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Objectives: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector. The aim of this paper is to review the importance of work in the management of medically unexplained physical symptoms., Methods: In this paper, different actors involved explain their views and handling concerning work in the management of MUPS., Results: Symptom severity and lack of understanding from the environment can negatively impact on earning an independent income from labor for years. Work, whether or not paid, is however, an important life domain with positive effects on physical, psychological, and social well-being. Therefore, health actors are pivotal in starting the professional reintegration process as soon as possible and should discuss this item from the early stage onward. Support services can be consulted in mutual interaction as required. A case manager, acting as a central intermediator within this multidisciplinary approach, may promote effective communication and coordination between the patients and their surrounding actors., Conclusion: The professional reintegration process should start as soon as possible within the management of medically unexplained physical symptoms. As such, the care sector, the evaluation sector, and the professional integration sector should collaborate and effectively communicate with each other.

Dual screen e‐Paper is expected to be useful when creating documents using reference documents. This study evaluated performances of referencing conditions using paper, e‐Paper, and LCD and suggested that the working conditions using dual screen e‐Paper brought almost the same performance as the working conditions using paper as a reference. [ABSTRACT FROM AUTHOR]

Introduction: Transient ischaemic attack (TIA) is defined by short-lasting, stroke-like symptoms, and is recognised as a medical emergency. Symptoms are assumed to completely resolve, and treatment is focused on secondary stroke/TIA prevention. However, evidence suggests that patients with TIA may experience ongoing residual impairments, which they do not receive therapy for as standard practice. TIA-induced sequelae could impact on patients' quality of life and ability to return to work or social activities. We aim to investigate whether TIA is associated with subsequent consultation for fatigue, psychological or cognitive impairment in primary care., Methods and Analysis: A retrospective open cohort study of patients with first-ever TIA and matched controls. Relevant data will be extracted from The Health Improvement Network (THIN) database, an anonymised primary care database which includes data for over 12 million patients and covers approximately 6% of the UK population. Outcomes will be the first consultation for fatigue, anxiety, depression, post-traumatic stress disorder or cognitive impairment. Principal analysis will use Kaplan-Meier survivor functions to estimate time to first consultation, with log-rank tests to compare TIA and control patients. Cox proportional hazard models will predict the effect of demographic and patient characteristics on time to first consultation., Ethics and Dissemination: Approval was granted by a THIN Scientific Review Committee (ref: 14-008). The study's findings will be published in a peer-reviewed journal and disseminated at national and international conferences and through social media., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: Hemodialysis is an important health problem that negatively affects psychosocial status and support systems. Through practices such as mandala coloring, individuals transfer the unknowns they experience to the outside and make them visible. This study was conducted to examine the effects of mandala coloring on fatigue, psychological well-being, and factors associate with coping with stress in patients receiving hemodialysis treatment., Methods: The design was a prospective, parallel-group controlled trial. The study was conducted in the dialysis unit of a university hospital in eastern Turkey between April 4 and October 31, 2022, with a total of 60 patients, 30 in the intervention group, and 30 in the control group. The patients in the intervention group colored mandala once a week for 2 h, for a total of 8 weeks. The data were collected face-to-face using a patient information form, a Fatigue Severity Scale, a Psychological Well-Being Scale, and a Ways of Coping Questionnaire., Results: There were improvements in fatigue severity and psychological well-being over the 8-week study period in both the intervention and control groups. Scores were similar at baseline in the control and intervention groups, but better in the intervention groups compared to controls at 4 and 8 weeks for both metrics (p < 0001). Five factors from the Ways of Coping Questionnaire (self-confident approach, optimistic approach, seeking social support, helpless approach, and submissive approach) each improved during the 8-week period in the intervention group (p < 0.001). Three of these five factors improved in the control group as well. Scores for each of the five coping factors were better in the intervention group compared to controls at 4 and 8 weeks (p < 0.001)., Conclusion: Mandala coloring improved fatigue and psychological well-being and was associated with improved patient coping strategies., (© 2024 International Society for Hemodialysis.)

An Electronic Portable Information Collection audio device (EPIC-Vox) has been developed to deliver questionnaires in spoken word format via headphones. Patients respond by pressing buttons on the device. The aims of this study were to determine limits of agreement between, and test-retest reliability of audio (A) and paper (P) versions of the Brief Fatigue Inventory (BFI). Two hundred sixty outpatients (204 male, mean age 55.7 years) attending a sleep disorders clinic were allocated to four groups using block randomization. All completed the BFI twice, separated by a one-minute distracter task. Half the patients completed paper and audio versions, then an evaluation questionnaire. The remainder completed either paper or audio versions to compare test-retest reliability. BFI global scores were analyzed using Bland-Altman methodology. Agreement between categorical fatigue severity scores was determined using Cohen's kappa. The mean (SD) difference between paper and audio scores was -0.04 (0.48). The limits of agreement (mean difference+/-2SD) were -0.93 to +1.00. Test-retest reliability of the paper BFI showed a mean (SD) difference of 0.17 (0.32) between first and second presentations (limits -0.46 to +0.81). For audio, the mean (SD) difference was 0.17 (0.48) (limits -0.79 to +1.14). For agreement between categorical scores, Cohen's kappa=0.73 for P and A, 0.67 (P at test and retest) and 0.87 (A at test and retest). Evaluation preferences (n=128): 36.7% audio; 18.0% paper; and 45.3% no preference. A total of 99.2% found EPIC-Vox "easy to use." These data demonstrate that the English audio version of the BFI provides an acceptable alternative to the paper questionnaire.

Introduction/aims: Fatigue is a common and debilitating symptom encountered in the neuromuscular clinic. The 7-item Fatigue Severity Scale (FSS-7) is a Rasch-modified assessment validated in inflammatory neuropathies but not across a typical neuromuscular patient population. The aim of this study was to validate this measure in neuromuscular disorders and to compare between patient sex, age and diagnoses., Methods: The modified FSS-7 was mailed to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis and descriptive statistics were performed on the Rasch converted data., Results: The mFSS-7 met the Rasch model expectations with an overall Chi-square probability of 0.4918, a strict unidimensional scale free from differential item functioning (DIF) that satisfied the model with substantial test-retest reliability using Lin's concordance correlation coefficient 0.71 (95% CI 0.63-0.77). A 15.7% ceiling effect was observed in this patient cohort. Post hoc analysis did not show any significant difference in fatigue between sex, age or neuromuscular diagnoses., Discussion: The self-completed Rasch mFSS-7 showed acceptable test-retest reliability across patients with varied disorders under follow-up in a specialist neuromuscular clinic. The ceiling effect constrains its use for those with the most severe fatigue. Future considerations could include assessment of the benefits of clinical interventions, particularly multidisciplinary team input or dedicated fatigue clinics., (© 2024 Wiley Periodicals LLC.)

Purpose: Inflammation is thought to be a vital element in the etiology of cancer-related fatigue (CRF), and circulating blood cell parameters could be important markers of inflammatory response. However, the associations of several major blood cell counts and their derived inflammatory indices with CRF are not well described. The present study aimed to establish whether a relationship exists between the counts of three white blood cell (WBC) types, platelets, and CRF and investigate whether several systemic inflammatory indices were associated with CRF in patients with breast cancer (BC)., Methods: A cross-sectional survey was conducted with a sample of 824 patients with BC undergoing chemotherapy. The cancer fatigue scale was administered to assess CRF. Hematological indicators, including neutrophils, lymphocytes, monocytes, and platelets, were retrieved from routine blood test. Network analyses were used to examine the associations among them., Results: Among 824 participants, the mean score of CRF was (27 ± 10), ranging from 0 to 57. The results of network models indicated that physical fatigue was negatively linked to lymphocyte counts (weight =  - 0.161), and affective fatigue was positively associated with neutrophil counts (weight = 0.070). Additionally, physical fatigue was positively linked to the platelet-to-lymphocyte ratio (PLR) (weight = 0.049)., Conclusion: There were preliminary associations of counts of three WBC types, platelet counts, and systemic inflammatory indices, with distinct dimensions of CRF in patients with BC. Findings provide empirical support for the cellular basis of fatigue-associated inflammatory states., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Veterinary nursing is physically and emotionally demanding, putting veterinary nurses at risk of acute work-related fatigue (AWRF). Despite the increased recognition of chronic occupational syndromes such as burnout and compassion fatigue in recent years, few studies have investigated how AWRF impacts individuals and the profession., Methods: An anonymous survey open to all UK-based registered veterinary nurses (RVNs) was distributed via email and social media. The survey investigated work patterns, hobbies, opinions about work and intentions to leave the veterinary profession. An English translation of the need for recovery (NFR) scale was used to quantify the AWRF., Results: The median NFR score from 387 responses was 81.8, indicating high levels of AWRF. Long shifts, sole-charge work and overtime were associated with higher scores, while having support at work and a better work-life balance were associated with lower scores. Higher scores were correlated with intentions to leave the profession., Limitations: Although validated as a measure of AWRF, the unidimensional NFR scale oversimplifies the complexities of fatigue. A limited number of RVNs responded to the survey, reducing statistical power., Conclusion: Although there is no single solution to staff turnover, the results from this survey suggest that addressing AWRF may improve retention of RVNs., (© 2024 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.)

Purpose: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work., Methods: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis., Results: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning., Conclusion: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping., Competing Interests: The authors declared no conflict of interest., (© 2024 Korean Society of Nursing Science.)

This study provides optimal correlated color temperature and illuminance to increase comfort and reduce fatigue by considering psychological and physiological quantities when working with paper and electronic devices. Task performance was not affected by devices and lighting conditions. The subjective evaluation revealed no significant differences between devices. The participants felt tired with an illuminance of 300lx and preferred a correlated color temperature of 5000K or 6500K and an illuminance of 750lx. However, the participants were more comfortable at 3000K and 750lx than at high correlated color temperature and low illuminance. The adjustment method demonstrated that comfortable illuminance does not show a significant difference in correlated color temperature and that paper requires significantly higher brightness levels than a screen. The adjustment method and subjective evaluation found consistent results for comfortable illuminance. Physiological measurements revealed that oxygenated hemoglobin was higher for computer than for paper use. In addition, illuminance of 500lx and correlated color temperature of 5000K resulted in the least fatigue. Although the subjective evaluation found no significant differences in fatigue, physiological measurements revealed that illuminance and correlated color temperature were accompanied by the least fatigue. Therefore, the results of this study highlight the necessity of creating a work environment that considers psychological and physiological quantities based on the work medium. • Illuminance and color temperature with computers and paper were examined. • Objective and subjective measurements were used for comfort and fatigue. • Comfort level with different types of lightning was identified. • Differences between perceived and measured comfort were found. • The importance of device and task content was discerned. [ABSTRACT FROM AUTHOR]

The paper focuses on the cutting behavior of Glass Fiber Reinforced Polymer (GFRP) composites and GNP–GFRP composites that contain varying amounts of Graphene Nano Platelets (GNP). GFRP composites are increasingly being used in a variety of industrial applications due to their excellent mechanical properties, such as high strength, stiffness, and low weight. However, their machining and cutting behavior can be challenging due to the presence of the reinforcing fibers. Therefore, the study aims to investigate the machining behavior of GFRP composites and the effect of adding GNP on their cutting behavior. The effect of different parameters such as cutting speed, feed rate and reinforcement rate on cutting forces and delamination factor is investigated. In addition, the tensile strength and fatigue behavior of the composite materials with the best and worst delamination factors were also determined. Addition of up to 0.2 wt.% of GNP to GFRP composites resulted in an increase in cutting forces and delamination factor when drilling GFRP composites. While the cutting force and delamination factor decreased with the increase in cutting speed, the cutting force and delamination factor increased with the increase in the feed rate. Analysis of variance (ANOVA) was performed to determine the effects of drilling parameters and reinforcement ratio on cutting force and delamination factor according to full factorial experimental design. The most efficient factor on the cutting forces is found to be feed rate (84.97%), followed by the reinforced rate (6.48%) and cutting speed (6.13%). The most efficient factor on the delamination factor is determined to be feed rate for (44.49%), followed by the reinforced rate (29.20%) and cutting speed (21.73%). [ABSTRACT FROM AUTHOR]

The effects of processing parameters on fatigue lives of graphene oxide papers (GOP) and reduced GOP (RGOP) are investigated. The fabrication method could be either vacuum filtration or pressure filtration, and the important processing parameters include graphene weight fraction in suspension, sonication time for suspension and pressure value for pressure filtration. Fatigue performance of the papers are studied by strain‐controlled fatigue test. Under vacuum filtration method, fatigue lives of both GOP and RGOP decrease with increasing graphene weight fraction. The longest fatigue life is 403 284 cycles for the GOP under highest power sonication time and lowest graphene weight fraction. Fatigue lives of most GOP increase with increasing sonication time up to medium level. Under pressure filtration method, all GOP have shorter fatigue lives than those by vacuum filtration. Scanning electron microscopy is employed to carefully analyse the failed papers in order to clarify the fatigue failure mechanism. [ABSTRACT FROM AUTHOR]

Background: Fatigue after breast cancer treatment is a common burden that is challenging to treat. The aim of this study was to explore if such integrated rehabilitation program reduces the prevalence of chronic fatigue compared to simple, non-integrated rehabilitation., Patients and Methods: The subjects of our prospective study were 600 female breast cancer patients (29-65 [mean 52 years] of age), who participated in the pilot study on the individualized integrated rehabilitation of breast cancer patients in 2019-2021 and were monitored for one year. The control group included 301 patients and the intervention group numbered 299 patients. The patients completed three questionnaires (EORTC QLQ-C30, -BR23 and NCCN): before cancer treatment, and then six and twelve months after the beginning of cancer treatment. The control group obtained the standard rehabilitation program, while the intervention group was part of the early, individualized multidisciplinary and integrated approach of rehabilitation. The rehabilitation coordinator referred patients for additional interventions ( e.g. , psychologist, gynecologist, pain management team, physiotherapy, clinical nutrition team, kinesiologist-guided online training, vocational rehabilitation, general practitioner). Data on the patients' demographics, disease extent, cancer treatment and complaints reported in questionnaires were collected and analyzed., Results: There were no differences between the control and the intervention group of patients in terms of age, education, disease extent, surgical procedures, systemic cancer treatment, or radiotherapy, and also no differences in the fatigue before the beginning of treatment. However, patients from the control group had a greater level of constant fatigue than patients from the intervention group half a year (p = 0.018) and a year (p = 0.001) after the beginning of treatment. Furthermore, a greater proportion of patients from the control group experienced significant interference with their usual activities from fatigue than from the intervention group, half a year (p = 0.042) and a year (p = 0.001) after the beginning of treatment. A multivariate logistic regression showed that one year after the beginning of treatment, the only independent factor correlated to fatigue was inclusion into the intervention group (p = 0.044). Inclusion in the intervention group was beneficial-patients from the control group were 1.5 times more likely to be fatigued., Conclusions: Early individualized integrated rehabilitation is associated with a lower prevalence of chronic fatigue or fatigue interfering with usual activities in breast cancer patients in comparison to the control group of patients., (© 2024 Masa Auprih et al., published by Sciendo.)