Physical fatigue negatively affects postural control, resulting in impaired balance performance in young and older adults. Similar effects on postural control can be observed for mental fatigue mainly in older adults. Controversial results exist for young adults. There is a void in the literature on the effects of fatigue on balance and cortical activity. Therefore, this study aimed to examine the acute effects of PF and MF on postural sway and cortical activity. Fifteen healthy young adults aged (...) 28 ± 3 years participated in this study. MF and PF protocols comprising of an all-out repeated sit-to-stand task and a computer-based attention network test, respectively, were applied in random order. Pre and post fatigue, cortical activity and postural sway were tested during a challenging bipedal balance board task. Absolute spectral power was calculated for theta, alpha-2, beta-1, and beta-2 in frontal, central, and parietal regions of interest and baseline-normalized. Inference statistics revealed a significant time-by-fatigue interaction for CoPd and CoPv, and a significant main effect of time for CoP variability. Post hoc analyses showed a significant increase in CoPd and CoPv following PF but not MF. For cortical activity, a significant time-by-fatigue interaction was found for relative alpha-2 power in parietal areas. Post hoc tests indicated larger alpha-2 power increases after PF compared to MF. In addition, changes in parietal alpha-2 power and measures of postural sway did not correlate significantly, irrespective of the applied fatigue protocol. No significant changes were found for the other frequency bands, irrespective of the fatigue protocol and ROI under investigation. Thus, the applied PF protocol resulted in increased postural sway and CoP variability accompanied by enhanced alpha-2 power in the parietal ROI while MF led to increased CoP variability and alpha-2 power in our sample of young adults. Potential underlying cortical mechanisms responsible for the greater increase in parietal alpha-2 power after PF were discussed but could not be clearly identified as cause. Therefore, further future research is needed to decipher alternative interpretations. (shrink)

Background: Mental fatigue can impact physical demands and tactical behavior in sport-related contexts. Small-sided games are often used to develop a specific sport-related context. However, the effects of mental fatigue on physical demands and tactical behaviors during soccer SSGs have not been aggregated for systematical assessment.Objective: This systematic review was conducted to compare the effects of mental fatigue vs. control conditions in terms of the total running distance and tactical behavior of soccer players during SSGs.Methods: The data (...) sources utilized were PubMed, PsycINFO, Scielo, Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were established based on PICOS: Population: healthy youth and young adult men soccer players with regular training practice and belonging to teams with regular competitions; Intervention: exposed to mental fatigue-induced protocols only before SSGs; Comparator: control conditions before SSGs; Outcomes: physical demands and tactical behavior ; Study design: counterbalanced cross-over design; and only full-text and original articles written in English.Results: The database search initially identified 111 titles. From those, six articles were eligible for the systematic review and meta-analysis. Results showed no significant effect of fatigue on total running distance and tactical behavior.Conclusions: A non-significant effect of mental fatigue on total running distance and tactical behaviors performed by soccer players during SSGs was found in this systematic review. (shrink)

ObjectiveBasic combat training is a kind of necessary high-intensity training to help each military recruit convert into a qualified soldier. In China, both the physical fatigue and passive psychological state have been observed in new recruits during BCT. However, after same-intensity training, the degree of fatigue and passive mood vary among recruits. Therefore, this study aimed to explore the effect of BCT on mood state of recruits with different physical fitness levels from a perspective of fatigue.Materials (...) and methodsBefore and after BCT, the degree of fatigue and mood state of participants were evaluated via the Borg Rating of Perceived Exertion Scale and Profile of Mood States Questionnaire immediately after 20 push-ups as RPE and POMS scores [total mood disturbance, passive mood and positive mood ]. The participants were divided into two groups according to the RPE score measured after BCT: group 1: RPE score after BCT < 13 and group 2: RPE score after BCT ≥ 13.ResultA total of 564 recruits were included. After BCT, in group 1, TMD and passive mood Ttension, Tfatigue, Tdepression, Tconfusion declined significantly, but positive mood both increased significantly ; while in group 2, only Tanger and Testeem increased significantly.ConclusionBCT could alleviate passive mood and add to positive mood for recruits with better physical fitness, while had no ameliorative effects on or even deteriorate most of the passive mood for recruits with worse physical fitness. (shrink)

Mental fatigue (MF) jeopardizes performance and safety through a variety of cognitive impairments and according to the complexity loss theory, should represent “complexity loss” in electroencephalogram (EEG). However, the studies are few and inconsistent concerning the relationship between MF and loss of complexity, probably because of the susceptibility of brain waves to noise. In this study, MF was induced in thirteen male college students by a simulated flight task. Before and at the end of the task, spontaneous EEG and (...) auditory steady-state response (ASSR) were recorded and instantaneous frequency variation (IFV) in alpha rhythm was extracted and analyzed by multiscale entropy (MSE) analysis. The results show that there were significant differences in IFV in alpha rhythm either from spontaneous EEG or from ASSR for all subjects. Therefore, the proposed method can be effective in revealing the complexity loss caused by MF in spontaneous EEG and ASSR, which may serve as a promising analyzing method to mark mild mental impairments. (shrink)

Mental fatigue is a psycho-biological state that impairs sports-related performances. Recently, it has been proved that MF can affect basketball performance. However, a systematic overview detailing the influences of MF on basketball performance is still lacking. This study aims to investigate the effects of MF on the physical, technical, tactical, and cognitive performance of basketball. We used the databases of PubMed, Web of Science, SPORTDiscus, Scopes, and CKNI for articles published up to 31 May 2021. The articles included in (...) this study were projected to test whether MF influences basketball athlete performance. Only experimental design studies were selected, and the control condition was without MF. Finally, seven articles fit the inclusion criteria. The results imply that MF impairs the technical aspects of basketball and the players' cognitive [take-the-first heuristics and decision-making] performance, which results in athletes not using their techniques skillfully and being unable to make practical decisions during critical points in the game. In addition to that, the influences of MF on physical and tactical performance have not been studied. Further studies should look into comprehensive research on the influences of MF on basketball performance, especially on a player's physical and tactical performance.Systematic Review Registration: [https://inplasy.com/] [INPLASY2021100017]. (shrink)

To further develop three-dimensional (3D) applications, it is important to elucidate the negative effects of 3D applications on the human body and mind. Thus, this study investigated differences in the effects of visual fatigue on cognition and brain activity using visual and auditory tasks induced by watching a 1-h movie in two dimensions (2D) and 3D. Eighteen young men participated in this study. Two conditions were randomly performed for each participant on different days, namely, watching the 1-h movie on (...) television in 2D (control condition) and 3D (3D condition). Before and after watching the 1-h movie on television, critical flicker fusion frequency (CFF: an index of visual fatigue), and response accuracy and reaction time for the cognitive tasks were determined. Brain activity during the cognitive tasks was evaluated using a multi-channel near-infrared spectroscopy system. In contrast to the control condition, the decreased CFF, and the lengthened reaction time and the decreased activity around the right primary somatosensory cortex during Go/NoGo blocks in the visual task at post-viewing in the 3D condition were significant, with significant repeated measures correlations among them. Meanwhile, in the auditory task, the changes in cognitive performance and brain activity during the Go/NoGo blocks were not significant in the 3D condition. These results suggest that the failure or delay in the transmission of visual information to the primary somatosensory cortex due to visual fatigue induced by watching a 3D movie reduced the brain activity around the primary somatosensory cortex, resulting in poor cognitive performance for the visual task. This suggests that performing tasks that require visual information, such as running in the dark or driving a car, immediately after using a 3D application, may create unexpected risks in our lives. Thus, the findings of this study will help outlining precautions for the use of 3D applications. (shrink)

Both daily demands as well as training and competition characteristics in sports can result in a psychobiological state of mental fatigue leading to feelings of tiredness, lack of energy, an increased perception of effort, and performance decrements. Moreover, optimal performance will only be achievable if the balance between recovery and stress states is re-established. Consequently, recovery strategies are needed aiming at mental aspects of recovery. The aim of the study was to examine acute effects of potential mental recovery strategies (...) on subjective-psychological and on cognitive performance outcomes after a mentally fatiguing task. A laboratory-based randomized cross-over study with twenty-four students was applied. Participants were run through a powernap intervention, a systematic breathing intervention, a systematic breathing plus mental imagery intervention, and a control condition with one trial a week over four consecutive weeks. Mental fatigue was induced by completion of the 60-min version of the AX-continuous performance test. The Short Recovery and Stress Scale and Visual Analog Scales were assessed to measure effects on perceptual outcomes. Cognitive performance was measured with a reaction time test of the Vienna Test System. During all three recovery interventions and CC portable polysomnography was applied. Results showed a significant increase from pre-AX-CPT to pre-MR on fatigue states and recovery-stress states indicating that the induction of mental fatigue was effective. Moreover, results underlined that analysis yielded no significant differences between recovery interventions and the control condition but they revealed significant time effects for VAS, SRSS items, and cognitive performance. However, it could be derived that the application of a rest break with 20 min of mental recovery strategies appears to enhance recovery on a mainly mental and emotional level and to reduce perceived mental fatigue. (shrink)

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and (...) Ovid databases. Data were extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

Background The Covid-19 pandemic has impacted compassion fatigue and the mental health of health care providers, particularly midwives and nurses. Although there are studies involving health workers such as nurses and physicians affected by the pandemic’s compassion fatigue, few studies include midwives. Research objective The present study seeks to investigate the effects of compassion fatigue experienced by midwives working under intense stress during the third wave of the COVID-19 pandemic on the level of moral sensitivity. Research design (...) This is a descriptive-correlation study. Participants The statistical population consisted of all the midwives in Türkiye hospitals in 2021. This cross-sectional study was collected through a questionnaire using convenience sampling. Three hundred and ten midwives working in different units of the country participated in the study. Ethical considerations Approval from the researcher’s university Institutional Review Board for ethical review was obtained with the code of IRB 20/510. Findings The average age of the midwives is 34.29 ± 8.39. It has been noticed that 43.5% of the midwives work in public hospitals and 38.1% in family health and community health centers. Midwives’ mean MR-CS score is 67.11 ± 25.13, secondary trauma sub-dimension average 15.77 ± 6.23, and occupational burnout sub-dimension 40.69 ± 16.35. The mean moral sensitivity questionnaire score is determined as 93.86 ± 19.51. It has been observed that the working style and working time are effective on compassion fatigue. In the linear regression model, 98% of compassion fatigue was explained. Age, secondary trauma, and occupational burnout sub-dimensions affect the model. Discussion Working year, working style, second trauma, age, and occupational burnout parameters may help explain some of the links between midwives’ symptoms of compassion fatigue. Conclusion The pandemic affects the compassion fatigue of midwives. It is crucial to provide social support to midwives and health workers to prevent compassion fatigue and examine and control groups at risk in mental health. (shrink)

The effects of mental fatigue on both cognitive and physical performance are well described in the literature, but the recovery aspects of mental fatigue have been less investigated. The present study aimed to fill this gap by examining the persistence of mental fatigue on behavior and electrophysiological mechanisms. Fifteen participants performed an arm-pointing task consisting of reaching a target as fast as possible, before carrying out a 32-min cognitively demanding task [Time Load Dual Back task], and immediately, (...) 10 and 20 min after completion of the TLDB task. During the experiment, electroencephalography was continuously recorded. The significant increase in mental fatigue feeling after the TLDB task was followed by a decrease during the 20 min of recovery without returning to premeasurement values. Brain oscillations recorded at rest during the recovery period showed an increase in both theta and alpha power over time, suggesting a persistence of mental fatigue. Arm-pointing movement duration increased gradually over time during the recovery period, indicating that behavioral performance remained impaired 20 min after the end of the cognitively demanding task. To conclude, subjective measurements indicated a partial recovery of mental fatigue following a cognitively demanding task, whereas electrophysiological and behavioral markers suggested that the effects of mental fatigue persisted for at least 20 min. While the subjective evaluation of mental fatigue is a very practical way to attest the presence of mental fatigue, electrophysiological and behavioral measures seem more relevant to evaluate the time course of mental fatigue effects. (shrink)

Most computational theories of cognition lack a representation of physiology. Understanding the cognitive effects of compounds present in the environment is important for explaining and predicting changes in cognition and behavior given exposure to toxins, pharmaceuticals, or the deprivation of critical compounds like oxygen. This research integrates physiologically based pharmacokinetic (PBPK) model predictions of caffeine concentrations in blood and tissues with ACT-R's fatigue module to predict the effects of caffeine on fatigue. Mapping between the PBPK model parameters and (...) ACT-R model parameters is informed by the neurophysiological literature and established associations between ACT-R modules and brain regions. The results from three such parameter mappings are explored to explain observed data from sleep-deprived participants performing the psychomotor vigilance test with and without caffeine. Predicted caffeine concentrations in the brain are used to modulate procedural parameters in the fatigue module to explain caffeine's effects on multiple performance metrics. (shrink)

ObjectiveThe objective of the study was to explore the relationship between social support and fatigue as well as the mediating role of social functioning on that relationship.BackgroundPsychosocial factors such as social support and social functioning may influence patients’ fatigue symptoms. There is limited evidence on the relationship between social support, social functioning, and fatigue in liver transplant recipients.MethodsA total of 210 patients with liver transplants from two tertiary hospitals were enrolled in the current study. Questionnaires used include (...) one for general demographic data, the Perceived Social Support Scale, Social Disability Screening Schedule, and Fatigue Symptom Inventory.ResultsA total of 126 recipients reported fatigue. Gender, residence, BMI, and liver function were the primary factors affecting fatigue. Social support was positively correlated with social functioning and was negatively correlated with fatigue. The effect of social support on fatigue was partially mediated by social functioning.ConclusionThe fatigue of liver transplant recipients should be attended to. The higher the social support, the lower the fatigue of liver transplant recipients. Social support may also reduce fatigue through social functioning. The liver transplant team should help the liver transplant recipient establish a social support system, restore social functioning, and reduce fatigue symptoms. (shrink)

ObjectiveTo explore the relations among perceived stress, fatigue, sleepiness, and the pathway of their effects on the ambulatory arterial stiffness index among medical staff.MethodsThis cross-sectional study was conducted at a tertiary hospital in Wuhan, China. Perceived stress, fatigue, and sleepiness were measured using the perceived stress scale, Fatigue assessment scale, and Epworth Sleepiness Scale, respectively. AASI was obtained from 24-h ambulatory blood pressure monitoring. Path analysis was used to clarify the relations among the PSS, FAS, and ESS (...) scores, and their relations to AASI values.ResultsA total of 153 participants were included herein. The PSS and FAS correlated with the ESS, and the PSS correlated with the FAS. In addition, the ESS correlated with the AASI. According to the path analysis results, the PSS and FAS had no direct effect on the AASI, but did have an indirect effect on this index by influencing the ESS.ConclusionSleepiness was a mediator of the effects of perceived stress and fatigue on AASI. (shrink)

Today it would seem that being fatigued is a fairly common physical and psychological effect of educational systems based on an increasing demand for high-yield performance quotas. In higher education, ‘publish or perish’ is a kind of imperative to perform, perform better, and perform optimally leading to an overall economy of fatigue. In this paper we provide a critical theory of what we are calling the ‘fatigue university.’ While highlighting the negative costs of fatigue, we also (...) provide a philosophical distinction between tiredness and exhaustion that disrupts the biopolitics of fatigue from the inside. To do so, we turn to Gilles Deleuze and Giorgio Agamben whose writings on exhaustion point to its educational importance. Indeed, it is through the very ‘illnesses’ of exhaustion that the biopolitics of research can be problematized and opened up for new configurations. (shrink)

Proprioception is a crucial sensory modality involved in the control and regulation of coordinated movements and in motor learning. However, the extent to which proprioceptive acuity is influenced by local muscle fatigue is obscured by methodological differences in proprioceptive and fatiguing protocols. In this study, we used high resolution kinematic measurements provided by a robotic device, as well as both frequency and time domain analysis of signals captured via surface electromyography (sEMG) to examine the effects of local muscle (...) class='Hi'>fatigue on wrist proprioceptive acuity in 16 physically and neurologically healthy young adults. To this end, participants performed a flexion/extension ipsilateral joint position matching test (JPM), after which a high-resistive robotic task was used to induce muscle fatigue of the flexor carpi radialis (FCR) muscle. The JPM test was then repeated in order to analyze potential changes in proprioceptive acuity. Results indicated that the fatigue protocol had a significant effect on movements performed in flexion direction, with participants exhibiting a tendency to undershoot the target before the fatigue protocol (-1.218°), but overshooting after the fatigue protocol (0.587°). In contrast, in the extension direction error bias values were similar before and after the fatigue protocol as expected (pre = -1.852°, post = -1.237°) and reflected a tendency to undershoot the target. Moreover, statistical analysis indicated that movement variability was not influenced by the fatigue protocol or movement direction. In sum, results of the present study demonstrate that an individual’s estimation of wrist joint displacement (i.e., error bias), but not precision (i.e., variability), is affected by muscular fatigue in a sample of neurologically and physically healthy adults. (shrink)

PurposeEven low intensity exercise bouts of at least 15 min can improve feelings of energy and reduce systolic blood pressure. However, little is known about the psychological outcomes of briefer exercise bouts, particularly for modes of exercise that are more intense than level walking, and readily available to many working adults. This study assessed the effects of a 4-min bout of stair walking on FOE and feelings of fatigue.MethodsThirty-six young adult participants were randomized to either stair walking or seated (...) control groups. All participants walked on level-ground from a laboratory to a nearby stairwell and were seated for 4 min before beginning their experimental condition. Stair-walking participants walked up and down one flight of 16 stairs at their own pace for 4 min, while control participants remained seated during that time. Participants walked back to the laboratory for post-condition assessments. Measures of blood pressure, heart rate, rated perceived exertion, and the intensity of feelings of mental energy, mental fatigue, physical energy, and physical fatigue were assessed pre-and post-condition. Separate one-way ANOVAs were conducted on change scores for all variables.ResultsThe stair climbing group experienced significant increases in heart rate [F = 13.167, p < 0.001] and RPE [F = 93.844, p < 0.001] that were not observed in the seated control group. Four minutes of self-paced stair climbing resulted in small changes and non-significant differences within and between groups in blood pressure as well as FOE and FOF.ConclusionAlthough a 4-min self-paced exercise bout can convey short-term physiological health benefits, a 4-min bout of self-paced indoor stair walking in a stairwell was insufficient to lower blood pressure or change subjective FOE and fatigue in a sample that exhibited better than typical FOE and FOF at the pre-test. (shrink)

Background: Compassion fatigue, moral distress, and moral injury are interconnected phenomena that have a detrimental impact on the delivery of nursing care. Nurses possess the inherent resilience necessary to effectively handle these three adverse occurrences. Aim: To determine the mediating impact of resilience on compassion fatigue, moral distress, and moral injury among nurses in Saudi Arabia. Design: The final product was a structural equation model (SEM) generated using a quantitative correlation cross-sectional design, and we followed the STROBE guidelines (...) for this study. Methods: The study involved a sample of 511 staff nurses, who were selected using consecutive sampling. The study was conducted in three government hospitals in Saudi Arabia. Ethical considerations: This study received approval from Ethics Committee under approval number H-2021-151 on March 5, 2021. The survey’s description and consent statements were clearly presented on Google survey forms in both English and Arabic. Results: Results showed that resilience negatively influenced moral distress, while compassion fatigue and moral injury had a positive influence. Likewise, compassion fatigue had a direct, positive effect on moral distress and moral injury, and moral distress had a direct, positive effect on moral injury. Analyses also showed that resilience had positive, indirect effects on moral injury through the mediation of both compassion fatigue and moral distress. Similarly, compassion fatigue had a positive, indirect effect on moral injury through the mediation of moral distress. Conclusion: Because resilience enables nurses to adapt, it helps them overcome obstacles in their career and professional lives. Resilience is frequently cited by nurses as a protective quality. Moral injury, compassion fatigue, and moral distress can negatively impact the health of nurses. Implications for the profession and/or patient care: Nurse leaders should develop programs and initiate efforts to improve nurses’ resilience as an important protective trait against compassion fatigue, moral distress, and moral injury. Patient or Public Contribution: There was no public or patient participation in this study. (shrink)

Cognitive fatigue is a problem for the safety of critical systems as it can lead to accidents, especially during unexpected events. In order to determine the extent to which it disrupts adaptive capabilities, we evaluated its effect on online and anticipatory control. Despite numerous studies conducted to determine its effects, the exact mechanism affected by fatigue remains to be clarified. In this study, we used distribution and electromyographic analysis to assess whether cognitive fatigue increases the capture (...) of the incorrect automatic response or if it impairs its suppression, and whether the conflict adaptation effect is reduced. To this end, we evaluated the evolution of the performance over time during the Simon task, a classic conflict task that elicits incorrect automatic responses. To accentuate the presence of fatigue during the Simon task, two groups previously performed a dual-task with two different cognitive load levels to create two different levels of fatigue. The results revealed that time on task impaired online control by disrupting the capacity to suppress the incorrect response but leaving unaffected the expression of the automatic response. Furthermore, participants emphasized speed rather than accuracy with time on task, with in addition more fast guesses, suggesting that they opted for a less effortful response strategy. As the implementation of the suppression mechanism requires cognitive effort, the conjunction of these results suggests that the deficits observed may be due to disengagement of effort over time rather than reflecting an incapacity to make an effort. (shrink)

In this systematic review, we collected and analyzed literature works comparing self-reported fatigue and objectively-measured fatigue in individuals with cerebral palsy and in age-matched typically developing/typically developed controls. The search was conducted on four electronic databases/platforms using the key words “cerebral palsy” combined with “fatig*,” where the asterisk was used as a wildcard. As a critical appraisal tool, the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies was used. A total of 22 studies passed the critical appraisal (...) rating and were included in both narrative and quantitative analyses. The overall evidence quality of the findings was considered very good. Data of objectively-measured fatigue in performing maximal fatiguing tasks indicated lower fatigue levels in participants with CP, possibly due to their pathological inability to recruit highly fatigable muscle fibers. Highly trained individuals with CP and TD controls performing maximal fatiguing tasks seem to be an exception to this, as they exhibited similar levels of fatigue. In submaximal fatiguing tasks, including daily physical activities, either objectively-measured or self-reported fatigue was higher in participants with CP than in TD controls, indicating a lower ability for development of neurophysiological compensation for fatigue among participants with CP. Further studies on fatigue are needed to gain an insight into the multifold mechanisms of fatigue in individuals with CP. Understanding fatigue mechanisms could help in setting up strategies for effective intervention programs, with benefits in healthcare and improved quality of life of individuals with CP.Systematic Review Registration: [PROSPERO 2019], identifier [CRD42019143524]. (shrink)

This paper uses the Multidimensional Fatigue Inventory to investigate the fatigue status of pilots, and the reliability and validity of the scale are tested by Cronbach’s α and exploratory factor analysis. The founding shows that mild fatigue and above accounted for 67.7%. For further quantify the impact of different flights on pilots’ fatigue, research improves the fatigue coefficient model based on the results of pilot fatigue feeling questionnaire. Combined with multifactor analysis of variance and (...) multiple linear regression, it is found that the independent variables have different and positive effects on the dependent variables, and there is no multicollinearity. Through the actual test, its accuracy is improved by 16.7% compared with the original model. (shrink)

Chronic fatigue syndrome or myalgic encephalomyelitis remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker’s concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of (...) treatments. Against this background, robust qualitative and quantitative research from a range of countries has found that many doctors display uncertainty about whether CFS/ME is real, which may result in delays in diagnosis and treatment for patients. Strikingly, qualitative research evinces that patients with CFS/ME often experience suspicion by health professionals, and many patients vocally oppose the effectiveness, and the conceptualization, of their illness as psychologically treatable. We address the intersection of these issues and healthcare ethics, and claim that this state of affairs can be explained as a case of epistemic injustice. We find evidence that healthcare consultations are fora where patients with CFS/ME may be particularly vulnerable to epistemic injustice. We argue that the marginalization of many patients is a professional failure that may lead to further ethical and practical consequences both for progressive research into CFS/ME, and for ethical care and delivery of current treatments among individuals suffering from this debilitating illness. (shrink)

Background Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses. Aim This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses. Research design Correlational, cross-sectional design following the STROBE guidelines. Participants and research context Convenience sampling was used (...) to recruit nurses ( n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses’ Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data. Ethical considerations The ethics review committee of a government university in Ha’il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured. Results The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue. Conclusion Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses. (shrink)

BackgroundIt has been well investigated that nature exposure intervention can restore directed attention and improve subsequent cognitive performance. The impairment of decision-making skills in mentally fatigued soccer players was attributed to the inability of attention allocation. However, nature exposure as the potential intervention to counter mental fatigue and improve the subsequent decision-making skill in soccer players has never been investigated.ObjectsThis study aimed to evaluate the effects of nature exposure intervention on decision-making skills among mentally fatigued university soccer players. Moreover, (...) different durations of nature exposure were also evaluated.MethodsA random control between-subject design was adopted. Players were randomly assigned into six groups with three different durations of the experimental group compared with the corresponding control group. All players were first mentally fatigued by performing a 45-min Stroop task; then, they viewed virtual photos of natural or urban scenes; and finally, they performed a soccer decision-making task.ResultsThe subjective ratings of mental fatigue were significantly higher following the Stroop task. Only Exp 3 significantly improved decision-making reaction time compared with Con 3. Moreover, the accuracy slightly increased in Exp 3 after the intervention.ConclusionIn line with attention restoration theory, nature exposure significantly improved decision-making skills in mentally fatigue university players. However, the duration must be 12.50 min for each stimulus to stay longer to attract involuntary attention. (shrink)