Fatigue and psychological distress in the working population: psychometrics,prevalence, and correlates

Objective: The purposes of this study were: (1) to explore the relationship between fatigue and psychological distress in the working population; (2) to examine associations with demographic and health factors; and (3) to determine the prevalence of fatigue and psychological distress. Methods: Data were taken from 12,095 employees. Fatigue was measured with the Checklist Individual Strength, and the General Health Questionnaire (GHQ) was used to measure psychological distress. Results: Fatigue was fairly well associated with psychological distress. A separation between fatigue items and GHQ items was shown. No clear, distinct pattern of associations was found for fatigue vs. psychological distress with respect to demographic factors. The prevalence was 22% for fatigue and 23% for psychological distress. Of the employees reporting fatigue, 43% had fatigue only, whereas 57% had fatigue and psychological distress. Conclusions: The results indicate that fatigue and psychological distress are common in the working population. Although closely associated, there is some evidence suggesting that fatigue and psychological distress are different conditions, which can be measured independently.     

Biological mechanisms in the relationship between depression and heart disease

Psychological depression is shown to be associated with several aspects of coronary artery disease (CAD), including arrhythmias, myocardial infarction, heart failure and sudden death. The physiological mechanisms accounting for this association are unclear. Hypothalamic–pituitary–adrenal dysregulation, diminished heart rate variability, altered blood platelet function and noncompliance with medial treatments have been proposed as mechanisms underlying depression and cardiovascular disease. Recent evidence also suggests that reduced baroreflex sensitivity, impaired immune function, chronic fatigue and the co-morbidity of depression and anxiety may be involved in the relationship between depression and cardiovascular dysregulation. An experimental strategy using animal models for investigating underlying physiological abnormalities in depression is presented. A key to understanding the bidirectional association between depression and heart disease is to determine whether there are common changes in brain systems that are associated with these conditions. Such approaches may hold promise for advancing our understanding of the interaction between this mood disorder and CAD.     

成年医学生心身健康与疲劳相关研究

目的探讨成年医学生的心身状况、疲劳及其相关性。方法用CMI量表和FAI量表进行调查问卷,自编程序输入,用SPSS10郾0软件分析。结果成年医学生男学生康奈尔医学指数总分莛35分,占总体6郾40%,M—R莛15分,占总体6郾02%。女学生康奈尔医学指数总分≥40分,占总体12郾27%,M—R≥20分,占总体7郾30%。男女之间疲劳因子3有统计学意义穴P<0.005雪。康奈尔医学指数总分与疲劳总分、疲劳因子1、疲劳因子2、疲劳因子3呈正相关。经多重线性回归分析,康奈尔医学指数总分与4个疲劳因子有直线关系。M—R与疲劳总分、疲劳因子1、疲劳因子2、疲劳因子3呈正相关。经多重线性回归分析,M—R与4个疲劳因子有直线关系。年龄与康奈尔医学指数总分、躯体健康、不适应、既往健康、消化系统、心血管系统、生殖泌尿系统呈负相关。结论在成年医学生中,女性比男性更易出现心身障碍,对女性给予更多的关注;疲劳与心身健康、精神症状的相关性提示心身健康状况对疲劳有影响;疲劳也可导致心身障碍。积极采取有效的干预措施,减少心身疾病的发生。     

RELEVANCE OF HYPERCHOLESTEROLEMIA TO FETAL AND PEDIATRIC ATHEROSCLEROSIS

Ubiquitous atherosclerotic changes in fetal and pediatric subjects demonstrate the fundamental importance of repetitive hemodynamic stresses and cannot be explained on the basis of the hypercholesterolemic/lipid hypothesis because serum cholesterol levels at this age lie within allegedly "desirable blood levels." This fact, inconsistent with the lipid hypothesis, renders absurd the widespread dietary restriction of cholesterol and animal fats as prevention of atherosclerosis. Iatrogenic effects of atherosclerosis in humans and its experimental production in herbivores at serum cholesterol levels below infant levels strongly support the "vascular fatigue" concept and negate the lipid hypothesis. Neither is atherosclerosis a manifestation of senescence because age is merely a time factor indicating the duration of exposure to hemodynamic stresses that are variable with time and location.     

Caring for women living with ovarian cancer: recommendations for advanced practice nurses

This article summarizes advice for advanced practice nurses (APNs) that grew out of research with women living with premenopausal ovarian cancer. We claim that the process of diagnosis and being told, battle metaphors, treatment expectations, the patient's sense of normalcy, her sense of being heard, her ability to make sense of her new world, her inability to have children, issues of sexuality, and the irrelevance of most support groups are important considerations in the treatment of such women. The APN's major role in caring for these women is understanding the experience as it informs the APN's practice and serving as advocates for the women.     

Pain and fatigue in patients with rheumatic disorders

Summary The purpose of the study was to investigate whether fibromyalgia patients (n=50) differed from patients with rheumatoid arthritis (n=22) and ankylosing spondylitis (n=31) with respect to pain experience, pain coping and fatigue. A high general pain intensity level was recorded by the McGill Pain Questionnaire (p<0.01) and the visual analogue scale (p<0.01) in the fibromyalgia group compared to the other groups. The pain was of continuous duration in the fibromyalgia patients while the rheumatoid arthritis and ankylosing spondylitis patients experienced intermittent pain. A high correlation between sensory and affective pain rating indexes was determined in all patient groups (p<0.01). No statistically significant difference between the groups in pain coping was recorded. A high frequency of reported gastrointestinal problems (p<0.01) and high intensity of fatigue (p<0.01) were seen in the fibromyalgia group compared to the other groups. In the fibromyalgia group there was no correlation between the sleep problems and fatigue intensity. Thus, the fibromyalgia patients differed from the other groups in reporting frequently shoulder and upper arm pain, continuous pain, higher levels of fatigue and pain intensities as well as high frequency of gastrointestinal problems.     

Reduction of swimming time in mice through interaction of infrasound and alcohol

The effects of noise, alcohol, and the combination of the two were studied on muscular fatigue in several mouse strains to investigate a possible interaction between the two stresses. Muscular fatigue was measured by latency to submersion during a forced-swimming test. Animals were exposed to acoustic stimuli of fixed frequency and intensity for 2 h preceding the test. Ethanol was administered orally from 30 min to 3 h 30 min prior to testing. Alcohol doses and sound intensities were subliminal when administered separately. While no significant interaction occurred between alcohol and audible sound, the interaction between alcohol and infrasound was highly interaction between alcohol and infrasound was highly significant indicating that their joint effects are more than merely additive. Blood alcohol measurements indicate that these interactive effects are prolonged for more than 2 h after elimination of alcohol from the blood. Effects are similar in genetically deaf and hearing mice, implicating involvement of nonauditory pathways.     

慢性疲劳综合征患者心理学特征的研究

目的研究我国慢性疲劳综合征(CFS)患者的认知功能和心理学特征。方法通过表格病例记录临床症状及使用《临床记忆量表手册》、SCL-90、Hamilton抑郁量表(HAMD)和Hamilton焦虑量表(HAMA)对91例CFS患者和30名健康对照进行记忆力评定和心理学测试,结合临床表现,分析CFS患者的认知功能、心理学异常的特点。结果CFS组记忆商为85±14,对照组为98±12,两者比较t=4·627,P=0·000。CFS患者临床计算力、工作效率下降,其SCL-90测试总分为192±47,对照组为140±46,两组比较t=5·297,P=0·000;CFS患者HAMD为9·9±6·1,对照组为6·5±2·5,两组比较t=2·948,P=0·004;CFS患者HAMA分值为9·9±7·0,对照组为5·9±2·9,两组比较t=3·015,P=0·003。结论我国CFS患者认知功能受损明显,广泛存在心理学异常,其特点与原发心理疾病不同。     

Relationship Between Distance of Schools from the Nearest Municipal Waste Incineration Plant and Child Health in Japan

In Japan, the main source of dioxins is incinerators. This study examined the relationship between the distance of schools from municipal waste incineration plants and the prevalence of allergic disorders and general symptoms in Japanese children. Study subjects were 450,807 elementary school children aged 6–12 years who attended 996 public elementary schools in Osaka Prefecture in Japan. Parents of school children completed a questionnaire that included items about illnesses and symptoms in the study child. Distance of each of the public elementary schools from all of the 37 municipal waste incineration plants in Osaka Prefecture was measured using geographical information systems packages. Adjustment was made for grade, socioeconomic status and access to health care per municipality. Decreases in the distance of schools from the nearest municipal waste incineration plant were independently associated with an increased prevalence of wheeze, headache, stomach ache, and fatigue (adjusted odds ratios [95% confidence intervals] for shortest vs. longest distance categories =1.08 [1.01–1.15], 1.05 [1.00–1.11], 1.06 [1.01–1.11], and 1.12 [1.08–1.17], respectively). A positive association with fatigue was pronounced in schools within 4 km of the second nearest municipal waste incineration plant. There was no evident relationship between the distance of schools from such a plant and the prevalence of atopic dermatitis or allergic rhinitis. The findings suggest that proximity of schools to municipal waste incineration plants may be associated with an increased prevalence of wheeze, headache, stomach ache, and fatigue in Japanese children.