The monitoring requests on young driver's fatigue and take-over performance in prolonged conditional automated driving.

INTRODUCTION: L3 automated vehicles can perform all dynamic driving tasks unless a take-over occurs due to operational limits. This issue is potentially important for young drivers who are vulnerable road users since they have skill deficits and easily evolve into aberrant driving. However, drivers lacking active involvement may be fatigued and drowsy. Previous research indicated that performing a voluntary non-driving-related task (NDRT) could keep drivers alert, but there was no difference in take-over performance with or without NDRT. Providing a monitoring request (MR) before a possible take-over request (TOR) exhibited better take-over performance in temporary automated driving. Therefore, the study aimed to investigate the effects of MR and voluntary NDRT on young drivers' fatigue and performance. METHOD: Twenty-five young drivers experienced 60 min automated driving on a highway with low traffic density and a TOR prompted due to a collision event. A within-subjects was designed that comprised three conditions: NONE, TOR-only, and MR + TOR. Drivers were allowed to perform a self-paced phone NDRT during automated driving. RESULTS: The PERCLOS and blink frequency data showed that playing phones could keep drivers vigilant. The take-over performance on whether taking phone had no difference, but with MRs condition exhibited better take-over performance including the shorter reaction time and the longer TTC. Subjective evaluations also showed the advantages of MRs with more safety, trust, acceptance, and lower workload. CONCLUSIONS: Taking MRs had a positive effect on relieving fatigue and improving take-over performance. Furthermore, MRs could potentially improve the safety and acceptance of automated driving. PRACTICAL APPLICATIONS: The MR design can be used in the automotive industry to ensure the safest interfaces between fatigue drivers and automation systems.

Advancing a U.S. navy shipboard infrastructure for sleep monitoring with wearable technology.

Development of fatigue management solutions is critical to U.S. Navy populations. This study explored the operational feasibility and acceptability of commercial wearable devices (Oura Ring and ReadiBand) in a warship environment with 845 Sailors across five ship cohorts during at-sea operations ranging from 10 to 31 days. Participants were required to wear both devices and check-in daily with research staff. Both devices functioned as designed in the environment and reliably collected sleep-wake data. Over 10,000 person-days at-sea, overall prevalence of Oura and ReadiBand use was 69% and 71%, respectively. Individual use rates were 71 ± 38% of days underway for Oura and 59 ± 34% for ReadiBand. Analysis of individual factors showed increasing device use and less device interference with age, and more men than women found the devices comfortable. This study provides initial support that commercial wearables can contribute to infrastructures for operational fatigue management in naval environments.

How much advance notice do workers need? A review and theoretical framework for determining advance notice periods for unpredictable work.

Regulatory guidance materials for fatigue management typically advise that employees be provided with days or weeks of advance notice of schedules/rosters. However, the scientific evidence underpinning this advice is unclear. A systematic search was performed on current peer reviewed literature addressing advance notice periods, which found three relevant studies. A subsequent search of grey literature to determine the quality of evidence for the recommendation for advance notice periods returned 37 relevant documents. This review found that fatigue management guidance materials frequently advocated advance notice for work shifts but did not provide empirical evidence to underpin the advice. Although it is logical to suggest that longer notice periods may result in increased opportunities for pre-work preparations, improved sleep, and reduced worker fatigue, the current guidance appears to be premised on this reasoning rather than empirical evidence. Paradoxically, it is possible that advance notice could be counterproductive, as too much may result in frequent alterations to the schedule, particularly where adjustments to start and end times of the work period are not uncommon (e.g., road transport, rail). To assist organisations in determining the appropriate amount of advance notice to provide, we propose a novel theoretical framework to conceptualise advance notice.

Long term effects of continuous positive airway pressure treatment of obstructive sleep apnea-hypopnea syndrome in multiple sclerosis patients.

BACKGROUND: Obstructive sleep apnea-hypopnea (OSAH) is common in MS patients and is associated with fatigue. We recently published a randomized, controlled trial (RCT) of active vs sham continuous positive airway pressure (CPAP) treatment in MS patients with fatigue, poor sleep quality, and (OSAH) (Mult Scl J 2022;28:82-92). Our aim was to evaluate the long-term effects of CPAP treatment on fatigue (Fatigue Severity Scale, FSS, primary outcome) and other clinical outcomes in MS patients with OSAH. METHODS: Following the RCT, participants were offered treatment with CPAP and participation in an open label study. Patients were re-evaluated with RCT outcome measures at least 6 months after completion of the RCT. RESULTS: Twenty-eight of 34 (82 %) RCT-completers participated in this study a mean of 2.7 years after the RCT. Sixteen (57 %) patients were treated with CPAP (mean use 5.4 ± 1.0 h/night during the 6 months prior to follow-up visit), while the other 12 patients declined CPAP use and received no other OSAH treatments. Baseline clinical characteristics, including MS related disability and sleep outcomes, were not significantly different between CPAP-treated vs non-CPAP treated patients. Patients using CPAP at follow-up (n = 16) demonstrated significant improvements from RCT baseline in FSS (p = 0.005), Fatigue Scale for Motor and Cognitive Functions (p = 0.008, p = 0.012), Pittsburgh Sleep Quality Index (p = 0.016), Center of Epidemiological Studies-Depression Scale (p = 0.05), and Multiple Sclerosis Quality of Life-54 (MSQOL-54) physical and mental component scores (p = 0.012, p = 0.023), but no improvements in Epworth Sleepiness Scale, Pain Visual Analog Scale, or Expanded Disability Status Scale. Patients not using CPAP (n = 12) had no significant improvements in outcome measures. Using a linear mixed model, FSS (p = 0.03), morning fatigue (p = 0.048), and MSQOL-54 physical component score (p = 0.02) improved significantly in CPAP treated patients compared with non-CPAP treated patients from RCT baseline. CONCLUSION: In this post-RCT open label study, long-term CPAP use was associated with improved fatigue (FSS, our primary outcome) and physical quality of life in MS patients with OSAH.

Effect of a Standardized Ginger Root Powder Regimen on Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Double-Blind, Placebo-Controlled Randomized Trial.

BACKGROUND: There is substantial interest in the role of ginger as an adjuvant therapy for chemotherapy-induced nausea and vomiting (CINV). However, available evidence lacks robust methodology. OBJECTIVE: To assess the effect of adjuvant ginger compared with placebo on chemotherapy-induced nausea-related quality of life (QoL) and CINV-related outcomes. DESIGN: A parallel, double-blind, placebo-controlled randomized trial with 1:1 allocation was conducted. PARTICIPANTS/SETTING: One hundred three chemotherapy-naïve adults scheduled to receive moderately to highly emetogenic chemotherapy at two hospitals in Australia were enrolled and analyzed. INTERVENTION: Four standardized ginger capsules (totaling 84 mg/day active gingerols/shogaols), or placebo, were administered commencing the day of chemotherapy and continuing for 5 days for chemotherapy cycles 1 through 3. MAIN OUTCOME MEASURES: The primary outcome was chemotherapy-induced nausea-related QoL. Secondary outcomes were vomiting- and CINV-related QoL; anticipatory, acute, and delayed nausea and vomiting; fatigue; nutritional status; depression and anxiety; health-related QoL; and adverse events. STATISTICAL ANALYSES PERFORMED: Intention-to-treat analysis was performed. Mixed analysis of variance with repeated measures determined differences between groups. The null hypothesis was no difference between groups. After applying a Bonferroni multiple testing correction, evidence against the null hypothesis was considered at P= 0.003. RESULTS: One hundred three participants (ginger: n = 52; placebo: n = 51) were enrolled and analyzed. There was clinically relevant evidence against the null hypothesis, favoring ginger, in change scores for nausea-related QoL (F[df] = 9.34[1,101]; P = 0.003; partial η2 = 0.09), overall CINV-related QoL (F[df] = 12.26[1,101]; P < 0.001; partial η2 = 0.11), delayed nausea severity (F[df] = 9.46[1,101]; P = 0.003; partial η2 = 0.09), and fatigue (F[df] = 10.11[1,101]; P = 0.002; partial η2 = 0.09). There was a clinically meaningful lower incidence of delayed nausea and vomiting in the ginger group at Cycle 2 (53% vs 75%; P = 0.020 and 4% vs 27%; P = 0.001, respectively) and Cycle 3 (49% vs 79%; P = 0.002 and 2% vs 23%; P = 0.001, respectively). There was a clinically meaningful lower incidence of malnutrition in the ginger group at Cycle 3 (18% vs. 41%; P = 0.032) and in change scores for Patient-Generated Subjective Global Assessment (F[df)] = 4.32[1,100]; P = 0.040; partial η2 = 0.04). Change scores between groups favored ginger for vomiting-related QoL and number of vomiting episodes; however, findings were not clinically meaningful. There was no effect of ginger on anticipatory or acute CINV, health-related QoL, anxiety, or depression. No serious adverse events were reported. CONCLUSIONS: Ginger supplementation was a safe adjuvant to antiemetic medications for CINV that enhanced QoL during chemotherapy treatment. Future trials are needed to examine dose-dependent responses to verify optimal dosing regimens.

In-vehicle fragrance administration as a countermeasure for driver fatigue.

Driver fatigue is a contributing factor in about 10-30% of all fatal crashes. Prevention of fatigue-related crashes relies on robust detection of driver fatigue and application of effective countermeasures. A potential countermeasure is fragrance administration since odors can have alerting effects on humans. The aim here was to investigate if a fragrance incorporating trigeminal components could be used as an in-vehicle countermeasure for driver fatigue. The fragrance was tested in a driving simulator with 21 healthy but sleep-deprived participants. Each participant performed a monotonous driving task twice, once with active fragrance containing a trigeminal component and once with olfactory fragrance, in a cross-over single-blind design. The order of trigeminal/olfactory fragrance was randomized and blinded to the participants. Both fragrances (trigeminal/olfactory) were administered either when the participant fell asleep (defined as eye closure > 3 s) or after approximately 45 min if the participant did not fall asleep. Self-reported sleepiness was assessed using the Karolinska Sleepiness Scale (KSS) every 5 min during driving. Variability in speed and lateral position and line crossing frequency were logged for each drive to measure driving performance. Heart rate measurements (ECG) and eye blinks (EOG) were collected to investigate potential arousing effects of the fragrance and to track objective signs of sleepiness. Mean blink duration, which was used as an objective measure of sleepiness, decreased significantly, after fragrance exposure, as did the frequency of line crossings, but there were no statistically significant differences between the fragrance with trigeminal stimulus and the pure olfactory fragrance. The results are in line with the effects found for other commonly used fatigue countermeasures, like playing loud music. These countermeasures can restore alertness and driving performance for a short while. Whether this is sufficient to support driving performance until the driver can make a safe stop in real traffic remains a topic for future studies.

The Potential Role of Nutrition in Overtraining Syndrome: A Narrative Review.

Competition between athletes and an increase in sporting knowledge have greatly influenced training methods while increasing the number of them more and more. As a result, the number of athletes who have increased the number and intensity of their workouts while decreasing recovery times is rising. Positive overtraining could be considered a natural and fundamental process when the result is adaptation and improved performance; however, in the absence of adequate recovery, negative overtraining could occur, causing fatigue, maladaptation, and inertia. One of the earliest forms of fatigue is overreaching. It is considered to be an accumulation of training that leads to reduced sports performance, requiring days or weeks to recover. Overreaching, if followed by adequate recovery, can lead to an increase in athletic performance. Nonetheless, if overreaching becomes extreme, combined with additional stressors, it could lead to overtraining syndrome (OTS). OTS, caused by systemic inflammation, leads to central nervous system (CNS) effects, including depressed mood, further inflammation, central fatigue, and ultimately neurohormonal changes. There are therefore not only physiological, biochemical, and immunological but also psychological symptoms or markers that must be considered, independently or together, being intrinsically linked with overtraining, to fully understand OTS. However, to date, there are very few published studies that have analyzed how nutrition in its specific food aspects, if compromised during OTS, can be both etiology and consequence of the syndrome. To date, OTS has not yet been fully studied, and the topic needs further research. The purpose of this narrative review is therefore to study how a correct diet and nutrition can influence OTS in all its aspects, from prevention to treatment.

Cognitive behavioral stress management for parents: Prevention and reduction of parental burnout

Context: Parental burnout increases the risk of deleterious consequences on parents’, couples’, and children's physical and mental health. Methods: The current study (N = 134) aimed to assess the effectiveness of a Cognitive Behavioural Stress Management (CBSM) group programme in terms of parental burnout reduction. In total 67 parents attended the 8-week CBSM intervention groups, and another 67 parents were assigned to the waiting-list control group. We compared the effectiveness of the CBSM intervention with a waiting-list control group directly after the end of the programme and at three-months follow-up. Results: The results showed that compared to the control group the CBSM programme contributed to the reduction of parental burnout symptoms with statistically significant and small effect size. Moreover, the contrast analyses showed that the reduction in parental burnout severity was maintained at 3 month-follow-up. The reduction in parental burnout scores was mediated by the decrease in stress and the increase in unconditional self-kindness. Conclusions: These results highlight the potential benefits of the CBSM programme for parental burnout prevention and reduction. (AU)

Evidence of high compliance and fatigue in mask adherence in two mandates in Barcelona, Spain: a naturalistic observational study.

OBJECTIVE: We investigated a possible pandemic fatigue effect, comparing adherence to compulsory mask use outdoors in Barcelona during the fourth and sixth waves of the pandemic. STUDY DESIGN: We used naturalistic observation to determine the degree of pedestrians' compliance. METHODS: We assessed mask use outdoors in a sample of pedestrians in Barcelona between 28 December 2021 and 9 February 2022 (during the sixth wave in Spain), and compared it with the fourth wave (which was between 5 April 2021 and 29 April 2021). Masks were compulsory in both periods. RESULTS: The population studied amounted to 45,116 people (21,246 in the fourth wave and 23,870 in the sixth wave). In the sixth wave, only 67.3% wore a mask correctly, 18.6% did so incorrectly and 14.1% did not wear a mask, while the figures for the fourth wave were 78.2%, 16.3% and 5.5%, respectively (P = 0.001). CONCLUSION: Our results suggest that adherence was high in the population studied, but with an evident fatigue effect when the two waves were compared, as the proportion of individuals wearing a mask correctly declined compared to the fourth wave. These results suggest that policymakers need guidance on adopting clear and enforceable guidelines during future mask mandates, assessing advantages and drawbacks in terms of the population's behavior to prevent the fatigue effect.

Breast cancer survivors with pain: an examination of the relationships between body mass index, physical activity, and symptom burden.

PURPOSE: Overweight and obesity are common for breast cancer survivors and associated with high symptom burden (i.e., pain, fatigue, depressive symptoms). Physical activity may protect breast cancer survivors with higher body mass indexes (BMI) from increased symptoms. However, the role of physical activity in buffering the relationship between higher BMI and greater symptoms is unclear. METHODS: Baseline data from a randomized trial investigating Pain Coping Skills Training among breast cancer survivors (N = 327) with pain were used to examine the relationship between self-reported BMI (kg/m2) and physical activity level (Rapid Assessment of Physical Activity; suboptimal vs. optimal) with pain (Brief Pain Inventory; severity and interference), fatigue (PROMIS-Fatigue short form), and depressive symptoms (Center for Epidemiological Studies Depression Scale). Analyses were conducted in SPSS. Hayes PROCESS macro (Model 1) assessed whether physical activity moderated the relationship between BMI and symptoms. RESULTS: Lower BMI (B = .06, p < .01) and optimal physical activity (B = - .69, p < .01) were independently associated with lower pain interference. Lower BMI was also associated with lower pain severity (B = .04, p < .001). Neither BMI nor physical activity was associated with fatigue or depressive symptoms. Physical activity did not moderate the relationship between BMI and symptoms. CONCLUSIONS: Among breast cancer survivors experiencing pain, higher BMI and being less physically active were related to greater pain (i.e., severity and/or interference). Physical activity did not buffer the relationships between BMI and pain, fatigue, and depressive symptoms, suggesting that physical activity alone may not be sufficient to influence the strength of the relationships between BMI and symptoms.

A systematic review and meta-analysis of randomized controlled trials on the effectiveness of immersive virtual reality in cancer patients receiving chemotherapy.

PURPOSE: Immersive virtual reality (IVR) shows promise in cancer care, especially for chemotherapy patients. This systematic review and meta-analysis assesses IVR's impact on adult and pediatric cancer patients undergoing chemotherapy. METHODS: We searched PubMed, Cochrane Library, Embase, Scopus, Web of Science, and Google Scholar for relevant randomized controlled trials (RCTs). We focused on anxiety, depression, fatigue, pain, and anxiety in adults and pain and anxiety in pediatric patients. RESULTS: Fifteen trials were included, enrolling 607 adult and 257 pediatric cancer patients. IVR significantly reduced anxiety (SMD = -1.89, 95% CI = -2.93 to -0.85), depression (SMD = -1.85, 95% CI = -3.14 to -0.55), fatigue (SMD = -3.40, 95% CI = -5.54 to -1.26), and systolic blood pressure (MD = -3.54, 95% CI = -6.67 to -0.40) in adults. In pediatric patients, IVR significantly lowered pain (SMD = -1.17, 95% CI = -1.84 to -0.50) and anxiety (SMD = -1.18, 95% CI = -1.77 to -0.59) but not heart rate (MD = 0.48, 95% CI = -2.38 to 3.34). CONCLUSION: IVR effectively reduces anxiety, depression, fatigue, systolic blood pressure, pain, and anxiety in cancer patients. More robust RCTs are needed for further IVR research.

Effects of lactotripeptide ingestion and physical activity intervention on the fatigue status of middle-aged and older adults: a randomized controlled trial.

This randomized controlled trial aimed to investigate the effects of eight weeks of lactotripeptide (LTP) ingestion, physical activity (PA) intervention, and combined intervention on the fatigue status of middle-aged and older adults. A total of 78 middle-aged and older adults (63 ± 8 years of age) were randomly assigned to four groups: placebo, LTP, placebo with PA intervention (placebo + PA), and LTP with PA intervention (LTP + PA). All participants ingested the placebo or LTP tablets daily (three tablets/day). The placebo + PA and LTP + PA groups participated in a weekly supervised exercise class and were instructed to increase their moderate- to vigorous-intensity PA at home. The visual analog scale, Brief Fatigue Inventory, Profile of Mood States second edition (POMS2), and Beck Depression Inventory second edition (BDI-II) were administered before and after the intervention. No significant interactions or main effects were observed between LTP ingestion and PA intervention on any of the fatigue scales. The main-effect analyses revealed that the PA intervention improved the total mood disturbance score of the POMS2 (F = 5.22, P = 0.03) and BDI-II score (F = 4.81, P = 0.03). After the post hoc paired comparisons, the total mood disturbance and BDI-II scores improved more with the combined intervention than with the PA intervention alone (percentage difference between the effect of combined intervention and PA intervention alone was 3.7% for total mood disturbance score and 13.7% for BDI-II score). The present study suggests that eight weeks of LTP ingestion and PA intervention did not have a significant effect on fatigue status. However, the PA intervention improved mood status and depressive symptoms, and these effects were enhanced by LTP ingestion.

Physical activity interventions for cancer-related fatigue: A scoping review of randomized controlled trials from a Nursing Science Precision Health Model perspective.

BACKGROUND: The Nursing Science Precision Health (NSPH) Model has the potential to guide research on the development, testing, and targeting of interventions. PURPOSE: This scoping review examines the relationship between physical activity (PA) and cancer-related fatigue (CRF) within the context of the NSPH Model. METHODS: The Joanna Briggs Institute scoping review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this review. We included randomized controlled trials in people with cancer that investigated PA interventions and measured change in CRF as an outcome. DISCUSSION: A total of 181 studies met the eligibility criteria. Over 20 different instruments were used to measure CRF. The most common PA interventions were strength training (48%), walking (36%), cycling (26%), and yoga (15%). A limited number of studies reported phenotypic characteristics (32/181, 17%) or biomarkers (31/181, 17%) associated with CRF. CONCLUSION: This scoping review identified the body of existing research exploring CRF and PA from a precision health perspective.

The Tech4Rest Randomized Controlled Trial: Applying the Hierarchy of Controls to Advance the Sleep, Health, and Well-being of Team Truck Drivers.

OBJECTIVE: The aim of the study was to evaluate the effectiveness of interventions to improve sleep, reduce fatigue, and advance the well-being of team truck drivers. METHODS: In a randomized controlled trial ( k = 24 teams; N = 49 drivers; 61.3% of planned sample), intervention teams were exposed to baseline (3-4 weeks), cab enhancements (active suspension seat, therapeutic mattress; 3-4 weeks), and cab enhancements plus a behavioral sleep-health program (1-2 months). Control teams worked as usual during the same period. RESULTS: Trends in sleep-related outcomes favored the intervention. Large and statistically significant intervention effects were observed for objectively measured physical activity (a behavioral program target). The discussion of results addresses effect sizes, statistical power, intervention exposure, and work organization. CONCLUSIONS: Trends, effect sizes, and significant findings in this rare trial provide valuable guidance for future efforts to improve working conditions and outcomes for team drivers.

Effectiveness of immersive virtual reality on anxiety, fatigue and pain in patients with cancer undergoing chemotherapy: A systematic review and meta-analysis.

PURPOSE: This Systematic review and meta-analysis aimed to assess the effectiveness of Virtual Reality on anxiety, fatigue and pain in patients with cancer during chemotherapy and provide evidence for decision-making in clinical practice. METHODS: A systematic literature search was performed in the databases PubMed, Web of Science, Scopus, Cumulative Index of Nursing and Allied Health Literature and the Cochrane Library. Risk of Bias was used to assess the quality of individual studies, and Grading of Recommendations Assessment, Development and Evaluation was used to assess confidence for each individual outcome. A random-effects model was used to examine the overall effect. RESULTS: Four randomized controlled trials and four crossover studies were included, with an overall sample of 459 patients. Results showed that Virtual Reality compared with standard care had a significant reduction of anxiety only (MD = -6.57, 95% CI: -11.59 to -1.54, p = 0.01) but with considerable heterogeneity (I2 = 92%), while Virtual Reality was not significantly different from integrative interventions. The trials included showed small sample sizes, lack of statistical power, low methodological quality, high heterogeneity, and different Virtual Reality technology types, lengths and frequencies. CONCLUSION: The quality of evidence is very low and the strength of recommendation is weak. Further research has large potential for reducing uncertainty about the effects of Virtual Reality in patients with cancer receiving chemotherapy. This study was registered with PROSPERO as CRD42020223375.

Effectiveness of exergaming in reducing cancer-related fatigue among children with acute lymphoblastic leukemia: a randomized controlled trial.

BACKGROUND: Little is known about the effectiveness of the newly emerging technology of exergaming in reducing Cancer Related Fatigue (CRF). OBJECTIVES: The study's primary aim was to examine the effectiveness of exergaming in reducing CRF; the secondary aims were to improve functional capacity/endurance and promote physical activity (PA) among children with acute lymphoblastic leukemia (ALL). METHODS: In this Randomized Controlled Trial (RCT), 45 children aged 6-14 years were randomly assigned into group-I, n = 22, and group II, n = 23. Group-I played exergaming of moderate intensity for 60 min, twice a week for three weeks. Group II was given an instructional session regarding the benefits of PA with advice to practice PA for 60 min twice a week. CRF, functional capacity/endurance, and PA were measured using the pediatric quality of life multidimensional fatigue scale (Ped-QLMFS), six-minute walk test (6-MWT), and Godin-Shepard Leisure Time Physical Activity Questionnaire (QSLTPAQ) respectively. All measurements were taken thrice; in the first, third, and fifth weeks of intervention. RESULTS: Group-I demonstrated a significant reduction of CRF, and a significant increase of functional capacity/endurance compared to group-II over the five weeks study period. The effect of time × intervention interaction was significant. Based on Cohen's guidelines, CRF and functional capacity/endurance had large effect sizes (η2 = 0.41, p = .00) and (η2 = 0.27, p = .00) respectively. CONCLUSION: The protocol of exergaming used in this RCT effectively reduces CRF and promotes functional capacity/endurance and PA in children with ALL undergoing chemotherapy. It may provide an alternative treatment modality to decrease the healthcare load.Key messagesCancer-related fatigue (CRF) is described as physical exhaustion, sleep disturbance, emotional distress, and cognitive dysfunction.Exergaming reduces CRF and promotes functional capacity/endurance and physical activity in children with acute lymphoblastic leukemia undergoing chemotherapy.Exergaming may provide an alternative treatment modality to decrease the healthcare load.

Exploring Work-Time Affective States Through Ecological Momentary Assessment in an Office-Based Intervention to Reduce Occupational Sitting.

BACKGROUND: The aim of this study was to examine whether a low-cost standing desk intervention that reduced occupational sitting was associated with changes in work-time cognitive-affective states in real time using ecological momentary assessments at the start and end of the trial. METHODS: Forty-one office employees (91.7% female, mean age = 39.8 [10.1] y) were randomized to receive a low-cost standing desk or a waitlist control. Participants received 5 surveys each day for 5 workdays via smartphone application prior to randomization and at trial's end. Ecological momentary assessment assessed current work-time psychological states (valence and arousal, stress, fatigue, and perceived productivity). Multilevel models assessed whether changes in work-time outcomes over the course of the intervention were significantly different between treatment groups. RESULTS: There were no significant differences in outcomes between the groups except for fatigue, with the control group reporting a significant decrease in daily fatigue following the intervention (P < .001). The intervention group reported no significant changes in any of the work-time outcomes across the study period (P > .05). CONCLUSIONS: A low-cost standing desk intervention to reduce occupational sedentary behavior did not negatively impact work-time outcomes such as productivity and fatigue in the short term.

An evening light intervention reduces fatigue and errors during night shifts: A randomized controlled trial.

OBJECTIVE: Shift work causes circadian rhythms to misalign with the demands of the environment, which has been associated with sleep difficulties and cognitive impairments. Although bright light exposure during night shifts can improve circadian alignment, its implementation is often infeasible. Here, we tested whether light exposure in the evening, before the night shift, could improve fatigue, work performance, mood, and sleep. METHODS: Fifty-seven healthy nurses who worked full-time rapidly rotating shift schedules completed the study. In a mixed-design randomized controlled trial, participants completed a baseline observation period before following 1 of 2 interventions. The experimental intervention aimed to improve circadian alignment using evening light exposure and morning light avoidance; the control intervention aimed to improve alertness and reduce sleep disturbances by modifying diet. Every morning and evening for 30 days, participants completed measures of fatigue, work-related errors, sleepiness, mood, sleep duration, and sleep quality. RESULTS: Compared to the baseline observation period, the experimental intervention reduced errors by 67%, while the control intervention reduced them by only 5%. This reduction was partially mediated by fatigue; experimental participants reported less fatigue on work days than control participants (d = 0.25 [0.10, 0.38]). The experimental group also showed a small improvement in mood. Both groups showed reductions in fatigue (d = 0.29 [0.20, 0.36]) and sleepiness (d = 0.21 [0.12, 0.28]) as well as a small increase in sleep duration. CONCLUSIONS: Interventions based on evening light may be a feasible and effective strategy to reduce fatigue and errors in night-shift workers.

A remote Whole Food Dietary Intervention to Reduce Fatigue and Improve Diet Quality in Lymphoma Survivors: Results of a Feasibility Pilot Study.

Long-term, persistent cancer-related fatigue (CRF) is the most common side effect reported by lymphoma survivors. CRF reduces quality of life, and treatments are limited. This pilot study aimed to determine feasibility of recruiting and retaining diffuse large B-cell lymphoma (DLBCL) survivors in a 12-week remote Fatigue Reduction Diet (FRD) intervention and evaluate preliminary efficacy of the intervention. Participants met remotely with a registered dietitian nutritionist for eight individual sessions. FRD goals included consuming specific fruits, vegetables, whole grains, and omega-3 fatty acid rich foods. Acceptability was assessed by session attendance, FRD goal attainment, and exit surveys. Self-reported dietary intake and fatigue were measured using the Healthy Eating Index-2015 and PROMIS Fatigue Short Form, respectively, at baseline and post-intervention. Ten DLBCL survivors enrolled; nine attended all sessions and completed the intervention. Weekly adherence to targeted food intake goals improved significantly throughout the study (all p < 0.05), with participants meeting goals over 4 day per week by week 11. Mean[SD] diet quality improved significantly from baseline (65.9[6.3]) to post-intervention (82.2[5.0], p < 0.001). Mean[SD] fatigue reduced significantly from baseline (50.41[9.18]) to post-intervention (45.79[6.97], p < 0.05). The 12-week remote FRD intervention was feasible, acceptable, and holds promise to improve diet quality and fatigue in DLBCL survivors.