Tadeusz Marek

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

Abstract It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan...

DIURNAL PATTERNS OF ACTIVITY OF THE ORIENTING AND EXECUTIVE ATTENTION NEURONAL NETWORKS IN SUBJECTS PERFORMING A STROOP-LIKE TASK: A FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY

Attentional processes are fundamental to good cognitive functioning of human operators. The purpose of this study was to analyze the activity of neuronal networks involved in the orienting attention and executive control processes from the perspective of diurnal variability. Twenty-three healthy male volunteers meeting magnetic resonance (MR) inclusion criteria performed the Stroop Color-Word task (block design) in the MR scanner five times/day (06:00, 10:00, 14:00, 18:00, 22:00 h). The first scanning session was scheduled 1–1.5 h after waking. Between MR sessions, subjects performed simulated driving tasks in stable environmental conditions, with controlled physical activity and diet. Significant activation was found in brain regions related to the orienting attentional system: the parietal lobe (BA40) and frontal eye-fields (FEFs). There were also activations in areas of the executive control system: the fronto-insular cortex (FIC), dorsal anterior cingulate cortex (dACC), presupplementary motor area (preSMA), supplementary motor area (SMA), basal ganglia, middle temporal (MT; BA21), and dorsolateral prefrontal cortex (DLPFC), as a part of the central executive network. Significant deactivations were observed in the rostral anterior cingulate cortex (rACC), posterior cingulate cortex (PCC), superior frontal gyrus (SF), parietal lobe (BA39), and parahippocampal that are thought to comprise the default mode network (DMN). Additionally, the activated regions included bilaterally lingual gyrus and fusiform gyrus. The insula was bilaterally deactivated. Visual attention controlled by the goal-oriented attention system and comprising top-down and bottom-up mechanisms, activated by Stroop-like task, turned out to be prone to diurnal changes. The study results show the occurrence of time-of-day–related variations in neural activity of brain regions linked to the orienting attentional system (left parietal lobe—BA40, left and right FEFs), simultaneously providing arguments for temporal stability of the executive system and default mode network. These results also seem to suggest that the involuntary, exogenous (bottom-up) mechanism of attention is more vulnerable to circadian and fatigue factors than the voluntary (top-down) mechanism, which appear to be maintained at the same functional level during the day. The above phenomena were observed at the neural level. (Author correspondence: marek@uj.edu.pl)

Neural networks related to pro-saccades and anti-saccades revealed by independent component analysis

The saccadic eye movement system provides an excellent model for investigating basic cognitive processes and flexible control over behaviour. While the mechanism of pro-saccades (PS) is well known, in the case of the anti-saccade task (AS) it is still not clear which brain regions play a role in the inhibition of reflexive saccade to the target, nor what is the exact mechanism of vector inversion (i.e. orienting in the opposite direction). Independent component analysis (ICA) is one of the methods being used to establish temporally coherent brain regions, i.e. neural networks related to the task. In the present study ICA was applied to fMRI data from PS and AS experiments. The study revealed separate networks responsible for saccade generation into the desired direction, the inhibition of automatic responses, as well as vector inversion. The first function is accomplished by the eye fields network. The inhibition of automatic responses is associated with the executive control network. Vector inversion seems to be accomplished by the network comprising a large set of areas, including intraparietal sulcus, precuneus/posterior cingulate cortices, retrosplenial and parahippocampal. Those regions are associated with the parieto-medial temporal pathway, so far linked only to navigation. These results provide a new insight into understanding of the processes of the inhibition and vector inversion.

CHRONOTYPE, SLEEP LOSS, AND DIURNAL PATTERN OF SALIVARY CORTISOL IN A SIMULATED DAYLONG DRIVING

The study focused on chronotype-related differences in subjective load assessment, sleepiness, and salivary cortisol pattern in subjects performing daylong simulated driving. Individual differences in work stress appraisal and psychobiological cost of prolonged load seem to be of importance in view of expanding compressed working time schedules. Twenty-one healthy, male volunteers (mean ± SD: 27.9 ± 4.9 yrs) were required to stay in semiconstant routine conditions. They performed four sessions (each lasting ∼2.5 h) of simulated driving, i.e., completed chosen tasks from computer driving games. Saliva samples were collected after each driving session, i.e., at 10:00–11:00, 14:00–15:00, 18:00–19:00, and 22:00–23:00 h as well as 10–30 min after waking (between 05:00 and 06:00 h) and at bedtime (after 00:00 h). Two subgroups of subjects were distinguished on the basis of the Chronotype Questionnaire: morning (M)- and evening (E)-oriented types. Subjective data on sleep need, sleeping time preferences, sleeping problems, and the details of the preceding night were investigated by questionnaire. Subjective measures of task load (NASA Task Load Index [NASA-TLX]), activation (Thayers Activation-Deactivation Adjective Check List [AD ACL]), and sleepiness (Karolinska Sleepiness Scale [KSS]) were applied at times of saliva samples collection. M- and E-oriented types differed significantly as to their ideal sleep length (6 h 54 min ± 44 versus 8 h 13 min ± 50 min), preferred sleep timing (midpoint at 03:19 versus 04:26), and sleep index, i.e., ‘real-to-ideal’ sleep ratio, before the experimental day (0.88 versus 0.67). Sleep deficit proved to be integrated with eveningness. M and E types exhibited similar diurnal profiles of energy, tiredness, tension, and calmness assessed by AD ACL, but E types estimated higher their workload (NASA-TLX) and sleepiness (KSS). M types exhibited a trend of higher mean cortisol levels than E types (F = 4.192, p < .056) and distinct diurnal variation (F = 2.950, p < .019), whereas E types showed a flattened diurnal curve. Cortisol values did not correlate with subjective assessments of workload, arousal, or sleepiness at any time-of-day. Diurnal cortisol pattern parameters (i.e., morning level, mean level, and range of diurnal changes) showed significant positive correlations with sleep length before the experiment (r = .48, .54, and .53, respectively) and with sleep index (r = .63, .64, and .56, respectively). The conclusions of this study are: (i) E-oriented types showed lower salivary cortisol levels and a flattened diurnal curve in comparison with M types; (ii) sleep loss was associated with lower morning cortisol and mean diurnal level, whereas higher cortisol levels were observed in rested individuals. In the context of stress theory, it may be hypothesized that rested subjects perceived the driving task as a challenge, whereas those with reduced sleep were not challenged, but bored/exhausted with the experimental situation. (Author correspondence: mmoginsk@cyf-kr.edu.pl)

The reliability of self-ratings based on Borg's scale for hand-arm vibrations of short duration (Part II)

Abstract The purpose of the study was to investigate the manner in which the perceptual apparatus of the body reacts to local vibrations. We also wanted to study the reliability of self-ratings based on Borgs scale in the assessment of hand-arm vibrations of short duration. Thirdly, the study is of ergonomic importance in that it demonstrates the possibility of supplementing objective measuring methods with psychophysical ratings in order to attain better insight into the overall situation of the worker. The investigation shows that the general reliability coefficients are statistically significant (p ⩽ 0.05) and high: 0.986 for experienced subjects and 0.841 for inexperienced subjects. This means that Borgs scale is generally highly reliable in the evaluation of hand-arm vibrations of short duration. Analyses of the partial reliability coefficients for all subjects for different amplitudes (range 26–5130 μm) at frequencies of 30 Hz, 75 Hz and 187 Hz show that the reliability coefficients are statistically significant (p ⩽ 0.05) within the sensitive range of amplitudes from 162 μm to 2276 μm (peak-to-peak values) for the frequency of 75 Hz and partly for 30 Hz.

Chronic sleep deficit and performance of a sustained attention task : an electrooculography study

Electrooculography (EOG) was used to explore performance differences in a sustained attention task during rested wakefulness (RW) and after 7 days of partial sleep deprivation (SD). The RW condition was based on obtaining regular sleep, and the SD condition involved sleep restriction of 3 h/night for a week resulting in a total sleep debt of 21 h. The study used a counterbalanced design with a 2-wk gap between the conditions. Participants performed a sustained attention task for 45 min on four occasions: 10:00–11:00, 14:00–15:00, 18:00–19:00, and 22:00–23:00 h. The task required moving gaze and attention as fast as possible from a fixation point to a target. In each session, 120 congruent and 34 incongruent stimuli were presented, totaling 1232 observations/participant. Correct responses plus errors of omission (lapses) and commission (false responses) were recorded, and the effect of time-of-day on sustained attention following SD was investigated. The analysis of variance (ANOVA) model showed that SD affected performance on a sustained attention task and manifested itself in a higher number of omission errors: congruent stimuli (F(1,64) = 13.3, p < .001) and incongruent stimuli (F(1,64) = 14.0, p < .001). Reaction times for saccadic eye movements did not differ significantly between experimental conditions or by time-of-day. Commission errors, however, exhibited a decreasing trend during the day. The visible prevalence of omissions in SD versus RW was observed during the mid-afternoon hours (the so-called post-lunch dip) for both congruent and incongruent stimuli (F(1,16) = 5.3, p = .04 and F(1,16) = 5.6, p = .03, respectively), and at 18:00 h for incongruent stimuli (F(1,13) = 5.7, p = .03). (Author correspondence: magda.fafrowicz@uj.edu.pl)

Muscular loading and subjective ratings of muscular tension by novices when typing with standard and split‐design computer keyboards

The objective of this research project was to compare two different computer keyboard designs with respect to their effect on the extent of muscular loading in the right and left trapezius and extensor muscles during typing. The two computer keyboards used in this study were (1) a classic or standard keyboard, and (2) a split‐design keyboard. Evaluation of muscular loading was done using the electromyography (EMG) technique and subjective ratings of muscular tension. Sixteen women, between 18 and 26 years of age, with similar secretarial experience and limited typing abilities, took voluntary part in the experiment. Each subject used both keyboards for 15 min. The EMG signals recorded during typing sessions were those of the left and right sides of trapezius (m. trapezius pars descendeus) and extensor (m. extensor carpi radialis brevis et longus) muscles. Upon completion of each task, subjects were asked to evaluate perceived levels of muscular tension in the shoulder‐neck area and forearms. The results s...

Measuring individual vulnerability to sleep loss—the CHICa scale

The aim of this project was to construct a psychometrically satisfying scale to describe subjective reactions to sleep deprivation. First, on the basis of a literature review, a list of items was generated which reflected the negatively affected mood and reduced wellbeing associated with sleep loss. Additionally, psychology students were asked to describe their cognitive and emotional symptoms following a night with curtailed sleep. As a result, 69 items were included in the experimental set. University students (n = 102, females, mean age 22.5 ± 1.9 years) completed the form several times during 1 week in June (while preparing for examinations) and on a free day in September; a total of 460 forms were collected. The final, 26‐item version of the scale was validated in a sleep deficit experiment lasting 1 week, conducted with 25 female participants (mean age 23.4 ± 1.9 years). Factor analysis showed 71.7% of total variance explained by four components: impaired thermoregulation (C for cold), disrupted appetite (H for hunger), affective problems (I for irritability) and lowered level of cognitive functioning (Ca for cognitive attenuation). A Polish version of the CHICa scale showed satisfactory psychometric properties. Cronbachs alpha of the subscales were between 0.90 and 0.95. All four subscales exhibited a significant increase with an experimental 3‐h daily sleep restriction over a period of 1 week; cognitive attenuation was the most symptomatic. Cognitive problems (reduced concentration, comprehension and accuracy) and a lack of energy seem to be the most specific subjective manifestations of the chronic sleep deficit state. CHICa may be helpful in research on inter‐and intra‐individual differences and on the efficacy of various counteractive treatments for the consequences of sleep deprivation.

Neural circuit of verbal humor comprehension in schizophrenia - an fMRI study

Individuals with schizophrenia exhibit problems with understanding the figurative meaning of language. This study evaluates neural correlates of diminished humor comprehension observed in schizophrenia. The study included chronic schizophrenia (SCH) outpatients (n = 20), and sex, age and education level matched healthy controls (n = 20). The fMRI punchline based humor comprehension task consisted of 60 stories of which 20 had funny, 20 nonsensical and 20 neutral (not funny) punchlines. After the punchlines were presented, the participants were asked to indicate whether the story was comprehensible and how funny it was. Three contrasts were analyzed in both groups reflecting stages of humor processing: abstract vs neutral stories - incongruity detection; funny vs abstract - incongruity resolution and elaboration; and funny vs neutral – complete humor processing. Additionally, parametric modulation analysis was performed using both subjective ratings separately. Between-group comparisons revealed that the SCH subjects had attenuated activation in the right posterior superior temporal gyrus (BA 41) in case of irresolvable incongruity processing of nonsensical puns; in the left dorsomedial middle and superior frontal gyri (BA 8/9) in case of incongruity resolution and elaboration processing of funny puns; and in the interhemispheric dorsal anterior cingulate cortex (BA 24) in case of complete processing of funny puns. Additionally, during comprehensibility ratings the SCH group showed a suppressed activity in the left dorsomedial middle and superior frontal gyri (BA 8/9) and revealed weaker activation during funniness ratings in the left dorsal anterior cingulate cortex (BA 24). Interestingly, these differences in the SCH group were accompanied behaviorally by a protraction of time in both types of rating responses and by indicating funny punchlines less comprehensible. Summarizing, our results indicate neural substrates of humor comprehension processing impairments in schizophrenia, which is accompanied by fronto-temporal hypoactivation.

Scale-Free Fluctuations in Behavioral Performance: Delineating Changes in Spontaneous Behavior of Humans with Induced Sleep Deficiency

The timing and dynamics of many diverse behaviors of mammals, e.g., patterns of animal foraging or human communication in social networks exhibit complex self-similar properties reproducible over multiple time scales. In this paper, we analyze spontaneous locomotor activity of healthy individuals recorded in two different conditions: during a week of regular sleep and a week of chronic partial sleep deprivation. After separating activity from rest with a pre-defined activity threshold, we have detected distinct statistical features of duration times of these two states. The cumulative distributions of activity periods follow a stretched exponential shape, and remain similar for both control and sleep deprived individuals. In contrast, rest periods, which follow power-law statistics over two orders of magnitude, have significantly distinct distributions for these two groups and the difference emerges already after the first night of shortened sleep. We have found steeper distributions for sleep deprived individuals, which indicates fewer long rest periods and more turbulent behavior. This separation of power-law exponents is the main result of our investigations, and might constitute an objective measure demonstrating the severity of sleep deprivation and the effects of sleep disorders.