prevalent in outpatient care through information and communication technologies (ICT). In addition to a variety of options that ICT offers nursing staff, its use leads to additional stresses. Aims: The aim of the study is to identify relevant stress categories that are caused using ICT and provide an additional influence on the stress experience of employees in outpatient care. Methods: Problem-centred interviews were conducted with eight nurses from three outpatient care organizations as part of a qualitative study. Subsequently, these interviews were transcribed and evaluated using qualitative content analysis according to Mayring. Results: Ten factors were identified that were perceived as stress by ambulatory care employees: for example, insufficient participation and usability, increased documentation effort, information overload. Regarding the employees' ability to work and their health, no relevant impairments could be derived that could be attributed to the identified additional strains. Conclusions: Further analysis of the potential stress situations that could result from ICT use is needed to include this knowledge in primary prevention. It makes sense to establish demand-, participation-, and process-oriented structures in outpatient care organizations. The use of ICT can also be an advantage because, for example, information can be obtained more quickly.

[COVID-19 as an insurance case of the statutory accident insurance: occupational disease or occupational accident : Relevant knowledge for the (general and abdominal) surgeon]. / COVID-19 als Versicherungsfall der gesetzlichen Unfallversicherung: Berufskrankheit oder Arbeitsunfall : Relevantes Wissen für den (Allgemein­/Viszeral­)Chirurgen.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in many infections with the virus and sickness due to coronavirus disease 2019 (COVID-19). Therefore, there was a dramatic increase in the number of reported and recognized occupational diseases (Berufskrankheit, BK) and occupational accidents (Arbeitsunfall, AU) at the German Social Accident Insurance Institutions (BG) and accident insurance funds (Unfallkassen).The publication aims to show the differences between BK and AU and to review the current data on occupational diseases. It deals with the definitions of BK and AU, the differences in the conditions for recognition as BK or AU. Furthermore, the claims for benefits are presented. Finally, statistical key figures of the BK according to No. 3101 and the AU are presented.Results (key points)- According to § 7 SGB VII, AU and BK are insured events of the statutory accident insurance.- In surgery, like specifically in the rest of the healthcare system, the relevance of the SARS-CoV­2 infection with post-COVID in personnel for occupational medical prevention and as a case to be recognized by the statutory accident insurance (BK or AU) becomes clear.- Relevant for the recognition are the duration and the intensity of the contact (local proximity) and the SARS-CoV­2 occupational health and safety rule of 20 August 2020 essentially recognizes a contact duration of at least 15 min at a spatial distance of less than 1.5-2 m (further aspects: more intensive shorter contacts, number of verifiably infected persons in the closer activity environment or the usual personal contacts, spatial situation, work route, special constellations).- No case numbers can be elicited for the detailed presentation of the surgery setting.- There are still immense problems and challenges in the assessment of COVID-19 consequences or post-COVID as occupational disease, as numerous uncertainty factors, such as insufficiently secured knowledge about the further long-term course over the years or the widely varied symptom spectrum complicates the medical assessment of the consequences of this disease.Conclusion: the SARS-CoV­2 pandemic is a special challenge for surgery with intensive patient contact and for the entire healthcare system. This caused long-lasting changes and the adequate health care as well as insurance law processing of the (case-specific) consequences might still require considerable efforts and resources.

Effects of Occupation-Specific Vocal Stress on the Mental Health of Day Care Teachers.

INTRODUCTION: Kindergarten teachers are exposed to numerous kinds of strains, such as noise, which can negatively affect their voices. This cross-sectional study investigates whether and to what extent the profession-specific high vocal demand is associated with the educators' mental health. METHODS: One hundred and ninety-two kindergarten teachers from Magdeburg, Germany and its surrounding areas aged 43.4 ± 12.8 years, voluntarily participated in a survey. Vocal demand and vocal demand response, general strain factors, and mental health were assessed by using questionnaires (self-check on voice demands, Rudow checklist, General Health Questionnaire, and Maslach Burnout Inventory). The statistical analyses were carried out using SPSS. RESULTS: The interviewed educators felt stressed by the excessive number of work tasks and children in each class, noisy work environment, and loud conversations. In addition, educators complained of headaches and neck pain (66%), while 28% of them experienced hoarseness and a burning throat. The mental health of 39 of the educators was impaired, and nine were at an increased risk of burnout. Self-reported voice effort correlated low with mental health (r = 0.287; p < 0.001) and burnout risk (r = 0.306; p < 0.001). CONCLUSION: The vocal demands on educators in day care settings are very high, which is a major associated factor for the development of burnout syndrome and is also associated with headaches and neck pain. Measures for the prevention of occupational voice disorders and voice training should be a mandatory part of the educators' training and must be offered as in-service training.

A Systematic Review of Associations and Predictors for Job Satisfaction and Work Engagement in Prehospital Emergency Medical Services-Challenges for the Future.

Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important characteristics for a healthy organization and success in one's profession. The purpose of the current systematic review was to evaluate the predictors of job satisfaction and work engagement in prehospital emergency medical service personnel. Electronic databases, such as PubMed, Ovid Medline, Cochrane Library, Scopus, Web of Science, PsycINFO, PSYNDEX, and Embase, were utilized in this review. Predictors (ß coefficient, odds ratio, rho) of higher job satisfaction and work engagement were examined. Only prehospital emergency medical service personnel were considered. The review included 10 studies worldwide with 8358 prehospital emergency medical service personnel (24.9% female). The main predictor for job satisfaction was supervisors' support. Other predictors were younger or middle age and work experience. Emotional exhaustion and depersonalization, as burnout dimensions, were negative predictors for higher job satisfaction or work engagement. Quality demands for health care systems are a significant challenge for future emergency medical services. The psychological and physical strengthening of employees is necessary and includes constant supervision of managers or facilitators.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls.

BACKGROUND: Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. OBJECTIVE: The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. METHODS: Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). RESULTS: Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. CONCLUSION: The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

ANTECEDENTES: Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. OBJETIVO: Investigar o controle autonômico cardíaco em idosos com e sem MCI. MéTODOS: O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). RESULTADOS: Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. CONCLUSãO: Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

Recovery and stress of control center dispatchers in the first waves of the SARS-CoV-2 pandemic.

Control center dispatchers (CCDs) are exposed to high levels of work-related mental stress, which are exacerbated by the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The aim of this study was to comparatively analyze the recovery and stress state of CCDs during the first and second waves of the SARS-CoV­2 pandemic. A total of 490 CCDs (n = 440, t1 and n = 50, t2) with a mean age of 42.26 ± 8.79 years participated directly at the end of the first wave from June to August 2020 (t1) and during the second wave between January and February 2021 (t2) of the SARS-CoV­2 pandemic. The short form (EBF-24/A; test form S2) of the Kallus recovery-stress questionnaire (EBF) was applied. Over the course of the two survey phases, the dimensions strain significantly increased (t1: 2.47 ± 1.08 vs. t2: 3.12 ± 0.93 points, p < 0.001) and recovery significantly decreased (t1: 3.03 ± 0.94 vs. t2: 2.50 ± 0.81 points, p < 0.001). Significant to highly significant differences were present in the EBF dimensions of the two waves in the majority of cases, even when taking the waves into account. For the variable "recovery in the social field", a medium effect was noticeable in the corrected model (η2 = 0.064). The SARS-CoV­2 pandemic illustrates that the stress experience increased from the first to the second waves, and the recovery of CCDs decreased. These data provide a directional trend as the pandemic is ongoing, and stress and strain situations in control centers may continue to worsen. Immediate health promotion and prevention measures are essential.

[Professional gratification crisis, overcommitment, and burnout among Ukrainian anesthesiologists and intensive care physicians during the SARS-CoV-2 pandemic]. / Berufliche Gratifikationskrisen, Verausgabungsneigung und Burnout bei ukrainischen Anästhesisten und Intensivmedizinern während der SARS-CoV-2-Pandemie.

Background: Mental stress of anesthesiologists and intensive care physicians is varied and complex. Overcommitment (OC) is characterized by an excessive tendency to professional commitment, which can lead to psychological stress and consequently to psychological disorders, such as burnout. The prevalence of burnout among intensive care physicians is internationally widespread. The aim of this study was to determine OC and gratification among Ukrainian anesthesia and intensive care physicians during the SARS-CoV­2 pandemic and to analyze the risk of burnout in this professional group, and the associations between OC and burnout. Methods: A total of 73 Ukrainian male (47.9%) and female (52.1%) intensive care physicians participated in the survey. The mean age was 39.8 ± 10.94 years (range 23-78 years). In addition to sociodemographic and occupational data, occupational gratification was collected using the effort-reward imbalance (ERI) questionnaire with additional questions on OC, and the Maslach burnout inventory (MBI). Participants were classified and compared into groups with different OC (< 16 points and ≥ 16 points). Results: Of the participants 75% (55) could be classified into a group with OC < 16 points, and 18 presented an elevated OC. A significant difference in effort (13.9 ± 4.1 vs. 17.2 ± 3.6 points; p = 0.003) and ERI ratio (0.58 ± 0.2 vs. 0.77 ± 0.2; p = 0.006) was found between these two groups. In the group with OC ≥ 16 points, 50% of participants reported high emotional exhaustion (vs. 12.7% with OC < 16 points; p = 0.002), but also high performance (61.1% vs. 32.7%; p = 0.005). Overall, a burnout prevalence of 2.7% was found in the total sample, with both subjects represented in the OC < 16 points group. Higher emotional exhaustion was associated with higher OC, higher effort, and lower reward. Discussion: The study results showed high emotional exhaustion among subjects with high overcommitment and three quarters of the respondents showed symptoms of burnout. For this reason, health promotion measures and prevention should be offered to counteract the high stresses during the pandemic. These should include relationship and behavioral prevention.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls / Existe uma ligação entre a variabilidade da frequência cardíaca e o declínio cognitivo? Um estudo transversal em pacientes com deficiência cognitiva leve e controles cognitivos saudáveis

Abstract Background Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. Objective The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. Methods Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). Results Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. Conclusion The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

Resumo Antecedentes Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. Objetivo Investigar o controle autonômico cardíaco em idosos com e sem MCI. Métodos O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). Resultados Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. Conclusão Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

[Influence of screen time on the sleep quality of students]. / Einfluss der Bildschirmzeit auf die Schlafqualität Studierender.

Introduction: The restorative effects of sleep are essential for physical, cognitive, emotional, and behavioral daily performance in college. In addition to the stress of everyday student life, the use of screen devices at the forefront of pandemic-related online teaching is also increasing dramatically. Particularly during evening and nighttime hours, increased screen use may contribute to physical, psychological, and cognitive activation, which in turn may negatively affect students' sleep quality. Methods: To determine possible associations between screen use in online teaching and its effects on sleep hygiene and quality, 216 students at Magdeburg-Stendal University of Applied Sciences anonymously and voluntarily participated in the online survey in May 2021. The positive ethics vote is available. Results: The general sleep quality of the student body can be rated as poor in 68.9% (n = 149) of the surveyed students. In particular, students who worked predominantly on screen devices in the evening or at nighttime for their studies, and thus had a chronobiological tendency to be a night person, tended to have poorer sleep. Discussion: The effects of long screen time in the evening and nighttime hours can have far-reaching consequences on sleep patterns and awareness of physical needs for breaks and sleep. Online teaching in times of the COVID-19 pandemic in particular led to an increase in screen time alongside equally high levels of personal use. This could result in a continued negative impact on sleep hygiene and quality, not only at the expense of daytime concentration and performance but rather of physical and mental health.

[Recovery-stress levels in paramedics during the first two waves of the SARS-CoV-2 pandemic]. / Erholungs-Beanspruchungs-Zustand im Rettungsdienst während der ersten beiden Wellen der SARS-CoV-2-Pandemie.

Background: The balance between stress perception and recovery of emergency medical service personnel during service and leisure time is an essential indicator of mental and physical health. It ensures success in emergency medical care and is also a health policy and economic factor for any organization. The aim of the study was to evaluate the recovery stress level of paramedics in the first and second waves of the SARS-CoV­2 pandemic. Materials and methods: The quantitative cross-sectional study included 1936 records of responders (334 women and 1602 men, mean age 34.9 ± 10.5 years). The online survey during the SARS-CoV­2 pandemic was performed during the first wave in 2020 and the second wave in 2021. The short form EBF-24/A (test version S2) of the recovery stress questionnaire according to Kallus was analyzed. Results: During the course of the two survey phases, the dimensions stress increased significantly (t1: 2.52 ± 0.98 and t2: 2.88 ± 1.04 points, p < 0.001) and recovery decreased significantly (t1: 2.98 ± 0.90 and t2: 2.64 ± 0.89 points, p < 0.001). Similar results were found for the corresponding subscales with the exception of the subscale "restful sleep" of the dimension recovery (t1: 2.81 ± 1.36 and t2: 2.72 ± 1.36 points). Conclusion: During the SARS-CoV­2 pandemic, which has been ongoing since the beginning of 2020, the stress experienced by emergency responders increased from the first to the second wave, while the perception of recovery for emergency responders decreased. The study presents the current situation of recovery stress in German emergency medical service employees and allows predictions about performance and health in pandemic situations.

The impact of music-imaginative pain treatment (MIPT) on psychophysical affect regulation - A single case study.

Music-imaginative Pain Treatment (MIPT) is part of the multi-professional treatment plan for hospitalised patients in departments for psychosomatic medicine. MIPT is an intervention that encourages the patient to create music representing pain and relief from pain and promotes active engagement and self-reflection. This single case study of a 46-year-old female patient diagnosed with chronic pain disorder with somatic and psychological factors includes narrative, demographic, psychometric, and cardiophysiological data. During the interventions, early childhood stress, which is a risk factor for developing chronic pain, turns out to be a crucial focal point in therapy and conspicuous in her handling of the music. Social trauma is considered an appropriate concept for a deeper understanding of the case.